Joe Timmerman / Wisconsin Watch
Wisconsin Assembly Speaker Robin Vos, R-Rochester, speaks to the Wisconsin Assembly during a floor session, Tuesday, Jan. 14, 2025, at the State Capitol in Madison, Wis.
Assembly Speaker Robin Vos did not respond to questions about 'Gail's Law,' which would require insurance companies to cover supplemental imaging for breast cancer detection.
In a rare bipartisan move, the state Senate in October voted nearly unanimously (32-1) to expand insurance coverage for breast cancer exams. But advocates say Assembly Speaker Robin Vos, R-Rochester, is blocking a vote on the bill in the Assembly due to objections from insurance companies.
“Seeing it passed with such flying colors through the Senate was like this real moment of hope, where it's like, oh my gosh, we're finally able to get to do this for mom,” says Sophie Zeamer, whose mother, Gail, was diagnosed with breast cancer in 2016 and spent the last years of her life lobbying for the bill’s passage. “To hear that one singular person was holding it up was definitely frustrating, because we've put in so much work, and we've done what we felt was needed to get done in order to make this already palatable.”
Gail died in Neenah, Wisconsin, on June 2, 2024. She was 56 years old.
“Gail’s Law” would require insurance companies in Wisconsin to cover supplemental diagnostic examinations for women with dense breast tissue.
“I have heard through some Republican members that the Speaker does not want this bill to get to the floor. I don't know that I heard them say, actually, he's opposed to this bill, but I have heard that he does not want it on the floor,” says Rep. Lisa Subeck, D-Madison, who sits on the Assembly Committee on Health, Aging and Long-Term Care.
Robert Kraig, executive director of Citizen Action Wisconsin, tells Isthmus that Rep. Patrick Snyder, R-Weston, who cosponsored the legislation, confirmed to the group during a meeting in the summer that Vos is opposed to the bill.
Snyder did not respond to a request for comment. Vos did not respond to multiple requests for comment.
During a Nov. 19 floor session, Vos moved the already-approved Senate version of the bill, as well as a widely supported bill that would extend Medicaid postpartum coverage for recent mothers to 12 months, to the Assembly Committee on Assembly Organization, which he chairs. The bills are the only two Senate-approved bills currently sitting in the committee.
Rep. Robyn Vining, D-Wauwatosa, says a Senate-approved bill would typically go to the Assembly Rules Committee and eventually be scheduled for a floor vote.
“Instead of putting it in the Rules Committee, he put it in the same place he's hiding postpartum Medicaid expansion from us,” says Vining, a member of the Assembly Committee on Health, Aging and Long-Term Care.
Democratic Gov. Tony Evers plans to sign the breast cancer bill and “remains hopeful it will be sent to his desk this session,” says Evers spokesperson Britt Cudaback.
Insurance companies in Wisconsin are required to cover annual mammograms for any woman over the age of 50. But mammograms are generally unable to detect breast cancer in the approximately 40% of women who have dense breast tissue.
“On a mammogram, dense breast tissue and tumors, or potential tumors, show up the same because obviously they're all black and white images. Tumors and dense breast tissue both show up as white,” explains Zeamer.
Advocates, led by Gail Zeamer, had previously successfully lobbied for the passage of legislation that required facilities providing mammograms to notify women that they have dense breast tissue.
Out-of-pocket costs to detect irregularities with additional imaging, such as ultrasounds or MRIs, can range up to $1,700, Zeamer says.
The bill failed to pass in the last two legislative sessions. This year is the first it has received a floor vote in one chamber.
At October’s Senate vote, Republican Sen. Chris Kapenga was the sole nay vote, arguing that "these types of bills contribute to a higher cost of living and also violate the principles of limited government and Constitutional restraint.”
The Assembly Committee on Health, Aging and Long-Term Care held a hearing on the Assembly version of the bill on Oct. 15, but never took a vote. Vining tells Isthmus she does not know why the bill has not yet received a vote in an executive session and says that, from her perspective, the “bill has been amended to a point that it can pass the Legislature.”
“They chose not to exec the bill. You should ask the chair why. He should answer that,” says Vining. “If it had, we could have voted on it yesterday.”
Maryjane Behm, a staffer for Rep. Clint Moses, R-Menominee, who chairs the Assembly Committee on Health, Aging and Long-Term Care, says their office has been told the bill authors are still working on amendments and would plan a hearing once they receive word that the bill is ready.
Caroline Lodes, a staffer for bill’s lead author, Republican Rep. Cindi Duchow, says in a statement that “at this time, our office has no new information.”
Eric Brooks, a staffer for Republican Rep. Amanda Nedweski, a leading advocate for the bill, says in an interview that he hasn’t “heard anything from the speaker's office that would indicate they are a hard no on this without X, Y or Z,” but also says that he is “not in those conversations.”
Insurance companies have lobbied in opposition to the bill in its current form. According to the Wisconsin Ethics Commission, the Alliance of Health Insurers and Wisconsin Association of Health Plans spent 27 hours and six hours, respectively, lobbying against the bill from January to June of this year.
“The big pushback we hear from folks who are a little bit skeptical of the bill, specifically the insurance companies, is just the fear that this is going to lead to premiums increase, that hospitals are going to raise the prices of these procedures,” says Brooks. “There have been 36 or 37 other states that have passed this.”
Adds Brooks: “While I can appreciate the concern, we're just not seeing it anywhere else in the states that have passed this, including states like Florida and Texas that are much larger than Wisconsin.”
Dawn Anderson, former executive director of the Wisconsin Breast Cancer Coalition, tells Isthmus that advocates for the bill, who are calling themselves the Early Detection Saves Lives Coalition, successfully negotiated with the Alliance of Health Insurers for an amendment prior to the Senate vote.
But the Wisconsin Association of Health Plans “did not participate in the conversation on the Senate side” and “arrived late to the discussion during the Assembly health committee hearing on the bill.”
“They are very opposed to the bill and appear to be suggesting amendments that would be very harmful,” says Anderson.
A representative of the Wisconsin Association of Health Plans told Isthmus she would work to arrange an interview prior to publication deadline, but did not communicate further. The organization did not return a subsequent voicemail seeking comment.
