Coverage of tests and ancillary procedures for services for which health insurance coverage is mandated.
Impact
If enacted, AB790 would significantly alter the landscape of health insurance coverage in Wisconsin by requiring additional provisions for tests and procedures associated with a variety of essential health services. This might lead to improved access to care for individuals needing these tests, ensuring that the requirements for treatment are met without additional costs. However, it will also necessitate health insurance providers to potentially reevaluate their coverage policies and adjust premium structures to accommodate these new mandates.
Summary
Assembly Bill 790, introduced in the 2023-2024 legislative session, mandates that health insurance policies and governmental self-insured health plans in Wisconsin must cover tests and ancillary procedures necessary for services that are already mandated under state law. This includes a wide range of essential health services such as treatment for kidney disease, home care, maternity coverage, and services for autism spectrum disorder, among others. The bill aims to ensure that healthcare providers deliver comprehensive services without forcing patients to bear additional financial burdens for necessary tests and procedures.
Contention
While the bill has the potential to enhance health service provision, it may face contention regarding its implications for insurance costs and the operational realities of insurance providers. Some stakeholders may argue that increasing coverage mandates could lead to higher premiums for policyholders, affecting affordability and overall market dynamics. Opponents may raise concerns about the feasibility and economic implications of such mandates, prompting discussions around the balance between necessary healthcare access and sustainable insurance practices.