Wisconsin Assembly Bill AB584

Wisconsin 2023-2024 Regular Session

• Introduced: 10/31/23
• Refer: 10/31/23
• Failed: 4/15/24

Caption

Cost-sharing cap on insulin.

Impact

The introduction of AB584 is expected to have a substantial impact on state laws governing health insurance. It will amend existing statutes to ensure that the cost-sharing for insulin aligns with the newly established cap, thus reconfiguring how insurance providers manage coverage for diabetes treatments. This legislative change is seen as a necessary step to ensure that those requiring insulin are not hindered financially when seeking essential medication. Furthermore, by stipulating that coverage for insulin must differ from other diabetes treatments in terms of cost-sharing, the bill may prompt a reevaluation of insurance policies statewide, potentially leading to wider reforms in health insurance practices regarding chronic illnesses.

Summary

Assembly Bill 584 aims to address the financial burden of insulin costs on individuals managing diabetes by imposing a cap on the cost-sharing amount for insulin prescriptions. Specifically, the bill mandates that health insurance policies and governmental self-insured health plans cannot impose cost-sharing on insulin that exceeds $35 for a one-month supply. This legislative measure is a response to the rising costs of insulin, which have become a significant concern for patients and advocates alike. By limiting out-of-pocket expenses for insulin, the bill seeks to enhance treatment accessibility and reduce financial strain on families affected by diabetes.

Contention

There may be points of contention surrounding AB584, particularly regarding the implications for insurance providers and their business models. While proponents argue that the bill is essential for patient welfare and aligns with public health objectives, critics might express concerns about the financial sustainability of such mandates on insurers. Additionally, discussions may arise regarding the equity of insulin coverage compared to other medical treatments, sparking debates on whether further regulations are needed to ensure all chronic disease treatments receive similar cost-sharing considerations.