Healthcare (Insurance)

failed · Wisconsin · Senate Mar 23, 2026

SB 434: Relating to: transparency and regulation of prior authorization requirements under health insurance plans. (FE)

SB 434 regulates prior authorization processes for health insurance plans by requiring greater transparency and standardizing procedures. It directly affects health insurers, self-insured employer plans, and utilization review entities (like insurance companies) that manage pre-approval for medical services. Key provisions include defining "prior authorization" and "adverse determination," mandating that adverse decisions be made by qualified healthcare providers (physicians, physician assistants, or nurse practitioners), and setting timeframes for non-urgent cases. The bill also establishes new requirements for notifying enrollees about coverage decisions. This focuses on clarifying the process for patients seeking covered treatments, not altering coverage benefits.

Topics ✓ HealthcareSupports HealthcareMandates transparency in prior authorization, requires decisions by qualified providers, and standardizes processes to improve patient access to care and protect rights.95% confidence

Sub-Topics Healthcare Workforce Insurance

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failed · Wisconsin · Senate Mar 23, 2026

SB 589: Relating to: statutory right to contraception.

SB 589 establishes a statutory right for individuals to obtain contraception and for health care providers to offer it, directly affecting patients, providers, and local governments. It prohibits state or local governments from restricting access to FDA-approved contraceptives (like pills, condoms, or IUDs) through laws, regulations, or policies that single out contraception or impede access. The bill allows individuals or providers to sue if a policy violates these rights, and courts can block such policies and award attorney fees to winning parties. It explicitly does not change health insurance coverage requirements or override existing constitutional protections.

Topics ✓ HealthcareSupports HealthcareBill establishes statutory right to contraception access, prohibits government restrictions on FDA-approved contraceptives, protecting patient access to healthcare services.95% confidence

Sub-Topics Insurance Women's Health

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failed · Wisconsin · Senate Mar 23, 2026

SB 223: Relating to: discrimination in employment, housing, public accommodations, education, insurance coverage, national guard, jury duty, and adoption and in the receipt of mental health or vocational rehabilitation services.

Senate Bill 223 aims to expand anti-discrimination protections within the state. It proposes to add "gender identity," "gender expression," and "sexual orientation" to the list of characteristics protected by state law. The bill amends numerous statutes to prohibit discrimination based on these categories across various sectors, including employment, housing, public accommodations, education, and insurance coverage. It also extends these protections to areas such as the National Guard, jury duty, and adoption processes.

Topics ✓ HealthcareSupports HealthcareBill explicitly prohibits discrimination in insurance coverage and mental health services, expanding protections for LGBTQ+ individuals and advancing patient access to healthcare.90% confidence ✓ HousingSupports HousingExpands housing anti-discrimination protections by adding gender identity/expression to protected categories, preventing housing discrimination per bill summary.90% confidence ✓ Labor & EmploymentSupports Labor & EmploymentAdds 'gender identity,' 'gender expression,' and 'sexual orientation' to employment discrimination protections, directly strengthening workers' rights in labor/employment sector.95% confidence

Sub-Topics Insurance Mental Health Employment Discrimination

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failed · Wisconsin · Assembly Mar 23, 2026

AB 173: Relating to: regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)

AB 173 regulates pharmacy benefit managers (PBMs) by requiring them to disclose formulary details and drug costs to health plans and patients before enrollment. It prohibits PBMs or insurers from penalizing patients for choosing specific pharmacies within a network or charging different fees for the same pharmacy services. The bill also mandates advance written notice (at least 90 days) to patients when drugs are removed from formularies or moved to higher-cost tiers, including exception request procedures. These changes directly affect PBMs, health insurance plans, and patients covered by those plans, aiming to increase transparency and choice in prescription drug coverage.

Topics ✓ HealthcareSupports HealthcareRegulates PBMs for transparency, protects patient choice, mandates formulary change notices - improves access and rights per bill's disclosure/penalty prohibitions.95% confidence

Sub-Topics Insurance Prescription Drugs

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failed · Wisconsin · Assembly Mar 23, 2026

AB 499: Relating to: coverage of nonopioid drug alternatives for the treatment and management of pain.

AB 499 requires health insurance plans and self-insured health plans to provide equal coverage for nonopioid pain treatments compared to opioids. Specifically, plans must cover at least two nonopioid prescription medications (not controlled substances) and three non-drug pain management options, without imposing stricter prior authorization or step therapy rules on nonopioid treatments than on opioids. The law prohibits designating nonopioid drugs as "nonpreferred" if opioids are listed and mandates annual public disclosure of pain management coverage details to enrollees and providers. This directly affects all health plans covering prescription drugs in Wisconsin, aiming to expand access to nonopioid pain management alternatives.

