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Capitol Newsletter: State scores high in health care sign-up
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Wisconsin has scored high in the early sign-up for the Affordable Health Care Act.

Federal statistics through the end of February put Wisconsin in 10th place among the states. The goal set for March 1 was to have every state enroll 75 percent of those expected to seek health insurance under the act. Wisconsin had met 113 percent of its March 1 target.

The enrollment deadline for Obamacare is March 31, and it will be weeks before there is a clear state-by-state picture available from the federal government.

Why is Wisconsin doing better than 40 other states? It's important to remember Wisconsin already had 90 to 92 percent of its population with either private or public-financed health insurance. Wisconsin was among the top three or four states for percentage of residents already with a form of health insurance going into the launch of Obamacare.

Then there are demographic factors. Wisconsin's Latino population is smaller than states in other parts of the nation, and the feds say insurance signup has lagged nationally among Latinos.

Wisconsin also has an older population than the national average. Stories appear regularly in newspapers with experts voicing concern about young people leaving Wisconsin to move to other states.

Obamacare has been popular among those in the 55-to-64 age bracket, according to the federal report. These are often the people who are the caregivers for older adults. There are no easy answers for those torn between working full-time to keep their own health insurance or cutting back on work hours to help keep their relatives out of nursing homes or assisted-care facilities.

Sending your mother to a nursing home is a very tough call under the best of circumstances. Dropping out of the work force to delay the nursing home admission may be an alternative for some. They may not get their old jobs back but the health insurance cloud hanging over the decision-making has been eased by the new law.

Retirement planning also should be easier under the Affordable Care Act, especially for those who have younger spouses. Few of them were thinking about old age, Social Security, and Medicare when they fell in love and got married.

Some major employers plan to help bridge the early-retirement coverage gap between the employee's job, with its health insurance, and Medicare eligibility at age 65. State government and many local governments currently allow retirees to convert their unused sick leave into premium payments for post-retirement health insurance. Government has found the policy encourages employees not to abuse sick-leave provisions as they approach retirement.

But those who are self-employed and many who work for small firms are on t heir own. Their jobs often aren't as secure as those in government. Obamacare provisions guaranteeing the ability to buy health insurance without regard to pre-existing conditions is important to them as they ponder when to retire.

Wisconsin is also different than larger-population states in that it has fewer of the very rich who are paying additional income taxes on their investment gains to help finance the Obamacare provisions. The law also requires all Americans to get health insurance. Republican critics have denounced the requirement.

Could it be the tax provisions on the wealthy are the real problem?

Repealing Obamacare and its financing wouldn't be easy. At a recent national governors' meeting there seemed wide-spread acceptance that the law is likely to continue.

A final note: Repeal would seem to suggest a return to providing health care to the uninsured through hospital emergency rooms. And those costs are largely borne by paying customers or facilities that have to assume the expenses and look for other ways to recoup them.

- Matt Pommer, a 35-year veteran of covering state government in Madison, writes the weekly State Capitol Newsletter for the Wisconsin Newspaper Association.