Consumer Assistance Program
Terminated by the Walker Administration, March 12, 2011
ABC for Health Files Brief in Claim against Insurance Commissioner for Consumer Assistance Contract Termination
On July 14, 2011, ABC for Health filed a supporting brief related to the claim against the Wisconsin Commissioner of Insurance Ted Nickel. The claim arises from the termination of the Consumer Assistance Grant contract between the Commissioner of Insurance (OCI) and ABC.
Click on the links below to read the brief and related documents.
- ABC Brief in Claim against OCI
- Exhibit 1: Timeline of Contacts
- Exhibit 2: Email chain Brynne and McKinney
- Exhibit 3: Client Referral Flow Chart
- Exhibit 4: Jen Stegall email to Michelle Feagins of DHS 1.23.11
- Exhibit 5: Nickels Termination Annoucement to DHS 2.10.11
- Exhibit 6: Belling Email to ABC Requesting Data
- Exhibit 7: Open Records Request
- Exhibit 8 Progress Report email 1.25.11
- Exhibit 8: Attachment to Progress Report Email Actual Data 1.25.11
- Exhibit 9: Jen Stegall email to Kitty Rhoades, Dennis Smith, Brett Davis ect. 2.9.11
- Exhibit 10: Ezalarab email 1.25.11
- Exhibit 11: Sub Agreement and MOU
- Exhibit 12: Project Narrative
- Exhibit 13: Communications Between Stegall and ABC
- Exhibit 14: David Wahlberg State Journal article
- Exhibit 15: Eric Schutt email to Jen Stegall
- Exhibit 16: Kitty Rhoades Ok on Termination 2.9.10
- Exhibit 17: Contract Cancellation Letter from OCI 2.10.11
- Exhibit 18: Parts A through G
- Exhibit 19: Exalarab email 1.26.11 re DOL
- Exhibit 20 and Exhibit 21: Case Cites
- EXHIBIT LIST
On February 10, the new Commissioner of Insurance, Ted Nickel, terminated Wisconsin’s federally funded consumer assistance program, effective March 12. (Although the Consumer Assistance Program will end on that day, ABC for Health, Inc., will remain open and at your service.)
The purpose of the program, supported by a U.S. Department of Health and Human Services Consumer Assistance Grant, is to "educate consumers about their health coverage options, empower consumers, and ensure access to accurate information."
The majority of the $637,114 grant to Wisconsin went to the Office of the Insurance Commissioner and supported the following initiatives:
- Upgraded and enhanced data systems, including consumer inquiry complaint and referral tracing systems, web-based intake forms, and data reporting and analysis systems.
- Efforts to develop greater ability to conduct sophisticated analysis of complaints, grievances, appeals, and external review reports.
- Efforts to develop and upgrade consumer assistance publications, including translation when appropriate, and increase community outreach and public relations activities.
- A contract with ABC for Health, for approximately $238,000, to accept referrals for consumers for advocacy or assistance on health coverage issues that were beyond what the Office of Consumer Information and Insurance Oversight can provide.
Click here to learn how other states are using the grants to give consumers greater control of their health care.
The Commissioner’s rationale for terminating the program is that consumer assistance is "a waste of taxpayer money," according to Deputy Commissioner Dan Schwartzer, a former insurance industry insider and lobbyist. Bobby Peterson, Public Interest Lawyer at ABC for Health, said "pulling the plug on Wisconsin consumers is a politically craven act that impacts consumers across the four corners of the state."
- Click here to read the OCI's termination letter.
- Click here to read ABC's press release, "Consumer Assistance in Wisconsin: Closed for Business."
- Click here to watch HealthWatch Wisconsin's webcast.
- Click here to read ABC's open letter to Commissioner Nickel.
- Click hereto read ABC's press release, "Wisconsin Commissioner of Insurance’s Hypocrisy Exposed."
On February 11, ABC for Health filed an open records request with the
OCI. The open records request will shed important sunshine on the conversations and notes that led to the termination decision. Peterson describes the
Commissioner’s move as nice payback for insurance industry pals, but believes the Commissioner
never bothered to consider the punitive impact for consumers, especially those in self-funded ERISA health plans.
Click here to read the open records request.
Click here to read ABC's press release, "Law Firm Files Open Records Request with Wisconsin’s Insurance Commissioner."
Open Records Request Results
ABC for Health’s open records request to the OCI reveals details surrounding the OCI’s decision to terminate the federally funded Consumer Assistance Program.
