LRB-1169/1
TJD:kjf
2019 - 2020 LEGISLATURE
2019 Assembly BILL 1
January 10, 2019 - Introduced by Representatives Petersen, Rohrkaste,
Magnafici, Oldenburg, Kitchens, Steineke, Petryk, Vorpagel, Krug,
Horlacher, Kulp, Tranel, Jagler, Loudenbeck, Skowronski, Ballweg,
Quinn, Dittrich, Brandtjen, Katsma, Thiesfeldt, Felzkowski, Plumer,
Spiros, Novak, Edming, Steffen, Snyder, Tittl, Stafsholt, Tauchen,
Kuglitsch, Murphy, Pronschinske, Rodriguez, Swearingen, Duchow,
Schraa, Tusler, Zimmerman, Kurtz, Vos, Macco, August, Summerfield,
Kerkman, Born, Brooks, Ramthun, VanderMeer, Wittke, Sanfelippo,
James, Gundrum, Mursau and Ott, cosponsored by Senators Jacque, L.
Taylor
, Darling, Wanggaard, Marklein and Olsen. Referred to Committee
on Health.
AB1,1,3 1An Act to amend 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g) and 185.983
2(1) (intro.); and to create 609.847 and 632.728 of the statutes; relating to:
3coverage of individuals with preexisting conditions.
Analysis by the Legislative Reference Bureau
Currently, the federal Patient Protection and Affordable Care Act generally
allows premium rates to be based only on individual or family coverage, rating area,
age, and tobacco use; requires group and individual health insurance policies to
accept every employer and individual that applies for coverage, known as
guaranteed issue, and renew health insurance coverage at the option of the sponsor
or individual; and prohibits health insurance policies from imposing preexisting
condition exclusions. If those requirements and prohibitions of the Affordable Care
Act are no longer enforceable or no longer preempt state law, all of the following apply
under this bill: every individual health benefit plan must accept every individual in
this state who applies for coverage and every group health benefit plan must accept
every employer in this state that applies for coverage, regardless of whether any
individual or employee has a preexisting condition; a health benefit plan may restrict
enrollment in coverage to open or special enrollment periods; the commissioner of
insurance must ensure a statewide open enrollment period allowing individuals,
including individuals who do not have coverage, to enroll in coverage; health benefit
plans must provide special enrollment periods for certain qualifying events
described in federal law; a health benefit plan offered on the individual or small
employer market or a self-insured health plan may not vary premium rates for a

specific policy or plan except on the basis of whether the policy or plan covers an
individual or a family, area in the state, age, and tobacco use; a group health benefit
plan, including a self-insured governmental health plan, may not impose a
preexisting condition exclusion; and an individual health benefit plan may not
reduce or deny a claim or loss incurred or disability commencing under the policy on
the ground that a disease or physical condition existed prior to the effective date of
coverage. Certain grandfathered and transitional health insurance policies that are
exempt from some requirements of the Affordable Care Act, including the premium
rate requirements, are exempt from the premium rate requirements under the bill.
This proposal may contain a health insurance mandate requiring a social and
financial impact report under s. 601.423, stats.