Wisconsin Legislators Consider Roadblocks to Health Insurance Benefit Mandates

Date: February 16, 2016 Last Edit: February 18, 2016

NFIB-supported bill would require a report on costs and benefits of proposed legislation before a vote.

Wisconsin Legislators Consider Roadblocks to Health Insurance Benefit Mandates

Current law in Wisconsin, which is strongly supported by NFIB, requires the Commissioner of Insurance to report to the legislature the cost and benefits of legislation that would create new mandated health insurance benefits. Legislators are also considering a bill that would take that a step further.

Assembly Bill 543, introduced by Rep. John Jagler and Sen. Leah Vukmir, would block the legislature from taking a vote on proposed bills mandating health benefits until after the Commissioner’s report on the cost and availability of health insurance had been received.

AB 543 would also expand the definition of a health insurance mandate. Current law defines a health insurance mandate as a statute that requires an insurance policy to do any of these four things:

  1. Permit a person to obtain treatment or services from a particular type of healthcare provider
  2. Provide coverage for the treatment of a particular disease or condition
  3. Provide coverage of a particular type of healthcare treatment or service, including particular drugs, supplies or equipment
  4. Provide coverage for a particular type of person based on the person’s relationship to the insured.

AB 543 stipulates that a statute is also a health mandate if it:

  • Requires a particular benefit design under an insurance policy for the treatment of a particular disease, condition or other healthcare need; for a particular type of healthcare treatment or service; or for the provision of equipment, supplies, or drugs used in connection with a healthcare treatment or service; or
  • Imposes limits or conditions on a contract between an insurer and a healthcare provider.


Assembly Bill 543, recently approved by the Assembly, would require the Commissioner of Insurance to submit a report to the Legislature if any amendment, as well as any bill, contains a health insurance mandate.
 

NFIB is urging members of the Senate to concur and to support passage of AB 543.

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