Assembly Bill 184 aims to establish specific requirements for health insurance coverage in Wisconsin, particularly concerning individuals with preexisting conditions and benefit limits, in the event that the federal Affordable Care Act (ACA) is no longer enforceable. The bill mandates that all individual health benefit plans must accept every individual who applies for coverage, regardless of preexisting conditions, and similarly, group health benefit plans must accept all employers. It also stipulates that premium rates can only vary based on age, tobacco use, area, and whether the plan covers an individual or a family. Additionally, the bill prohibits health plans from imposing preexisting condition exclusions and from setting annual or lifetime limits on benefits.

The bill introduces new statutory provisions, specifically sections 609.847 and 632.728, which define preexisting condition exclusions and outline the requirements for health benefit plans regarding coverage acceptance, premium rate variations, enrollment periods, and benefit limits. Notably, it includes a provision for a statewide open enrollment period of no longer than 45 days and mandates special enrollment periods for qualifying events. The bill also clarifies that its provisions will only apply if the ACA's relevant sections are no longer in effect, ensuring that any health benefit plans exempt from the ACA are similarly exempt from the new requirements.

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