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A newly unveiled component of President Obama’s healthcare law forcing insurers to pay annual fees is sowing angst in state capitols, where officials view the provision as a $15 billion tax that could disrupt Medicaid programs and other services.

The health insurance providers fee, included in the healthcare reform law over the objections of congressional Republicans, is designed to raise tens of billions of dollars in the coming years.

In Wisconsin alone, the fee would hit the state’s coffers to the tune of $23 million in 2014, and will likely total more than that in subsequent years, said J.P. Wieske, legislative liaison and public information officer for the state’s Commissioner of Insurance.

The blow to Wisconsin’s private insurance market would be far higher – $3 billion over the next 10 years, Wieske said.

The proposed regulation’s details were published this week, and prompted harsh criticism from the health insurance industry, which warns that the fees would ultimately raise the price of healthcare. The Obama administration has countered that the insurer fee is just one of many provisions, which, taken together, would drive costs down.

But in states that participate in Medicaid managed care plans, the fee would be painful. One study commissioned by the Medicaid Health Plans of America found that states would be on the hook for $15 billion over the next ten years.

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