The OCI decided to terminate the program on or before January 23, 2011. On that day, Jennifer Stegall of the OCI sent an email to the Department of Health and Human Services (HHS) mentioning the OCI’s desire to terminate the grant. Wrote Stegall, "Wisconsin is interested in ending its participation in the consumer assistance grant program. I am looking for specific steps for terminating the relationship between the state of Wisconsin and HHS in working on this program." Note that this January 23rd communication occurred 2 DAYS before OCI first obtained an unscheduled and rushed initial report of ABC for Health’s work on the project.
An OCI document dated January 26 lists "arguments in favor of terminating CAP." Several of the reasons, quoted below, are worth noting:
1) "Health related complaints, overall, declined last year compared to 2009. OCI received 4,198 health complaints in 2009 compared to 3,393 in 2010, an overall reduction of 19%"
An internal OCI email shows that while the total number complains declined by 19%, individual health insurance complaints increased by 13%.
2) "ABC has resolved 16 CAP cases and has 24 in progress. Only 2 cases were referred from OCI. A review of these case summaries indicates alternative resources are available to assist these consumers."
OCI had received ABC’s progress report only the day before, hardly enough time for a thorough review. In addition, the January 23 email mentioned above shows that the OCI had already decided to terminate the program before reviewing ABC’s progress report.
3) "One of the goals for the program, through the contract with ABC, is to assist individuals with self funded coverage. OCI staff recently received training from federal Department of Labor staff on how to best help consumers navigate their complaint process."
An internal OCI email dated January 26 indicates that the OCI staff did not in fact receive training from the Department of Labor. In the email, Jennifer Stegall asks a colleague, "Did the complaints staff recently get training from DOL staff? Dan is asking." The colleague replies, "No, more like a meet and greet to give us an overview of what they can do for consumers."
The OCI decision lacked any meaningful investigation into clients that ABC served or materials under development, nor did OCI suggest a meeting with ABC to discuss options to revise services. Instead, OCI staff canceled ABC’s regularly scheduled meetings with the Commissioner and trainings for OCI staff. The January 26 document included no information about the merits of helping and educating consumers and appeared to be the rapid execution of a fait accompli. The decision included sign off from Governor Walker’s Deputy Chief of Staff, Eric Schutt, a former insurance industry executive with UnitedHealth Group, and Department of Health Services Deputy Secretary Kitty Rhoades who simply signed off on the January 26 document, "Works for me." OCI refused to provide other documents to ABC for Health, claiming protection under the attorney client privileged. One can assume these were communications between OCI legal staff and Commissioner Nickel and Deputy Schwartzer.
If you would like access to more of the OCI documents, please contact ABC for Health.
Notice of Claim Filed
ABC for Health, Inc. (ABC) has filed a notice of claim against the Wisconsin Commissioner of Insurance Ted Nickel. The claim arises from the termination of the Consumer Assistance Grant contract between the Commissioner of Insurance and ABC. Also mentioned in the notice filed Thursday with Attorney General JB Van Hollen, are Deputy Commissioner of Insurance Dan Schwartzer, Department of Health Services Secretary Dennis Smith, Deputy Secretary Kitty Rhoades, and Gov. Walker’s Deputy Chief of Staff Eric Schutt.
See the articles below for coverage of the consumer assistance program's termination.
ABC for Health files legal claim against Walker officials for terminating contract (Shawn Doherty, Capital Times, 25 Mar. 2011
Wisconsin’s health-care fight illustrates challenges as states change leadership (Amy Goldstein, Washington Post, 18 Mar. 2011)
State official wants to keep Medicaid drug coverage, shift patients to managed care (David Wahlberg, Wisconsin State Journal, 9 Mar. 2011)
In GOP-led states, health-care law inspires attacks and accommodations (N.C. Aizenman and Amy Goldstein, Washington Post, 21 Feb. 2011)
Walker accepts $38M to create health care exchange (David Wahlberg, Wisconsin State Journal, 17 Feb. 2011)
Feds: Walker could use $37.7 million award for online consumer marketplace (Shawn Doherty, Capital Times, 16 Feb. 2011)
WisBusiness: Health Reform Law program canceled (WFRV News, 14 Feb. 2011)
New state insurance commissioner terminates $637K federal health care grant (David Wahlberg, Wisconsin State Journal, 10 Feb. 2011)
Insurance commissioner cancels consumer program, returns federal funds (Guy Boulton, Milwaukee Journal Sentinel, 10 Feb. 2011)