(WTAQ-WLUK) — During his state budget address earlier this month, Wisconsin’s Democratic Governor Tony Evers proposed making Wisconsin the first state in the country to begin auditing healthcare insurance companies over their denying coverage to patients.
Evers wants to spend more than $535,000 that would go towards establishing the office and creating two new full-time positions.
“It’s frustrating when your claim gets denied and it doesn’t seem like anyone can give you a good reason why,” said Evers during his Feb. 18 remarks.
State Republicans, though, aren’t quite on board with the governor’s proposal.
“There’s got to be a delineation between government and private industry. Are there things wrong with the healthcare system, insurance wise? Yeah, there probably is,” said State Rep. Dean Kaufert, R-Neenah. “We all have stories from family members or friends of people getting denied coverage. But this may not be the way to do it.”
For insurers of health plans on healthcare.gov — a federal government site which makes it easier for Americans to find and enroll in coverage plans — an average of 16% of in-network claims were denied in Wisconsin in 2023.
That’s according to a recently released study from health policy research group, KFF.
The number is slightly below the national average denial rate of 19% in 2023, according to the study.
Democrats like Amaad Rivera-Wagner, who represents the 90th Assembly District in Green Bay, say Evers’ effort is all about protecting the consumer.
“I don’t really see there being a conflict. I think this is a nonpartisan effort. We’re not meddling in a business. We’re saying that there seems to be a very clear gap that could be unfair denials of health insurance,” said Rivera-Wagner. “And what we’re saying is we’re going to look into that.”
Not long after the governor’s budget address, the Alliance of Health Insurers released a statement which was critical of some of the Evers’ recommendations, saying in part:
We need to tamp down on unproductive rhetoric and exchange it for an intentional discourse on the totality of the healthcare delivery system and the root causes of high costs. Conversations about meaningful reforms to our healthcare system need to be a priority and we look forward to opportunities for those discussions.
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