Wisconsin Assembly Bill AB921

Wisconsin 2025-2026 Regular Session

• Introduced: 1/28/26
• Refer: 1/28/26
• Failed: 3/23/26

Caption

An Act to renumber and amend 632.895 (6); to amend 609.83 and 632.895 (6) (title); to create 632.895 (6) (b) of the statutes; Relating to: cost-sharing cap on insulin.

Impact

This legislation, if enacted, will amend existing statutes regarding health insurance coverage related to diabetes treatment. It specifically alters the terms under which insurers can impose cost-sharing requirements, effectively prioritizing the treatment of insulin. This could lead to an overhaul in the way insurance companies structure their plans concerning diabetes, potentially encouraging more comprehensive coverage and reducing out-of-pocket expenses for patients, which could greatly impact health outcomes in this population.

Summary

Assembly Bill 921 aims to regulate limitations on cost-sharing for insulin under health insurance policies and governmental self-insured health plans. The bill explicitly prohibits any such plans from imposing costs on insulin exceeding $35 for a one-month supply. This provides a significant financial relief to individuals living with diabetes, ensuring that they can access this essential medication without burdensome financial constraints. The proposed changes are targeted at making diabetes management more affordable for Wisconsin residents.

Contention

While many health advocacy groups and individuals suffering from diabetes are likely to view AB921 favorably for its provisions aimed at making essential medication more affordable, there are concerns about the financial implications for insurers and the broader healthcare market. Critics may argue that placing strict cost limitations could lead to increased premiums or reduced access to other critical healthcare services. Additionally, the implementation of such mandates could raise questions about fairness and sustainability within the health insurance industry, as others may feel that such policies unduly burden them with higher costs or less comprehensive coverage overall.