Despite $11.4M Surplus, Premium Refund Seems Unlikely for Wisconsin’s Risk-Sharing Policyholders
Wisconsin's Health Insurance Risk-Sharing Plan (HIRSP), a government program that provides coverage to high-risk people denied private insurance, has developed an $11.4 million surplus, prompting state Sen. Judy Robson (D) to call for a policyholder refund, the Milwaukee Journal Sentinel reports. Despite the surplus, which nearly doubled from $5.9 million six months ago, the program's 9,000 policyholders are facing an 18% premium increase. Robson noted that state law prohibits premiums from exceeding 60% of the program's costs; health care providers, insurance companies and the state are to cover the remaining 40%. Robson said, however, that policyholders currently are paying 70% of the total costs and wants the state to return the surplus instead of raising premiums. But Joe Leean, secretary of Wisconsin's Department of Health and Family Services that oversees the plan, said while $2.5 million would be returned as a "dividend payment," state law requires HIRSP premiums to be no less than "150% of standard plans that insurance companies offer the typical person" -- prohibiting the return of the entire surplus. He added, "I can't go below 150%, and quite frankly, I would recommend to you that we don't. I don't want HIRSP to become an insurance product of first resort; it is an insurance product of last resort" (Jones, Milwaukee Journal Sentinel, 12/7).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.