APPLETON, Wis. (WBAY) – Some big changes are coming that are expected to drive up the cost of health care insurance premiums for those seeking coverage on the Affordable Care Act marketplace.
One of the providers, Common Ground Health Care Cooperative, is now telling its customers in 11 Wisconsin counties that it will no longer offer coverage starting next year.
This is happening as Congress debates whether to extend premium subsidies previously passed during the COVID pandemic.
Those counties include Outagamie and Winnebago, where Common Ground has nearly 7,000 customers.
These people will all need to find a new provider once open enrollment starts on November 1, with very limited options.
As a person who depends on the ACA marketplace for health insurance, Mike Ohlinger is concerned about the possibility of a premium increase if Congress fails to extend subsidies.
“We are paying almost $900 a month right now for insurance through the marketplace, and it’s just untenable. So, the prospect of these subsidies ending at the end of the year and those premiums going up is really scary,” Ohlinger said.
Ohlinger isn’t a Common Ground customer but understands the impact of having fewer options.
That’s why some state lawmakers are sounding the alarm, saying it’s not just low-income people who stand to lose.
“The biggest concern I have is that people don’t realize everyone is going to be affected. In this world, we often tend to assume that someone who doesn’t deserve something is losing something. This change, the lack of action at the Congressional level, is going to impact every kitchen table, small businesses, farmers, and retirees,” State Sen. Kristin Dassler-Alfheim said.
In its email to customers living in the 11 counties, no longer being offered coverage, Common Ground said, “Our decision to not offer health insurance in your area next year is due to rising health care costs and unexpected shifts in the use of health services. These trends are happening in our state and across the country, making it harder for us to operate sustainably.”
FULL INTERVIEW BELOW: Action 2 News Jason Zimmerman sits down with State Senator Kristin Dassler-Alfheim.
Besides Outagamie and Winnebago, other counties on that list include Calumet, Fond du Lac, Sheboygan, Waupaca, and Waushara.
“I think this was a wakeup call for me to see all those counties listed on that Common Ground memo that went out, with us being one of them, that even the insurance providers are not able to keep up with this,” Ohlinger said.
State Senator Kristin Dassler-Alfheim says the problem is that the insurance industry is confusing, and even many lawmakers don’t understand what’s happening right now.
Common Ground released the following statement:
“Common Ground Healthcare Cooperative (CGHC) has made the difficult decision to exit 11 counties in Wisconsin for its marketplace product. Current members in these counties will continue to receive high-quality care through the end of 2025 and can select a new health plan during the upcoming open enrollment period, which begins November 1st. This decision was not made lightly and is driven by the need to maintain sustainable operations amid rapidly shifting dynamics across the industry.”
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