Health Insurers, Doctors Want Lawmakers to Have More Say Over State Health Insurance

October 19, 2015

Health insurers, hospitals and doctors are supporting bipartisan bills to give GOP lawmakers final say over changes to the state employee group health and life insurance programs.

The measures, Assembly Bill 394 and Senate Bill 312, were approved last week by the legislature’s powerful Joint Finance Committee. The bills would require the state’s Group Insurance Board, which is an 11-member citizen board that oversees the state’s group health and life insurance plans for state and local employees and retirees, to submit changes to the state employee insurance plans to the Joint Finance Committee for final approval.

The board is chaired by the governor or his appointee, and nine of its remaining 10 members have been appointed by Republican Gov. Scott Walker or Walker administration officials. Walker says he intends to veto whichever bill legislators approve.

Legislators likely want a say in the board’s decisions because they are also covered by the state health plan. The bills, which are being cosponsored by more than four dozen Democratic and Republican lawmakers, follow an earlier decision by the Group Insurance Board that sharply increases out of pocket expenses for those covered by the state plan in 2016.

Health insurers likely support the legislative oversight bills because there are also indications that the Group Insurance Board may switch to a self-insurance program next year in which the state pays benefits directly rather than purchasing insurance from health maintenance organizations (HMOs). States or large companies that self-insure can contract with a third party to handle enrollment, claims and other program functions, thereby reducing business for multiple insurance providers.

Health care service providers, institutions and doctors contributed more than $333,000 between January 2011 and December 2014 to the 16-member Joint Finance Committee. Several committee members – all Republicans – were among the top recipients of campaign contributions from the industry. The top recipients were committee co-chair Sen. Alberta Darling, of River Hills, $99,577; Sen. Sheila Harsdorf, of River Falls, $33,430; Sen. Howard Marklein, of Spring Green, $30,312; Sen. Leah Vukmir, of Wauwatosa, $29,280; and committee co-chair Rep. John Nygren, of Marinette, $28,758.

Overall, health care service providers and hospitals contributed nearly $1.5 million between January 2011 and December 2014 to members of the current legislature.