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SB251 • 2025

cost-sharing caps on prescription drugs and medical supplies to treat asthma under health insurance policies and plans

cost-sharing caps on prescription drugs and medical supplies to treat asthma under health insurance policies and plans

Healthcare
Did Not Pass

The latest official action shows that this bill did not move forward in that session.

Sponsor
Senators Dassler-Alfheim, Keyeski, Drake, Hesselbein, L. Johnson, Larson, Ratcliff, Roys, Spreitzer and Wirch, cosponsored by Representatives Snodgrass, Mayadev, McCarville, Anderson, Andraca, Arney, Bare, Brown, Clancy, DeSmidt, Emerson, Fitzgerald, J. Jacobson, Joers, Johnson, Madison, Miresse, Moore Omokunde, Neubauer, Ortiz-Velez, Palmeri, Phelps, Prado, Roe, Sheehan, Spaude, Stroud, Stubbs, Subeck, Tenorio and Udell
Last action
2026-03-23
Official status
S - Health
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

cost-sharing caps on prescription drugs and medical supplies to treat asthma under health insurance policies and plans

cost-sharing caps on prescription drugs and medical supplies to treat asthma under health insurance policies and plans Status: S - Health

What This Bill Does

  • cost-sharing caps on prescription drugs and medical supplies to treat asthma under health insurance policies and plans Status: S - Health

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2026-03-23 Sen.

    Failed to pass pursuant to Senate Joint Resolution 1

  2. 2025-06-24 Sen.

    Representative Sinicki added as a cosponsor

  3. 2025-05-21 Sen.

    Fiscal estimate received

  4. 2025-05-13 Sen.

    Representative Haywood added as a cosponsor

  5. 2025-05-13 Sen.

    Commissioner of Insurance report received pursuant to s.601.423(2), Wisconsin Statutes

  6. 2025-05-09 Sen.

    Introduced by Senators Dassler-Alfheim , Keyeski , Drake , Hesselbein , L. Johnson , Larson , Ratcliff , Roys , Spreitzer and Wirch ; cosponsored by Representatives Snodgrass , Mayadev , McCarville , Anderson , Andraca , Arney , Bare , Brown , Clancy , DeSmidt , Emerson , Fitzgerald , J. Jacobson , Joers , Johnson , Madison , Miresse , Moore Omokunde , Neubauer , Ortiz-Velez , Palmeri , Phelps , Prado , Roe , Sheehan , Spaude , Stroud , Stubbs , Subeck , Tenorio and Udell

  7. 2025-05-09 Sen.

    Read first time and referred to Committee on Health

Official Summary Text

cost-sharing caps on prescription drugs and medical supplies to treat asthma under health insurance policies and plans
Status: S - Health

Current Bill Text

Read the full stored bill text
Wisconsin Legislature: SB251: Bill Text

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»
Related Documents
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Proposal Text
»
SB251: Bill Text

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2025 - 2026 LEGISLATURE
LRB-2917/1
JPC:cjs&skw
2025 SENATE BILL 251
May 9, 2025 - Introduced by Senators
Dassler-Alfheim
,
Keyeski
,
Drake
,
Hesselbein
,
L. Johnson
,
Larson
,
Ratcliff
,
Roys
,
Spreitzer
and
Wirch
, cosponsored by Representatives
Snodgrass
,
Mayadev
,
McCarville
,
Anderson
,
Andraca
,
Arney
,
Bare
,
Brown
,
Clancy
,
DeSmidt
,
Emerson
,
Fitzgerald
,
J. Jacobson
,
Joers
,
Johnson
,
Madison
,
Miresse
,
Moore Omokunde
,
Neubauer
,
Ortiz-Velez
,
Palmeri
,
Phelps
,
Prado
,
Roe
,
Sheehan
,
Spaude
,
Stroud
,
Stubbs
,
Subeck
,
Tenorio
and
Udell
. Referred to Committee on Health.
SB251,1,3
1
An Act

