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022418-wsj-news-bob-health-insurance

Dr. Michael Kloess checks on the health status of uninsured patient Donna Dalrymple during her visit to the Our Lady of Hope health care clinic in 2013.

The state Assembly on Tuesday passed a bill protecting insurance coverage for some people with pre-existing health conditions in the event a federal health care law is repealed or struck down in court — but it’s unclear if the state Senate or Gov. Tony Evers will support the bill.

A last-minute addition to the measure shortly before Tuesday’s vote did not appear to win over Evers, whose office quickly responded with a statement calling the changes “disappointing.”

Also unclear is the position of the GOP-controlled Senate, which failed to pass a similar bill last year.

The Assembly voted 76-19 to pass the new bill, with Democrats split on the measure. It would add to state law one of the most popular provisions of the federal Affordable Care Act: prohibiting insurers from denying or dropping coverage, or charging people more, solely on the basis of a pre-existing health condition.

Changes to the bill announced Tuesday added another key provision of the Affordable Care Act, also known as Obamacare: Banning insurers from imposing lifetime or annual limits on coverage for people with serious health conditions. That’s one of two key provisions Evers, a Democrat, said last week that the measure would need for him to support it.

But the bill did not include Evers’ other request: that insurers be required to cover a list of essential health benefits, such as prescription drugs and maternity and newborn care.

Republican Assembly Speaker Robin Vos, addressing reporters Tuesday, said those benefits are “not part of what we talked about.”

“Unfortunately if people want to try to throw other things into the mix to stop the deal from happening, I think that’s the cynicism that people do not want in politics,” Vos said.

Evers spokeswoman Melissa Baldauff said in a statement that the governor will review any changes to the bill but “doesn’t support Republican efforts to enshrine into state law lesser benefits for fewer Wisconsinites.”

“This bill is an attempt to provide political cover for Republicans who want to return to the days where insurance companies held all the power,” Baldauff said.

‘Band-Aid at best’

Assembly Minority Leader Gordon Hintz, D-Oshkosh, said Republicans have “found religion” in covering people with pre-existing conditions, but the bill they’re offering “can’t do what the ACA does.”

“This is a Band-Aid bill at best,” Hintz said.

Hintz was one of 16 Democrats who later voted for the bill. All 19 “no” votes were Democrats.

The bill would not protect people on private self-insured health plans, which a UW-Madison expert estimates is about 1.5 million Wisconsinites. That’s because such plans cannot be regulated under state law.

“For people that are self-insured, the state of Wisconsin has no control over them whatsoever,” Vos said.

‘Take that fear away’

Assembly Republicans acknowledged they frequently heard concerns from constituents during the 2018 campaign about protections being scrapped for people with pre-existing conditions.

As of 2015, the state had about 852,000 adults with pre-existing conditions that could have prevented them from getting insurance before Obamacare, according to the Kaiser Family Foundation.

“We want to take that fear away from them that they could lose coverage for either themselves or a loved one if there’s a pre-existing condition or if they would be affected by either an annual or a lifetime” limit on coverage, said Rep. Mike Rohrkaste, R-Neenah.

Democratic lawmakers said that if Republicans are serious about protecting people with pre-existing conditions, they should withdraw the state from participating in a consortium of states seeking to overturn Obamacare in court.

Personal stories

During floor debate, representatives from both parties offered personal stories of family members or friends affected by medical ailments. Republicans argued the bill was a “step in the right direction” and that withdrawing Wisconsin from the Obamacare lawsuit would accomplish nothing because it’s already working its way through the court system.

“We cannot control what’s happening at the federal level,” said Rep. Joe Sanfelippo, R-New Berlin. “We cannot control the courts. We can provide a safety net.”

Democrats argued Republicans are disingenuous in protecting pre-existing conditions because of the state’s involvement in the lawsuit as well as Gov. Scott Walker’s refusal to accept federal money to expand Medicaid. They pointed to legislation passed last month during a lame-duck session that prevents Attorney General Josh Kaul from withdrawing Wisconsin from the federal Obamacare suit.

Jimmy Anderson, D-Fitchburg, called the bill a “publicity stunt.”

“There are loopholes in this legislation that Wisconsinites will fall through by the thousands,” he said.

Capital W: Plug in to Wisconsin politics

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Kelly Meyerhofer covers higher education for the Wisconsin State Journal. She can be reached at 608-252-6106 or kmeyerhofer@madison.com.