Annual Report Finds Growing Cost Gap Between Health Insurance Plans

An annual report on Wisconsin health insurance costs found a growing cost disparity between employer-based insurance plans and those on the individual market.

Citizen Action of Wisconsin’s annual Health Insurance Cost Rankings Report found the cost of the average employer-based insurance plan decreased by 5 percent.

“We found for the first time in the 12-year history of this report an actual decrease in health insurance premiums in the large group market,” said Robert Kraig, executive director of Citizen Action of Wisconsin. “So you had for the first time, and this is something that’s very distressing, a decoupling of the insurance premiums and rates.”

Costs for small group health insurance increased by 10 percent and individual market costs increased by 50 percent on average across the state.

“It goes back to a differentiation where if you’re fortunate enough to work for a large employer and have good insurance there, that you’re in a much better situation than everyone else,” Kraig said.

Kraig said uncertainty about the future of the Affordable Care Act has continued to cause inflation for individual market insurance prices.

“Also the fact that the Affordable Care Act probably started out too small anyway as far as the number of people that were in the marketplaces for individuals and for small group,” Kraig said. “Those together have created a situation where health care inflation is going in opposite directions.”

Kraig said the trend is likely to continue next year, as lawmakers work to remove the federal mandate for insurance.

The report also compared the annual premiums for health insurance in 18 different metro areas around the state.

Eau Claire had the highest average cost of health insurance at $10,908.44, almost $900 more than the state average.

Looking at what’s impacting regional prices, Kraig said prescription drug prices are pretty similar across the state.

“The differential is going to be what big health systems are charging and then various market conditions around insurance because we’re seeing an impact on that as well,” said Kraig. “Literally how many people are signing up for the individual market and what their health conditions are.”

Madison had the lowest average health insurance cost at $9,095.80.