Members of the Wisconsin Senate have voted 18-15 to approve a $15 billion effort to create a subsidized, guaranteed-issue health plan that would be open to most state residents under age 65.

The “Healthy Wisconsin Plan” would offer participants the same benefits that members of the state legislature get through their plan, according to Sen. Jon Erpenbach, D-Middleton, Wis., who introduced the plan provision as an amendment to a major budget bill, S.B. 40.

Erpenbach estimates the plan would cost about $140 per month for employees and $370 per employee per month for employers.

Residents age 65 or older, participants in federal programs and participants in union plans would not be eligible for program coverage

Program administrators would supply coverage by buying it from private health care networks that would have to promise to spend at least 92% of their program revenue on payments to providers.

The state would pay for the program by imposing a 9% to 10% assessment on self-employed residents, an assessment of 9% to 12% of employees’ wages on employers, and an assessment of 0% to 4% on individuals who earn more than 150% of the federal poverty level.

The proposed $15 billion increase in spending on the health care plan would increase state spending by 23%, according to the state Legislative Fiscal Bureau.

Members of the Senate have been discussing similar proposals for months, but they voted on the version added to S.B. 40 less than 24 hours after it was released, opponents say.

Democrats control the Wisconsin Senate. Republicans, who have come out against the bill, control the state Assembly.

Democrats and consumer groups have welcomed passage of the Healthy Wisconsin Plan measure.

“We rejoice in the opportunity to pass meaningful health care reform,” says Senate Majority Leader Judy Robson, D-Beloit.

“This proposal puts control over health care decisions where it belongs–in the hands of individuals and their doctors,” says Lisa Ellinger assistant director of the Wisconsin Health Project, Milwaukee.

Republicans and health insurance groups are attacking both the process used to get the proposal through the Senate and the content of the proposal.

“If the Senate Democrats really cared about health care coverage, they would allow discussion on the bill and at least furnish members with the costs of the proposal before a vote is rammed through the Senate,” says Sen. Alan Lasee, R-De Pere, Wis.

J.P. Wieske, state affairs director at the Council for Affordable Health Insurance, Alexandria, Va., says the economics of the Healthy Wisconsin Plan proposal are unrealistic.

“Where is the money going to come from?” Wieske asks.

“The premium for state employees’ Cadillac coverage is roughly $600 per month for an individual and $1,400 per month for a family,” says Dan Schwartzer, executive vice president of the Wisconsin Association of Health Underwriters, Madison, Wis. “It is absurd to think that this same coverage under Healthy Wisconsin is only going to cost $510 per month. Under their plan, health care providers would have to be willing to voluntarily reduce their costs by 40%, which is not going to happen.”

A copy of the Healthy Wisconsin Plan measure is on the Web