to create
609.835 and 632.895 (16g) of the statutes;
relating to:
cost-
2
sharing caps on prescription drugs and medical supplies to treat asthma
3
under health insurance policies and plans.
Analysis by the Legislative Reference Bureau
This bill requires health insurance policies and plans that provide coverage of prescription drugs to cover prescription drugs and related medical supplies for the treatment of asthma. This bill provides that “related medical supplies” includes asthma inhalers and other medical supply items necessary to effectively and appropriately administer a prescription drug prescribed to treat asthma. This bill requires policies and plans to limit the amount of any enrollee cost-sharing for the coverage provided in the bill to no more than $25 per one-month supply for each prescription drug prescribed to treat asthma and to no more than $50 per month for all related medical supplies. Cost-sharing may not increase with the number of conditions for which an enrollee is treated. Further, the coverage provided in the bill may not be subject to any deductible. However, the bill provides that the limitations on cost-sharing and deductibles do not apply to the extent that the limitations would result in ineligibility for a health savings account under the federal Internal Revenue Code.
This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.
For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SB251,1
1
Section

1
.
609.835 of the statutes is created to read:
SB251,2,4
2
609.835 Coverage of prescription drugs and medical supplies to treat
3
asthma.
Limited service health organizations, preferred provider plans, and
4
defined network plans are subject to s. 632.895 (16g).
SB251,2
5
Section

2
.
632.895 (16g) of the statutes is created to read:
SB251,2,9
6
632.895
(16g)

Coverage of prescription drugs and medical supplies to
7
treat asthma
. (a) In this subsection, “related medical supplies” includes asthma
8
inhalers and other medical supply items necessary to effectively and appropriately
9
administer a prescription drug prescribed to treat asthma.
SB251,2,13
10
(b) Subject to par. (c), every disability insurance policy and every self-insured
11
health plan of the state or of a county, city, town, village, or school district that
12
provides coverage of prescription drugs shall cover prescription drugs and related
13
medical supplies for the treatment of asthma.
SB251,2,20
14
(c) A disability insurance policy or self-insured health plan of the state or of a
15
county, city, town, village, or school district to which par. (b) applies shall limit the
16
amount of any enrollee cost-sharing to no more than $25 per one-month supply for
17
each prescription drug prescribed to treat asthma and to no more than $50 per
18
month for all related medical supplies. The cost-sharing limitations under this
19
paragraph may not increase with the number of conditions for which an enrollee is
20
treated. Coverage under this subsection may not be subject to any deductible.
SB251,3,9
1
(d) If, under federal law, application of par. (c) would result in ineligibility for
2
a health savings account under section
22
3 of the Internal Revenue Code, par. (c)
3
shall apply to a health-savings-account-qualified high deductible health plan with
4
respect to the deductible of such a plan only after the enrollee has satisfied the
5
minimum deductible under section
22
3 of the Internal Revenue Code, except with
6
respect to items or services that are preventive care pursuant to section
22
3 (c) (2)
7
(C) of the Internal Revenue Code, in which case par. (c) shall apply regardless of
8
whether the minimum deductible under section
22
3 of the Internal Revenue Code
9
has been satisfied.
SB251,3
10
Section

3
. Initial applicability.
SB251,3,13
11
(
1
)

For policies and plans containing provisions inconsistent with this act, this
12
act first applies to policy or plan years beginning on the effective date of this
13
subsection, except as provided in sub. (
2
).
SB251,3,18
14
(
2
)

For policies and plans that are affected by a collective bargaining
15
agreement containing provisions inconsistent with this act, this act first applies to
16
policy or plan years beginning on the effective date of this subsection or on the day
17
on which the collective bargaining agreement is newly established, extended,
18
modified, or renewed, whichever is later.
SB251,4
19
Section

4
. Effective date.
SB251,3,21
20
(
1
)

This act takes effect on the first day of the 4th month beginning after
21
publication.
SB251,3,22
22
(end)

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/2025/related/proposals/sb251

true

proposaltext

/2025/related/proposals/sb251

proposaltext/2025/REG/SB251

proposaltext/2025/REG/SB251

section

true

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