A bill designed to protect health insurance coverage for people with pre-existing conditions earned bipartisan support in the state Assembly on Tuesday, but it's not clear whether the Senate or Gov. Tony Evers will approve it.
Sixteen Democrats joined Republicans in approving the bill.
Under the proposal, if the Affordable Care Act is struck down, health insurance providers could not deny coverage to people with pre-existing conditions. However, under federal law, the state cannot apply that requirement to private, self-funded insurance plans.
An amendment, approved with the bill on Tuesday, would also prevent insurers from imposing annual or lifetime caps on coverage. That amendment was one of two changes Evers requested in a meeting with Republican leaders last week. Assembly Republicans did not fulfill Evers' other request to require coverage of pre- and postnatal care and prescription drug costs.
Assembly Speaker Robin Vos, R-Rochester, argued the provision on annual and lifetime caps was a "reasonable" one, but the essential health benefits provision had "nothing to do" with pre-existing conditions.
"For them to say, ‘If I don’t get everything, I’m going to veto a bill that protects people with pre-existing conditions,' I think that would be a disappointment to the state and it certainly would be a bad sign for things to come," Vos told reporters before the Assembly vote. "We’re trying to listen, trying to accommodate where we can, but also stick to our principles."
Without the essential health benefit requirement, Evers signaled Tuesday he is unlikely to sign the bill into law.
In a statement, Evers spokeswoman Melissa Baldauff called the legislation "an attempt to provide political cover for Republicans who want to return to the days where insurance companies held all the power."
"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. "It would be very disappointing if Republicans don't agree with the governor that coverage like maternity and newborn care is an essential health benefit."
Evers will review the amendment, but "doesn't support Republican efforts to enshrine into state law lesser benefits for fewer Wisconsinites," Baldauff said.
Democrats in the Assembly argued the only way lawmakers can claim to support protections for people with pre-existing conditions is to also support upholding and improving the Affordable Care Act.
Under then-Gov. Scott Walker, Wisconsin joined a multi-state lawsuit seeking to overturn Obamacare. A federal judged in Texas ruled the ACA unconstitutional in December, but it is still being enforced as the lawsuit is appealed.
Although Evers campaigned on withdrawing the state from the lawsuit, a Republican-backed measure passed in an extraordinary session before he took office removed his ability to do so without legislative approval.
Rep. Gary Hebl, D-Sun Prairie, said he believes lawmakers on both sides of the aisle want to protect constituents with pre-existing conditions, but argued if the ACA and its subsidies are overturned, the bill passed by the Assembly would have no teeth.
"Today’s proposal can’t do what the Affordable Care Act does," said Assembly Minority Leader Gordon Hintz, D-Oshkosh. "It’s pure deception today to say we’re providing pre-existing coverage."
Hintz cited a Milwaukee Journal Sentinel article that quoted Scott Harrington, a professor of health care management and insurance and risk management at the University of Pennsylvania's Wharton School.
In the Journal Sentinel article, Harrington said if the Affordable Care Act is declared unconstitutional and nothing is done at the federal level, the Assembly bill would be "a Band-Aid at best."
The headline of the day, Hintz said, should be "Assembly passes Band-Aid at best."
Rep. Adam Neylon, R-Pewaukee, argued that "sometimes you have to put a Band-Aid on to stop the bleeding."
"Is there more to be done? Of course. Is there more we can do? We will," Neylon said. "Today we’re taking an important step."
A spokesman for Senate Majority Leader Scott Fitzgerald, R-Juneau, said Senate Republicans plan to meet next week to discuss "a path forward" on the Assembly bill.