On Friday, November 9th, leaders in the health care, medical and business community voiced their support for a state-based health insurance exchange for Wisconsin.  And it couldn’t be more timely with Governor Walker having to inform the federal government by tomorrow (Friday, November 16th) whether he will opt to have a state-based exchange, a federal exchange or a state-federal partnership exchange. 

We at WISPIRG concur with their announcement and would like to echo the points made by the Wisconsin Medical Society, the Wisconsin Hospital Association, and the Wisconsin Association of Health Plans in their letter submitted last Friday, November 9th.  We agree that the “correct choice for Wisconsin is to steer its own course to the greatest extent possible by beginning the process of operating a Wisconsin-run health insurance exchange.”

We applaud these organizations and their leaders for taking this stand which is in the best interest of Wisconsin consumers and small businesses.

We understand that the Affordable Care Act and its core components, including the health insurance exchanges, have become highly polarized and partisan, despite being solutions that have been embraced by both Republicans and Democrats for many years.

But, it is a time for cool heads to prevail and for Governor Walker and state leaders to do what is right for Wisconsin. 

Here is my take on why a state-based exchange would be best.

Wisconsin consumers and small businesses know that the existing health insurance marketplace is broken.  Insurers don’t compete for their business, instead offering take-it-or-leave-it deals.  Important information about coverage is buried in the fine print, making it hard to know what’s really covered.  Instead of working to lower costs and improve quality, too many insurers focus on covering healthy enrollees and dumping the sick.  And costs are continuing their unsustainable rise. 

The creation of a new state-based, pro-consumer health insurance exchange can address these problems and offers Wisconsin the chance to build a better marketplace for health care.  With a long history of bi-partisan support, the exchange can help individuals and small businesses by increasing competition and improving choices in the state’s insurance market.  Done well, the exchange could negotiate for a better deal on coverage much like large businesses currently do, and allow consumers and small businesses to compare plans apples-to-apples.
While many Americans struggle with the rising costs and eroding quality of health care, the plight of small businesses stands out, as they lack the advantages possessed by larger businesses and face unique challenges.  Without the bargaining power to negotiate with insurers for better rates, small businesses often get a worse value for their health care dollars.  Because smaller businesses often lack a human resources department, they are often left alone to navigate an often-confusing insurance market. And in today’s system, small businesses can only offer one health insurance plan to employees, as opposed to offering a choice.

Wisconsin can design our exchange to address these problems, giving small businesses and their employees access to a meaningful choice of higher-value, more affordable coverage options.  For these reasons, over 100 small business owners in Wisconsin have endorsed the creation of a state-based health insurance exchange and join with WISPIRG in urging you to move forward on this important free market improvement for small business.  

Success is not assured, however, because creating a state exchange presents both a challenge and an opportunity.  The Affordable Care Act leaves states substantial leeway to define critical aspects of the exchange, including who is eligible to buy coverage through it, how aggressively it will set standards and negotiate with insurers, and who will run it.  Some of these choices will allow the state to improve on the law, but others could undermine the exchange’s ability to deliver better choices and lower costs.  If Wisconsin decides to move forward with a state exchange, it will be incumbent on Wisconsin leaders to implement an exchange that best serves consumers and small businesses by addressing these challenges and implementing an exchange that actually, increases competition, improves choices and lowers costs. 

If Wisconsin wants to provide better coverage options to individuals and small businesses and begin lowering the cost of care, it must take quick action to create a pro-consumer exchange that lives up to the promise of a better marketplace for Wisconsin consumers and small business owners.


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The Patriots invest in tight ends because of the flexibility and matchups they create within their playbook. Here, the Patriots remove both tight ends from the core of the formation and slide Brandon Lloyd (X) and Wes Welker (Z) inside to slot alignments. This gives the Patriots a spread look while allowing Gronkowski (Y) and Hernandez (U) to match up versus cornerbacks outside of the numbers.Pin routeThe Pin route is a common scheme run throughout the NFL because it tests the eye discipline of Cover-4 safeties. Both Gronkowski and Hernandez will use a vertical stem to press up the field and then break back inside on the deep dig routes. Underneath, Lloyd will sit down in front of the free safety (FS) on the inside curl with Welker running the smash route under the strong safety (SS) to the closed side of the formation. The idea is to force the two safeties to take the bait, drive downhill on the underneath concepts and leave the corners trailing the tight ends with no help to the inside.Targeting tight endsThe Texans have talented cornerbacks in Johnathan Joseph (RC) and Kareem Jackson (LC). However, in Cover-4 both cornerbacks are coached to play from a {keyword} n off-man alignment with outside leverage. That's an advantage for the Patriots tight ends because of the skill sets they bring to the field. At the top of the route stem, Gronkowski and Hernandez will work to create separation and break back inside of the numbers. Even if the Texans cornerbacks play with the correct technique and drive to the upfield shoulder on the throw, they will have a tough time making a play o {keyword} n the ball because of the size of Gronkowski and Hernandez at the point of attack.Underneath optionsBrady will target the tight ends as his primary reads, but he will look underneath if the safeties play with depth and shield the deep dig routes. Welker will sit his route down between the Mike backer (M) and the nickel back (N) on the smash concept, with Lloyd finding room on the curl based off the drop of the Will backer (W). As a final option, Brady can target Danny Woodhead (R) on the checkdown and get the ball to his running back in open space.Brady factorDuring their previous meeting in Week 14, the Texans showed some pressure looks with combination man coverages in the secondary. But regardless of the scheme, allowing Brady to work the pocket leads to points for the Patriots. With only a four-man rush, including the Sam backer, the Texans and defensive end J.J. Watt (LE) have to generate a push up the field and force Brady to move off the spot. Brady is too talented and will fit the ball into tight throwing windows if you give him time to challenge the secondary. The Texans can't allow that to happen Sunday if they want to adv {keyword} ance to the AFC championship game.Twitter @MattBowen41Special contributor Matt Bowen, who played at Glenbard West and Iowa, spent seven seasons in the NFL as a strong safety. You also can find his work at


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