Assembly Passes Legislation Prohibiting Pre-Existing Condition Exclusions

In an unplanned vote along party lines just after 1:00 a.m. on June 22, the Assembly passed legislation to prohibit plans, when setting rates, premiums, deductibles, copayments, or coinsurance, from considering whether an individual (including a dependent) who has continuous coverage has a pre-existing condition. “Continuous coverage” would mean coverage in the 12-month period before the date of enrollment and during which there is no period longer than 63 continuous days during which the applicant did not have coverage. In addition, under the language passed by the Assembly, the Wisconsin Insurance Commissioner may propose a plan to assist individuals who have not maintained continuous coverage and who have pre-existing conditions. This plan is subject to passive review by the Joint Committee on Finance and may be implemented provided the committee does not schedule a meeting to review the plan. If the committee schedules a meeting to review the plan, the Commissioner may only implement the plan if approved by the committee.

No committee hearing or committee vote was held on the bill nor was the bill placed on the calendar. Rather, the Assembly used a procedural motion to remove the bill (AB 365, authored by Rep. Daniel Riemer (D-Milwaukee) and Sen. Jon Erpenbach (D-Middleton)) from committee and take it up. The substitute amendment was authored by Rep. Kevin Petersen (R-Waupaca) and Rep. Joe Sanfelippo (R-New Berlin).





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