Wisconsin Assembly Bill AB246

Wisconsin 2025-2026 Regular Session

• Introduced: 5/8/25
• Refer: 5/8/25
• Failed: 3/23/26

Caption

An Act to create 609.835 and 632.895 (16g) of the statutes; Relating to: cost-sharing caps on prescription drugs and medical supplies to treat asthma under health insurance policies and plans. (FE)

Summary

AB246 would require certain health insurance policies and plans in Wisconsin that cover prescription drugs to also cover prescription drugs and related medical supplies used to treat asthma. The bill defines related medical supplies to include asthma inhalers and other items needed to properly administer an asthma prescription drug. The bill places limits on enrollee cost-sharing for this coverage. For asthma medications, cost-sharing could not exceed $25 per one-month supply for each prescription drug, and cost-sharing for related medical supplies could not exceed $50 per month. The bill also prohibits deductibles for this coverage, except where federal health savings account rules require a high-deductible health plan to preserve HSA eligibility. It further provides that these limits cannot increase based on the number of conditions an enrollee has.

Impact

The bill would add new insurance coverage requirements by creating s. 609.835 and s. 632.895 (16g) of the Wisconsin Statutes. It would apply to limited service health organizations, preferred provider plans, defined network plans, disability insurance policies, and self-insured health plans of the state and local governments that cover prescription drugs. The measure would directly affect insurers, public employer health plans, and enrollees who use asthma medications and inhalers, while also creating a potential state health insurance mandate subject to fiscal and social impact review.

Sentiment

The bill appears to have been introduced with broad legislative support among its authors and cosponsors, suggesting generally favorable sentiment toward reducing out-of-pocket costs for asthma treatment. However, the available record shows no committee transcript discussion or recorded votes, and the bill ultimately failed to pass pursuant to Senate Joint Resolution 1. That outcome indicates the proposal did not advance through the full legislative process despite its consumer-protection framing.

Contention

The main policy tension in AB246 is between expanding affordable access to asthma medications and preserving existing insurance design, especially for high-deductible health plans tied to health savings accounts. The bill’s cost-sharing caps and deductible prohibition could be viewed by insurers and plan sponsors as a mandate that increases premiums or limits plan flexibility, while supporters would likely emphasize improved access and lower medication costs for people with asthma. The HSA exception reflects an effort to address one likely point of concern, but no recorded debate is available to show whether other objections were raised.