LRB-1999/1
PJK&JK:sac:rs
2013 - 2014 LEGISLATURE
June 6, 2013 - Introduced by Representatives Kapenga, Sanfelippo, Jacque, Tittl,
Schraa, Ripp and Craig, cosponsored by Senators Vukmir and Leibham.
Referred to Committee on Insurance.
AB238,1,4 1An Act to renumber 601.423 (1) (a), 601.423 (1) (b), 601.423 (1) (c) and 601.423
2(1) (d); to amend 601.423 (1) (intro.), 601.423 (2), 601.423 (3) (a) (intro.) and
3601.423 (3) (b) (intro.); and to create 13.0966, 601.423 (1) (bm) and 601.423 (1)
4(cm) of the statutes; relating to: social and financial impact reports.
Analysis by the Legislative Reference Bureau
Current law defines a health insurance mandate as a statute that requires an
insurance policy to do any of four things: 1) permit a person to obtain treatment or
services from a particular type of health care provider; 2) provide coverage for the
treatment of a particular disease or condition; 3) provide coverage of a particular type
of health care treatment or service, including particular drugs, supplies, or
equipment; and 4) provide coverage for a particular type of person based on the
person's relationship to the insured. This bill provides that a statute is also a health
insurance mandate if it: 1) requires a particular benefit design under an insurance
policy for the treatment of a particular disease, condition, or other health care need,
for a particular type of health care treatment or service, or for the provision of
equipment, supplies, or drugs used in connection with a health care treatment or
service; or 2) imposes limits or conditions on a contract between an insurer and a
health care provider.
Current law requires that, if any bill contains a health insurance mandate
affecting an insurance policy, plan, or contract, the Commissioner of Insurance
(commissioner) must submit to the presiding officer of the house in which the bill is
introduced a report on the social and financial impact of the mandate. Current law

provides that the presiding officer may require that the report be printed and
distributed as are amendments, but current law does not specify a time by which the
report must be submitted.
This bill requires that the commissioner submit a report if any amendment, as
well as any bill, contains a health insurance mandate. The commissioner may,
however, decide not to prepare a report and submit a written statement that explains
the reason for not preparing a report. In that case, the chairperson of a committee
to which the bill has been referred, the presiding officer of either house, or any other
member of the legislature may request that the commissioner submit a report
instead. The report or statement is printed as an appendix to the bill or amendment
and distributed to the members of the legislature, and made available to the public,
before any public hearing is held on the bill or amendment by a committee or before
any vote is taken on the bill or amendment by either house of the legislature.
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:
AB238,1 1Section 1. 13.0966 of the statutes is created to read:
AB238,2,3 213.0966 Review of bills or amendments establishing health insurance
3mandates.
(1) Definitions. In this section:
AB238,2,44 (a) "Bill," except as otherwise provided, includes an amendment.
AB238,2,55 (b) "Office" means the office of the commissioner of insurance.
AB238,2,8 6(2) Report on bills establishing health insurance mandates. (a) Any bill that
7requires a report by the office under s. 601.423 shall have that requirement noted on
8its jacket when the jacket is prepared.
AB238,3,39 (b) When a bill that requires a report under s. 601.423 is introduced, the
10legislative reference bureau shall submit a copy of the bill to the office. The office
11shall prepare the report or, if the office decides not to prepare the report, a written
12statement that explains the reason for not preparing the report. If the office prepares
13a written statement, the chairperson of a standing committee to which the bill has
14been referred, the presiding officer of either house of the legislature, either