Topics ✓ HealthcareSupports HealthcareMandates equal insurance coverage for nonopioid pain treatments vs opioids, expanding patient access to safer alternatives without restrictive prior authorization.95% confidence

Sub-Topics Insurance

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failed · Wisconsin · Senate Mar 23, 2026

SB 632: Relating to: naturopathic doctors. (FE)

SB 632 expands the legal scope of practice for naturopathic doctors in Wisconsin. It grants them the authority to prescribe, dispense, and administer prescription drugs (under specific rules) and allows them to provide expedited partner therapy for sexually transmitted infections like chlamydia and gonorrhea. The bill also requires naturopathic doctors to maintain malpractice insurance coverage (with limited exceptions for government employees) and formally includes them in the definition of "health care practitioner" for regulatory purposes. This legislation directly affects licensed naturopathic doctors by changing their legal practice boundaries and responsibilities.

Topics ✓ HealthcareSupports HealthcareExpands naturopathic doctors' prescribing authority and STI treatment access, enhancing provider scope and patient care options within healthcare services.90% confidence

Sub-Topics Healthcare Workforce Insurance Medical Licensing

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failed · Wisconsin · Assembly Mar 23, 2026

AB 184: Relating to: coverage of individuals with preexisting conditions and benefit limits under health plans.

AB 184 establishes state-level regulations for health plans concerning coverage for individuals with preexisting conditions and benefit limits. The bill mandates that most individual and group health plans accept all applicants, prohibits preexisting condition exclusions, and bans lifetime and annual dollar limits on benefits. It also restricts how health plans can vary premium rates based on factors like age and tobacco use. These provisions would only become applicable if related federal Affordable Care Act (ACA) requirements are no longer enforceable or no longer preempt state law.

Topics ✓ HealthcareSupports HealthcareMandates coverage for preexisting conditions, bans lifetime/annual benefit limits, and restricts premium variations - expanding access and protecting patient rights.95% confidence

Sub-Topics Insurance

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failed · Wisconsin · Assembly Mar 23, 2026

AB 448: Relating to: nonprofit agricultural organization health benefit coverage.

AB 448 allows eligible nonprofit agricultural organizations (specifically, long-standing, member-directed cooperatives established before 1922 and meeting IRS 501(c)(5) requirements) to provide health benefit coverage exclusively to their members and members' families. Key provisions require these organizations to offer coverage in all state counties, provide written notice clarifying this is not health insurance, cover all physician services without preexisting condition exclusions beyond six months, and maintain sufficient financial reserves via annual actuarial reviews. The bill also mandates reinsurance with state-authorized companies and establishes complaint resolution processes mirroring those for standard health insurance. This framework directly affects qualifying agricultural co-ops and their members, creating a regulated pathway for member-only health benefits while ensuring basic consumer protections.

Topics ✓ HealthcareSupports HealthcareAllows nonprofit agricultural cooperatives to provide comprehensive health coverage without preexisting condition exclusions, expanding access for members and families.90% confidence ✓ Labor & EmploymentSupports Labor & EmploymentAllows specific agricultural cooperatives to provide comprehensive health coverage to members without preexisting exclusions, expanding worker benefits under employment standards.75% confidence

Sub-Topics Insurance

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failed · Wisconsin · Senate Mar 23, 2026

SB 174: Relating to: coverage of individuals with preexisting conditions and benefit limits under health plans.

Senate Bill 174 establishes state regulations for health plans regarding preexisting conditions and benefit limits. It would prevent individual and group health plans from denying coverage or imposing exclusions based on an individual's preexisting health condition. The bill also prohibits lifetime and annual dollar limits on benefits and sets rules for how premium rates can vary for individual and small employer plans. These provisions would only take effect if federal Affordable Care Act regulations related to these issues are no longer enforceable or preempt state law.

Topics ✓ HealthcareSupports HealthcarePrevents denial of coverage for preexisting conditions and bans lifetime/annual benefit limits, directly protecting patient rights and expanding healthcare access.95% confidence

Sub-Topics Insurance

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failed · Wisconsin · Senate Mar 23, 2026

SB 373: Relating to: prior authorization for coverage of physical therapy, occupational therapy, speech therapy, chiropractic services, and other services under health plans.

SB 373 limits health insurance plans' use of prior authorization for physical therapy, occupational therapy, speech therapy, and chiropractic care. It prohibits requiring prior approval for the first 12 visits per condition (or 90 days for chronic pain management at up to twice weekly visits) and mandates equivalent copays to primary care. Insurance plans must explain coverage denials in plain language and decide on reauthorizations within 3 business days (or approval is automatic). This directly affects health insurance plans and patients seeking these specific therapies in the state.

Topics ✓ HealthcareSupports HealthcareLimits prior authorization barriers for therapy services, mandates equivalent copays, requires plain language denials, and speeds reauthorization decisions - directly improving patient access to healthcare coverage.95% confidence

Sub-Topics Insurance Primary Care

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