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State Assembly Passes Bill Protecting Pre-Existing Conditions Coverage

Evers, Democrats Argue Bill Doesn't Do Enough To Protect Consumers

Wisconsin State Capitol
Laura Zimmerman/WPR

The state Assembly voted Tuesday to approve a bill that would bar health insurance companies in Wisconsin from denying coverage to people with pre-existing conditions.

The proposal would also prohibit companies from refusing coverage for care needed to treat a pre-existing condition and charging a higher premium based on a person’s health status.

Under the plan, companies would also be barred from setting annual or lifetime limits on how much they will pay for a policyholder’s health care, something Gov. Tony Evers pushed for.

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The bill would only take effect if the federal Affordable Care Act, which includes guaranteed coverage for pre-existing conditions and restrictions on lifetime coverage limits, is repealed or struck down by the courts.

Lawmakers voted 76-19 to approve the proposal after three hours of debate. Sixteen Democrats joined all Republicans in the Assembly in supporting the measure.

Assembly Speaker Robin Vos, R-Rochester, said the bill’s passage fulfills a campaign pledge made by Republicans and Democrats during their 2018 campaigns.

“What today is about is fulfilling the promises we make, not just the rhetoric we spew,” Vos said.

The governor had pushed for additional amendments to the bill, including one that would require policies to include coverage for so-called “essential benefits.” Those benefits include maternity care for mothers and newborns, as well as coverage for prescription drugs.

Vos said during debate those amendments would have been “totally outside the scope of the bill.”

Evers’ spokeswoman, Melissa Baldauff, called lawmakers’ decision to omit essential benefits coverage “very disappointing.”

“The governor offered to meet with Republican leadership in good faith to offer some solutions on how they could improve AB 1 and hoped to see those improvements reflected in the amendment process,” Baldauff said.

She added the governor “doesn’t support Republican efforts to enshrine into state law lesser benefits for fewer Wisconsinites.”

Democratic lawmakers also argued the bill would cause more harm than good if the federal health care law is repealed.

“It might sound well in principle, but in reality, if the (ACA) is declared unconstitutional, this would be a Band-Aid at best,” said Assembly Minority Leader Gordon Hintz, D-Oshkosh.

Some health industry experts have said guaranteed coverage for pre-existing conditions without other tenets of the ACA in place would be ineffective and may cause premiums to rise.

Hintz said if Republicans want to protect coverage for pre-existing conditions, they should embrace the entire ACA and work to improve it. He pointed out Republicans back Wisconsin’s involvement in a federal lawsuit that seeks to strike down the ACA.

“Today’s proposal can’t do what the Affordable Care Act does,” said Hintz. “Drop the lawsuit, don’t be deceptive, don’t be disingenuous.”

The plan has yet to be taken up in the state Senate.

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