1cochairperson of the joint committee on finance, or any other member of the
2legislature may request that the office prepare a report instead, in which case the
3office shall prepare a report.
AB238,3,64 (c) 1. The report or written statement prepared under this section shall be
5printed as an appendix to the bill and shall be distributed in the same manner as
6amendments.
AB238,3,117 2. The report or written statement shall be distributed, and made available to
8the public, before any vote is taken on the bill by either house of the legislature if the
9bill is not referred to a standing committee, or before any public hearing is held before
10any standing committee or, if no public hearing is held, before any vote is taken by
11the committee.
AB238,2 12Section 2. 601.423 (1) (intro.) of the statutes is amended to read:
AB238,3,1413 601.423 (1) Definition. (intro.) In this section, "health insurance mandate"
14means a statute of this state which requires that does any of the following;
AB238,3,15 15(am) Requires an insurance policy, plan, or contract to do any of the following:
AB238,3 16Section 3. 601.423 (1) (a) of the statutes is renumbered 601.423 (1) (am) 1.
AB238,4 17Section 4. 601.423 (1) (b) of the statutes is renumbered 601.423 (1) (am) 2.
AB238,5 18Section 5. 601.423 (1) (bm) of the statutes is created to read:
AB238,3,2319 601.423 (1) (bm) Requires a particular benefit design under an insurance
20policy, plan, or contract for the treatment of a particular disease, condition, or other
21health care need, for a particular type of health care treatment or service, or for the
22provision of equipment, supplies, or drugs used in connection with a health care
23treatment or service.
AB238,6 24Section 6. 601.423 (1) (c) of the statutes is renumbered 601.423 (1) (am) 3.
AB238,7 25Section 7. 601.423 (1) (cm) of the statutes is created to read:
AB238,4,2
1601.423 (1) (cm) Imposes limits or conditions on a contract between an insurer
2and a health care provider, as defined in s. 146.81 (1).
AB238,8 3Section 8. 601.423 (1) (d) of the statutes is renumbered 601.423 (1) (am) 4.
AB238,9 4Section 9. 601.423 (2) of the statutes is amended to read:
AB238,4,115 601.423 (2) Preparation of report. The commissioner shall, in the manner
6provided under s. 13.0966,
submit a report on the social and financial impact of any
7health insurance mandate, contained in any bill or amendment affecting an
8insurance policy, plan, or contract, or a written statement explaining the reason for
9not preparing the report,
to the presiding officer of that house of the legislature in
10which the bill or amendment is introduced. At the discretion of the presiding officer,
11any such report may be printed and distributed as are amendments.
AB238,10 12Section 10. 601.423 (3) (a) (intro.) of the statutes is amended to read:
AB238,4,1613 601.423 (3) (a) Social impact factors. (intro.) Any report prepared under sub.
14(2) shall assess to the extent possible all of the following social impact factors which
15that are relevant to the type of health insurance mandate created, expanded, or
16continued by the bill or amendment:
AB238,11 17Section 11. 601.423 (3) (b) (intro.) of the statutes is amended to read:
AB238,4,2118 601.423 (3) (b) Financial impact factors. (intro.) Any report prepared under
19sub. (2) shall assess to the extent possible all of the following financial impact factors
20which that are relevant to the type of health insurance mandate created, expanded,
21or continued by the bill or amendment:
AB238,12 22Section 12. Nonstatutory provisions.
AB238,5,223 (1) Notification. As soon as possible after the effective date of this subsection,
24the Legislative Reference Bureau shall notify the commissioner of insurance of all
25bills and amendments that are in a committee of either house of the legislature for

1which a report is required under section 601.423 of the statutes, as created in this
2act.
AB238,13 3Section 13 . Initial applicability.
AB238,5,64 (1) Notation on jacket that report required. The treatment of section 13.0966
5(2) (a) of the statutes first applies to bills and amendments that are jacketed on the
6effective date of this subsection.
AB238,5,117 (2) Procedure for report preparation. The treatment of sections 13.0966 (2)
8(b) (with respect to preparation of a social and financial impact report) and (c) and
9601.423 (1) (intro.), (a), (b), (bm), (c), (cm), and (d), (2), and (3) (a) (intro.) and (b)
10(intro.) of the statutes first applies to bills and amendments that are in a committee
11on the effective date of this subsection.
AB238,5,1212 (End)
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