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Wisconsin health insurance

The Affordable Care Act has changed the way many Wisconsin residents access health insurance. According to a December 2012 Kaiser Family Foundation profile of health insurance exchanges in Wisconsin, Gov. Scott Walker announced the state would not create its own health insurance marketplace.

Additionally, Wisconsin is one of 21 states that decided not to move forward with Medicaid expansion at this time.

However, Wisconsin residents can still register and apply for marketplace plans at HealthCare.gov. After applying during open enrollment, state residents can determine if they qualify for subsidies, Medicaid, and the Children’s Health Insurance Program, known as CHIP.

Do you qualify for a Wisconsin health insurance subsidy?

According to a January 2014 Kaiser Family Foundation profile of Wisconsin, about 70 percent of the formerly uninsured in the state will qualify for some kind of help paying for health insurance. Qualification for federal financial assistance is determined by your income and family size, but if you can already access affordable health insurance through employers or public programs, you typically won’t qualify.

These are some ways Wisconsin residents can qualify for help:

Typically, eligibility for Medicaid and CHIP is determined using 2014 poverty level guidelines, and eligibility for subsidies is determined using 2013 guidelines.
People with income between 100 and 400 percent of the poverty level may qualify for a subsidy. This would be between $23,550 and $94,200 for a family of four and $11,490 and $45,960 for an individual.
Medicaid eligibility for nondisabled adults starts with incomes less than 100 percent of the poverty level, or about $23,850 for a family of four.
Children from Wisconsin families with incomes less than 306 percent of the poverty level, or about $72,980 for a family of four, may qualify for CHIP.

Marketplace health insurance companies in Wisconsin

These insurers offer qualified health insurance to Wisconsin residents:

Arise
Common Ground Healthcare Cooperative
CompCare Health Services Insurance Corporation
Dean Health Plan
Group Health Cooperative of South Central Wisconsin
Gundersen Health Plan
Health Tradition Health Plan
Medica Health Plans of Wisconsin
MercyCare Health Plans
Molina Healthcare of Wisconsin
Physicians Plus Insurance Corporation
Security Health Plan of Wisconsin
Unity Health Insurance

Wisconsin health and coverage statistics

Wisconsin population (2013): 5,742,7133

Population 65 and older (2012): 14.4 percent
Life expectancy (2010): 80.0 years
Number of Medicaid beneficiaries (2012): 973,500
Number of Medicare beneficiaries (2012): 794,900
Estimated number of uninsured residents (2012): 569,500

Overall state health ranking (2014): 20

Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.