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WI SB401

WI SB401
Coverage of maternity and newborn care under health insurance policies and plans and granting rule-making authority.


summary

Introduced
08/25/2025
In Committee
08/25/2025
Crossed Over
Passed
Dead

Introduced Session

2025-2026 Regular Session

Bill Summary

This bill requires certain health insurance policies, referred to in the bill as disability insurance policies, and governmental self-insured health plans to cover the essential health benefit of maternity and newborn care, as specified by the commissioner of insurance by rule. The bill specifies a list of requirements that the commissioner must follow when establishing the maternity and newborn care benefit, including certain limitations on cost sharing. If the maternity or newborn care benefit specified by the commissioner is also subject to its own mandated coverage requirement under current law, the bill requires the disability insurance policy or self-insured health plan to provide coverage under whichever requirement provides the insured or plan participant with more comprehensive coverage. This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.

AI Summary

This bill requires disability insurance policies and self-insured health plans to cover maternity and newborn care as an essential health benefit, with specific guidelines to be established by the commissioner of insurance. The commissioner must conduct a survey of employer-sponsored coverage to ensure the benefit scope matches typical employer offerings, and must mandate that this coverage be provided with minimal or no cost-sharing. The bill requires that coverage decisions and benefit designs cannot discriminate against individuals based on disability or expected length of life. The commissioner is required to periodically update the maternity and newborn care benefits to address potential coverage gaps. If the mandated maternity or newborn care benefit overlaps with existing coverage requirements, the insurance policy or health plan must provide the more comprehensive coverage. The bill specifically exempts certain types of disability insurance policies from these requirements and allows insurers to provide benefits beyond the minimum essential health benefit coverage. This legislation aims to standardize and improve access to maternity and newborn care across different health insurance plans in Wisconsin.

Committee Categories

Agriculture and Natural Resources

Sponsors (46)

Tim Carpenter (D)* Dora Drake (D)* Jodi Habush Sinykin (D)* Dianne Hesselbein (D)* LaTonya Johnson (D)* Sarah Keyeski (D)* Chris Larson (D)* Melissa Ratcliff (D)* Kelda Roys (D)* Mark Spreitzer (D)* Jamie Wall (D)* Bob Wirch (D)* Clint Anderson (D),  Deb Andraca (D),  Mike Bare (D),  Brienne Brown (D),  Ryan Clancy (D),  Karen DeSanto (D),  Ben DeSmidt (D),  Jodene Emerson (D),  Joan Fitzgerald (D),  Russell Goodwin (D),  Kalan Haywood (D),  Francesca Hong (D),  Alex Joers (D),  Tara Johnson (D),  Karen Kirsch (D),  Darrin Madison (D),  Maureen McCarville (D),  Vincent Miresse (D),  Supreme Moore Omokunde (D),  Greta Neubauer (D),  Lori Palmeri (D),  Christian Phelps (D),  Pricilla Prado (D),  Ann Roe (D),  Joe Sheehan (D),  Christine Sinicki (D),  Lee Snodgrass (D),  Angela Stroud (D),  Shelia Stubbs (D),  Lisa Subeck (D),  Sequanna Taylor (D),  Angelito Tenorio (D),  Randy Udell (D),  Robyn Vining (D), 

Last Action

Representative J. Jacobson added as a cosponsor (on 01/09/2026)

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