Frederica Freyberg:

The transition into health care options in the coming months is going to be complex. Having health care coverage will be required by the Affordable Care Act. In Wisconsin, there will basically be three routes. You can get insured through employer’s coverage. You can qualify for the BadgerCare Plus program we’ve just discussed. Or a person can qualify for one of the federal health care exchanges. The Wisconsin Primary Health Care Association is an organization whose members include the 17 federally-qualified nonprofit or public health care centers in the state. The association has applied to be a providing agency of health care advocates or navigators for people looking to enroll in the option that is the federal exchanges. Lisa Olson is the director of public policy and programs for the association and thanks very much for being here.

Lisa Olson:

Thanks for having me.

Frederica Freyberg:

So the people now losing their BadgerCare coverage might be really anxious for information from someone like you on these new health care exchanges. What is available out there now?

Lisa Olson:

Yeah, right now I think one of the best sources of information is truly healthcare.gov. Healthcare.gov revamped their website earlier this week. And they also launched their federal call line. That’s a great source of information. We’re also working with a really wide network, not just the community health centers, but a wider network of providers and other enrollment workers, to make sure that the places where consumers might go to get information have that really baseline knowledge, and are able to provide that information to consumers.

Frederica Freyberg:

How fast have people been scrambling to kind of put this together?

Lisa Olson:

Pretty quickly. There’s been a lot of work happening in the past couple of months and surely before that too.

Frederica Freyberg:

Is Wisconsin behind in its implementation in any way because we kind of deferred to the feds to do this for us?

Lisa Olson:

I think we’re in a different situation than those states that have state-based exchanges, but I don’t think the challenge is any smaller. States that develop their own exchanges are just a little bit more aware of how it will roll out. Whereas we’re still waiting for some of the federal guidance to be finalized. The challenge isn’t any smaller, but it’s still there.

Frederica Freyberg:

One of the things that we’ve been talking about is the affordability of these exchanges. What is your expectation as to whether or not people who are now bare or expect to be because they lose eligibility for some other kind of subsidized coverage, their ability to afford this coverage?

Lisa Olson:

Yeah, it’s an interesting question. So there are subsidies in place for folks that are between 100% and 400% of the federal poverty level, which makes the premiums quite affordable. It’s the co-pays and deductibles that we’re not quite sure what that will look like. I think our collective work between now and October 1 is really going to be to create this culture of insurance. Reasons for buying insurance aren’t necessarily obvious to everyone. Insurance doesn’t necessarily meet your basic human needs. It can’t feed you and can’t provide you warmth. In that regard it will always fall a little bit lower on the priority level. But my hope is if we can really start to help folks to understand the value of insurance, and understand what the new consumer protections are and that if you are sick and you do have diabetes, it doesn’t mean that you’re going to be denied coverage. I think that can go a long way.

Frederica Freyberg:

Is there some thought that people will decide to just pay whatever kind of fine there is for not having coverage instead of enrolling?

Lisa Olson:

It’s a concern. Certainly in this first year the cost of the tax penalty for not buying insurance is significantly cheaper than actually buying coverage. So again, it’s about understanding what the value is that insurance provides.

Frederica Freyberg:

Is it expected that most providers or insurers will take part in this kind of marketplace?

Lisa Olson:

So a lot of that’s still up in the air. What I’ve heard most recently is it’s at in the double digits for plans in Wisconsin that are going to be offered. Some of them have gone public. Some haven’t yet. We’ll all wait to see come September.

Frederica Freyberg:

Now, the Obama administration this week announced that they were delaying forcing companies with 50 or more employees to provide health insurance. How does this square with what’s going on in Wisconsin?

Lisa Olson:

Yeah. It’s interesting. I was surprised by that news yesterday as well. So what it means is that employers with 50 or more don’t have to provide coverage necessarily to their employees until 2015. But the individual mandate for individuals to purchase coverage is still in place. So for those employers that don’t offer coverage right now and aren’t planning to until 2015, it’s going to put those employees in a pretty tough spot. They’ll have to now purchase coverage through the exchange. My understanding though is a bulk of our large employers in Wisconsin do in fact offer coverage.

Frederica Freyberg:

Does it make you concerned that potentially there are other announcements even as we plan to try to ramp this thing up?

Lisa Olson:

You never know. I think the exchanges, the individual exchange and the shop exchange, will be operational in some degree come October 1. There will certainly be some more minor delays and tweaks and changes made along the way. It won’t be perfect come October 1, but I’m pretty confident something will be up and running at that time.

Frederica Freyberg:

I understand too that Wisconsin is requiring navigators to be credentialed or regulated through the office of insurance. Does that represent a cumbersome situation?

Lisa Olson:

You know, I don’t think so. For us in particular, the Primary Care Association, along with a number of other partner organizations have applied for this navigator grant. For us, we’re really familiar with the public insurance programs. We have a really close relationship with the Department of Health Services and the Medicaid office. We’re not as familiar with the private insurance market. It’s an opportunity for us to learn a little bit more about how the private market place works, what the expectations are of the insurance commissioner. So I’m really looking forward to it.

Frederica Freyberg:

Tell us once again where people should go online for further information?

Lisa Olson:

Sure, healthcare.gov.

Frederica Freyberg:

All right. Lisa Olson, thank you very much.

Lisa Olson:

Thank you.