Robert Kraig and Kevin Kane, Citizen Action of Wisconsin

The conservative obsession with repealing the health care law is such an assault on basic freedoms, threatening to force Americans to go back to the bad old days when insurance companies could discriminate based on age, gender, and pre-existing conditions, that even many conservative commentators now consider it politically impossible.

Less visible is the damage being done by conservative governors obstructing implementation of the law, which is raising health premiums and making families choose between life-saving coverage and other basic necessities.

This is the finding of a new report from Citizen Action of Wisconsin, which analyzes health insurance premiums data in the 34 states that participate in the federal health insurance exchange. The data, which is based on premiums from over 400,000 health plans, shows that consumers in states that reject enhanced federal Medicaid dollars pay hundreds of dollars more in premiums. Consumers in states that refuse to implement rigorous oversight of the health insurance industry rates pay even more.

For Wisconsin, the report finds that health consumers are paying $998 more in 2014 because of Gov. Scott Walker's refusal to take full advantage of the health care law. We are paying $251 more because Walker is rejecting up to $1 million a day in enhanced funding for BadgerCare and $747 more because he is taking a lax approach to the review of health insurance industry rates.

Walker's denial of BadgerCare to 84,700 Wisconsinites near the poverty line raises insurance rates for everyone. If they have health conditions people denied BadgerCare are more likely to enroll in private health insurance that is very expensive for them. This impacts everyone because insurers determine rates based on the estimated volume of medical utilization in their insured populations. In addition, many needlessly denied BadgerCare will be unable to pay higher premiums, copays and deductibles associated with private insurance. This forces more uncompensated care on medical providers, who will in turn will shift the cost, raising the price of insurance and medical services for everyone.

Another way Walker's obstruction of the health care law is raising premiums is his implementation of rate review. Under the health care law, states are given resources to review insurance rates to guard against excessive increases. To date, Walker's Insurance Commissioner has not found a single health insurance industry rate submission excessive. States also have the option of requiring prior approval of rates. The data in the study shows states that take this additional step dramatically lower premiums. The Walker administration is opposed to taking this step to prevent health insurance industry gouging.

The study quantifies that states with leaders who recognize that the health care law is here to stay, and take advantage of its provisions, benefit from lower health insurance costs. Affordable health coverage is not a luxury it is a necessity. Scott Walker's obstructionism puts politics and ideology above the freedom of Wisconsin families to have what they need to get ahead and pursue the American Dream.

Robert Kraig is the executive director and Kevin Kane is the lead organizer of the advocacy group Citizen Action of Wisconsin.

• The full report can be downloaded at www.citizenactionwi.org/taking_the_next_step_health_cost