Wisconsin Assembly Bill AB1149

Wisconsin 2023-2024 Regular Session

• Introduced: 3/6/24
• Refer: 3/6/24
• Failed: 4/15/24

Caption

Coverage of treatment for mental health or substance use disorders under health insurance policies and plans.

Impact

The implementation of AB1149 is anticipated to significantly impact the state's health insurance regulations. By requiring coverage for a defined number of mental health appointments without the need for prior authorization, the bill seeks to improve access to mental health services and potentially reduce the delays and barriers to treatment that many individuals currently experience. While the bill aims to enhance the quality of mental health care, it will likely involve careful scrutiny regarding the financial implications on insurance providers and the state's health care funding mechanisms.

Summary

Assembly Bill 1149 is a legislative proposal introduced to enhance coverage for mental health and substance use disorder treatments under health insurance policies in Wisconsin. It mandates that health insurance policies and self-insured governmental health plans provide a minimum of 28 visits per year with mental health care providers, or as many visits as necessary to meet treatment goals. This aims to alleviate some of the challenges individuals face in accessing necessary mental health services due to restrictive insurance practices.

Contention

One notable point of contention surrounding AB1149 involves the fiscal responsibilities placed on health insurers. The bill requires the Office of the Commissioner of Insurance to conduct actuarial estimates to ascertain the potential costs associated with implementing these coverage requirements. If the estimated increase in costs exceeds 10 percent, the enforcement of these mandates could be suspended. This particular provision raises concerns among insurance companies and stakeholders about the long-term economic impact of the bill, especially on premium rates and overall healthcare expenditures.