Medical marijuana, dental therapists, pharmacy benefit managers and direct primary care are among the health issues expected to be taken up by the Legislature this fall, lawmakers from both parties said Tuesday.
Sen. Jon Erpenbach, D-West Point, who has previously introduced legislation to allow medical marijuana, said he will do so again. Rep. Mary Felzkowski, R-Irma, said she also plans to submit a medical marijuana measure.
“People know how our constituents feel,” Felzkowski said at a Wisconsin Health News panel, referring to referendums around the state supporting medical marijuana and surveys like a Marquette Law School Poll in April that found 83% of respondents in favor.
For many patients, said Felzkowski, a cancer survivor, marijuana is “one more tool in the toolbox” to deal with pain, chemotherapy side effects and other symptoms.
But Rep. Joe Sanfelippo, R-New Berlin, doesn’t support the idea, saying medical organizations are against it and recently reported hospitalizations from vaping — including cases in which users inhaled THC, the active ingredient in marijuana — have revealed the dangers of permissive policies. “Why do we as politicians think we’re smarter than the researchers, smarter than the doctors?” he said.
Rep. Debra Kolste, D-Janesville, also opposes medical marijuana. More research is needed before considering approval, she said.
Assembly Speaker Robin Vos, R-Rochester, has said he supports medical marijuana, but Sen. Majority Leader Scott Fitzgerald, R-Juneau, has said he and most Senate Republicans are opposed.
Felzkowski’s bill to create a license for dental therapists — mid-level providers, like physician assistants — has received bipartisan support and backing from many groups. But it is opposed by the Wisconsin Dental Association and Marquette University, which has the state’s only dental school.
The bill wouldn’t increase access to dental care in underserved areas, as supporters claim, because it wouldn’t require dental therapists to work in such areas or see patients on Medicaid, the dental association has said.
Felzkowski said she hopes dentists will agree to a compromise bill. Dental therapists wouldn’t solve the state’s entire dental access problem, but they would “start chipping away” at it, she said.
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Pharmacy benefit managers
A bill by Kolste to regulate pharmacy benefit managers, or PBMs — which act as brokers between drug makers, insurers, pharmacies and patients — has considerable bipartisan support, with more than 100 co-sponsors.
The bill would require PBMs to report rebates from drug makers and ban them from telling pharmacists they can’t inform patients of lower cost options, among other stipulations.
“People are just looking for a way we can help consumers,” and the bill would help reduce drug costs for many people, Kolste said.
Sanfelippo said, however, that many employers rely on PBMs to keep employee pharmacy costs down. “Something has to happen, but we also have to recognize the important role, really, that PBMs play,” he said.
Direct primary care
Sanfelippo’s bill to encourage direct primary care — in which patients pay doctors monthly fees for routine visits and lab tests, outside of health insurance — would be another way to help consumers, he said.
The bill would make it clear the arrangements aren’t subject to state insurance regulations and don’t qualify as insurance under the federal Affordable Care Act, Sanfelippo has said.
Kolste questioned the need for the bill, saying some doctors in the state are already offering direct primary care.
Perhaps the biggest health policy debate in Wisconsin in recent years — whether to expand Medicaid — appears to continue to be deadlocked. Democrats, including Gov. Tony Evers, are in favor, and Republicans, who control the Legislature, remain opposed.