Once you cross the border, fewer health care choices under Obamacare

The world of health insurance under Obamacare is certainly going to vary from state to state. That much is clear on the border of Minnesota and Wisconsin.

The state’s insurance commissioner has released the county-by-county “service areas” under the health exchange Wisconsin is setting up, and while there’s competition in the larger counties in the state, there isn’t much on the western edge.

Buffalo, La Crosse, Pepin, Pierce, St. Croix, Polk counties will have only two firms selling insurance. Burnett and Douglas will have only one selling individual insurance, and two selling group insurance. Crawford, Grant Trempeleu, Vernon County residents can choose from three.

Wisconsin’s insurance commissioner stressed that the state isn’t running the exchange; the federal government is.

That, of course, is a different strategy than Minnesota, which chose to set up its own health insurance exchange, in which people without insurance can go online and choose from multiple providers.

“It’s what we were hoping for,” said Robert Kraig, director of the health care advocacy group Citizen Action Wisconsin, tells the Associated Press. “We were hoping that people would have a lot of options.”

But not that many.

A person living in Washington County, for example, will be able to choose from plans offered by about nine programs. A person living in Hudson, Wis., however, will be able to choose from only two.

It’s not clear yet if the differing amounts of competition will mean a significant difference in costs of insurance or quality of programs since Wisconsin has not made the information available on its exchange website.

What if you live in Wisconsin but work in Minnesota? You won’t be able to buy from the Minnesota health exchange. If you live in Minnesota but work in Wisconsin, you can. But MnSure’s website says it’s still working out details of how the two states will get along in coordinating coverage for people whose lives regularly cross the border.