Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB117

Introduced

3/24/23

Refer

3/24/23

Report Pass

3/13/24

Refer

3/13/24

Failed

4/15/24

Caption

Coverage of breast cancer screenings by the Medical Assistance program and health insurance policies and plans. (FE)

Impact

If enacted, AB117 would change the current landscape of breast cancer screening in the state significantly. Currently, insurance policies are required to cover basic mammographic examinations for certain age groups; however, this bill expands coverage to include a wider range of diagnostic procedures, thus potentially increasing early detection rates of breast cancer. The requirement for insurance providers to eliminate cost-sharing on these screenings will likely improve healthcare access for women who need supplemental examinations due to risk factors, which is crucial for effective early intervention.

Summary

Assembly Bill 117 mandates that health insurance policies provide coverage for supplemental or diagnostic breast screening examinations for individuals at increased risk of breast cancer. This includes adherence to the most recent guidelines from the National Comprehensive Cancer Network and specific standards for those with heterogeneously or extremely dense breast tissue as defined by the American College of Radiology. The bill aims to enhance access to essential preventive healthcare services for women by requiring comprehensive coverage without patient-imposed cost-sharing for these examinations.

Contention

Despite the potential benefits, AB117 may face opposition regarding its implications for insurance providers and the overall affordability of health coverage. Opponents could argue that mandating such coverage increases costs for insurers, which may be passed on to consumers through higher premiums or reduced other benefits. Additionally, there may be discussions about the balance between necessary feminist public health strategies and the financial implications on the state’s healthcare system, especially concerning self-insured plans and government contracts.