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Bill > AB921


WI AB921

WI AB921
Cost-sharing cap on insulin.


summary

Introduced
01/28/2026
In Committee
01/28/2026
Crossed Over
Passed
Dead

Introduced Session

2025-2026 Regular Session

Bill Summary

This bill prohibits every health insurance policy and governmental self- insured health plan that covers insulin and imposes cost sharing on prescription drugs from imposing cost sharing on insulin in an amount that exceeds $35 for a one-month supply. Current law requires every health insurance policy that provides coverage of expenses incurred for treatment of diabetes to provide coverage for specified expenses and items, including insulin. The required coverage under current law for certain diabetes treatments other than insulin infusion pumps is subject to the same exclusions, limitations, deductibles, and coinsurance provisions of the policy as other covered expenses. The bill’s cost-sharing limitation on insulin supersedes the specification that the exclusions, limitations, deductibles, and coinsurance are the same as for other 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 mandates that all health insurance policies and government-funded self-insured health plans (which are plans where an employer or organization directly pays for healthcare costs rather than using a traditional insurance company) that cover insulin and have cost-sharing for prescription drugs, meaning deductibles, copayments, or coinsurance, cannot charge more than $35 for a one-month supply of insulin. This new provision overrides existing rules that allowed these plans to apply the same limitations and costs to insulin as other covered diabetes treatments, ensuring that the cost of insulin is capped regardless of other policy terms.

Committee Categories

Business and Industry

Sponsors (26)

Last Action

Representative Sheehan added as a coauthor (on 02/20/2026)

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