The proposed bill, Senate Bill 174, aims to establish specific requirements for health insurance coverage in Wisconsin, particularly concerning individuals with preexisting conditions and benefit limits. It stipulates that all individual health benefit plans must accept every individual who applies for coverage, and group health benefit plans must accept every employer, regardless of preexisting conditions. The bill also mandates that health benefit plans can only vary premium rates based on age, tobacco use, area, and whether the plan covers an individual or a family. Additionally, it prohibits health plans from imposing preexisting condition exclusions and from setting annual or lifetime limits on benefits.

To implement these changes, the bill amends several sections of the statutes, including the addition of new sections 609.847 and 632.728, which specifically address the prohibition of preexisting condition discrimination and the establishment of benefit limits. The amendments also include the insertion of the new section 632.728, which outlines definitions and requirements for health benefit plans, including enrollment periods and premium rate variations. The bill is contingent upon the federal Patient Protection and Affordable Care Act no longer being enforceable or preempting state law, allowing Wisconsin to enforce these provisions independently.

Statutes affected:
Bill Text: 40.51(8), 40.51, 40.51(8m), 66.0137(4), 66.0137, 120.13(2)(g), 120.13, 185.983(1)(intro.), 185.983