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State lawmakers rekindle talk of state protections for people with pre-existing health conditions

January 16, 2019

State lawmakers are rekindling a debate about state coverage protections for people with pre-existing health conditions if the federal Affordable Care Act, which provides such protections, is repealed or struck down in court.

The debate comes after such a bill fell short of passage by a single vote in the state Senate last month.

Now there’s another variable: Democratic Gov. Tony Evers, who campaigned on preserving and expanding protections for people with pre-existing conditions.

On Tuesday Evers declined to show support for a pre-existing conditions bill that state Assembly Speaker Robin Vos, R-Rochester, wants to fast-track to passage in 2019. It also remains unclear if the state Senate will support the measure.

The state Assembly Health committee held a public hearing Tuesday on the measure, Assembly Bill 1.

“We want to be able to ensure, regardless of whatever dysfunction might occur in Washington, D.C., that there is going to be pre-existing condition protection for our constituents,” testified the bill’s Senate author, Sen. Andre Jacque, R-De Pere.

The federal health care law, known as Obamacare, prevented insurers from denying coverage, dropping coverage or charging more to someone on the basis of their pre-existing health condition.

AB 1 would add those protections into state law, contingent on Obamacare being repealed or struck down. But there’s a key exception: the protections would not extend to private self-insured plans, which only federal law can regulate.

That could exempt about 1.5 million Wisconsinites from the protection, according to Donna Friedsam, a researcher and health care policy expert at UW-Madison.

A centerpiece of Evers’ campaign message was his and other Democrats’ support for maintaining coverage protections for people with cancer, diabetes or other pre-existing health conditions.

Asked Tuesday about supporting the Assembly GOP bill, Evers declined to give a yes-or-no answer.

“I haven’t read it completely,” Evers said of the bill. “It’s important that whatever passes the Legislature has to be equal to or better than what exists at the federal level.”

Despite the exemption for people on self-insured plans, Jacque, speaking before Tuesday’s hearing, said he thinks the bill meets Evers’ standard.

Jacque predicted the bill will pass the Senate but said “small tweaks” to it may be needed; he declined to address what kind. He noted the bill has one Democratic co-sponsor, Sen. Lena Taylor, D-Milwaukee.

Rep. Mike Rohrkaste, R-Neenah, told the Assembly Health panel Tuesday that health insurers would not revert to limiting coverage for people with pre-existing conditions even if the law allowed it because it would make it impossible for them to compete in health care markets.

Democrats on the committee said the bill would not match the broader level of protections for people with chronic health conditions established by Obamacare — such as requiring insurers cover a set of essential benefits or ending annual or lifetime caps on coverage.

“My concern is that this goes down a rabbit hole,” said Rep. Debra Kolste, D-Janesville. “If you don’t have essential health benefits, there’s no guarantee people can get the coverage they need.”

Rep. Jimmy Anderson, D-Fitchburg, said the bill “feels more like a publicity stunt than actual health care policy.”

The Assembly Health committee is set to vote Thursday on whether to advance the bill.

Last session the state Assembly easily passed a less-sweeping pre-existing conditions bill. But it faltered in the state Senate when two Republicans, Sens. David Craig of the Town of Vernon and Chris Kapenga of Delafield, joined Democrats in opposing it.

Senate Majority Leader Scott Fitzgerald, R-Juneau, said earlier this month he’s tapping Jacque to work on a bill that can pass both chambers. Fitzgerald also sought to tamp down expectations that the Legislature would pass a bill quickly, saying “I don’t want to over-promise on that right out of the gate.”

State Journal reporter Riley Vetterkind contributed to this report.

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