Update at 5:13PM –
It seems Robin Vos is monkey wrenching the democratic process.
From Senator Bob Jauch’s facebook account: Last week Majority Leader Fitzgerald was blocking legislation that would require insurance companies to provide coverage for expensive forms of chemotherapy drugs that patients take as pills rather than as infusions and injections. He blocked the bill while admitting that there were sufficient votes to pass the bill but it lacked a majority of the Republican caucus.
Embarrassed by his actions and forced by good media coverage the bill was taken up and adopted on a 30-2 vote.
This vote will mean nothing if it is not adopted by the Assembly where it is expected that a “poison pill” amendment will be adopted to pretend that the Assembly favors the bill when in fact it wants to kill it.
The Speaker sent the bill to committee and stated that the Assembly will attempt to improve it.
Translation. “The Assembly will love the bill to death with an amendment that strangles it. The Assembly will adjourn on Thursday telling the Senate to “take it or leave it” meaning there will be no time to reconcile the differences.
It is the most cynical behavior to treat a bill of so much importance to cancer victims that is supported by so many as though it is nothing more than a political game.
The Governor has stated that he doesn’t have a position on the bill. Apparently the Governor is the only person in the state who doesn’t understand the plight of cancer victims. he ought to publicly tell the assembly to adopt the bill as is or get out of the way.
Wisconsin Coalition for Cancer Treatment Access (WCCTA) released a statement on this bill. An excerpt:
“Orally administered anticancer drugs have become the preferred treatment therapy for certain types of cancer, and in some cases the ONLY treatment therapy available. Yet, despite these major milestones in the advancement of cancer treatment, health insurance benefit design has not kept up with these advances. These life-saving oral anticancer drugs remain out of reach because some insurance policies require a drastically higher cost sharing component than is required for traditional intravenous anticancer drugs.”
Contact the Wisconsin Assembly Representatives, Wisconsin State Senators and the Guv.
“I think that within the next week or so they’ll find a way to bring it to the forefront,” Gov. Scott Walker said. “I think that in the end, it’s highly likely that the legislature will end up passing it.”
That’s what Walker said yesterday about a bill that would force health plans to provide coverage that is equivalent for both oral anti-cancer drugs and IV chemotherapy drugs.
Bipartisan rage still holds a candle to money sometimes?
Despite the positive messaging from Scott Walker on this issue, people should stay awake and keep the pressure on.
With the advent of online global banking, lobbyists and politicians can cash checks in their sleep.
You can contact Walker via an online form HERE.
You can call Senator Scott Fitzgerald by dialing 608 266 5660 or you can send him an email through Sen.Fitzgerald@legis.wisconsin.gov. Go HERE to see his mailing address and more.
As of March 16, this is where each Wisconsin state senator stood on the issue according to Jason Stein and Patrick Marley of Milwaukee Journal Sentinel.:
Democrats for the bill
Tim Carpenter (D-Milwaukee),
firstname.lastname@example.org, (608) 266-8535
Tim Cullen (D-Janesville),
email@example.com, (608) 266-2253
Jon Erpenbach (D-Middleton),
firstname.lastname@example.org, (608) 266-6670
Dave Hansen (D-Green Bay),
email@example.com, (608) 266-5670
Nikiya Harris (D-Milwaukee),
firstname.lastname@example.org, (608) 266-2500
Bob Jauch (D-Poplar),
email@example.com, (608) 266-3510
Chris Larson (D-Milwaukee),
firstname.lastname@example.org, (608) 266-7505
Julie Lassa (D-Stevens Point),
email@example.com, (608) 266-3123
John Lehman (D-Racine),
firstname.lastname@example.org, (608) 266-1832
Mark Miller (D-Monona),
email@example.com, (608) 266-9170
Fred Risser (D-Madison),
firstname.lastname@example.org, (608) 266-1627
Jennifer Shilling (D-La Crosse),
email@example.com, (608) 266-5490
Lena Taylor (D-Milwaukee),
firstname.lastname@example.org, (608) 266-5810
Kathleen Vinehout (D-Alma),
email@example.com, (608) 266-8546
Bob Wirch (D-Somers),
firstname.lastname@example.org, (608) 267-8979
Republicans for the bill
Rob Cowles (R-Allouez),
email@example.com, (608) 266-0484
Alberta Darling (R-River Hills),
firstname.lastname@example.org, (608) 266-5830
Mike Ellis (R-Neenah),
email@example.com, (608) 266-0718
Rick Gudex (R-Fond du Lac),
firstname.lastname@example.org, (608) 266-5300
Sheila Harsdorf (R-River Falls),
email@example.com, (608) 266-7745
Frank Lasee (R-De Pere),
firstname.lastname@example.org, (608) 266-3512
Mary Lazich (R-New Berlin),
email@example.com, (608) 266-5400
Joe Leibham (R-Sheboygan),
firstname.lastname@example.org, (608) 266-2056
Terry Moulton (R-Chippewa Falls),
email@example.com, (608) 266-7511
Luther Olsen (R-Ripon),
firstname.lastname@example.org, (608) 266-0751
Jerry Petrowski (R-Marathon),
email@example.com, (608) 266-2502
Dale Schultz (R-Richland Center),
firstname.lastname@example.org, (608) 266-0703
Tom Tiffany (R-Hazelhurst),
email@example.com, (608) 266-2509
Republicans against the bill
Paul Farrow (R-Village of Pewaukee),
firstname.lastname@example.org, (608) 266-9174
Scott Fitzgerald (R-Juneau),
email@example.com, (608) 266-5660
Leah Vukmir (R-Wauwatosa),
firstname.lastname@example.org, (608) 266-2512
Republicans who have not stated their positions
Glenn Grothman (R-West Bend),
email@example.com, (608) 266-7513
Neal Kedzie (R-Elkhorn),
firstname.lastname@example.org, (608) 266-2635
It’s widely suspected that Jeff Fitzgerald, brother to Senator Scott Fitzgerald, is the reason that Senator Scott Fitzgerald has been bottlenecking the legislation.
Jeff Fitzgerald is a partner in Paladin Consulting Group and he lobbies for Wisconsin Association of Health Plans along with a slew of other interest groups. W.A.H.P. opposes smoothing the way for orally administered cancer treatment as does A.H.I., the Alliance of Health Insurers U.A.
Madison — More than two-thirds of GOP senators and four-fifths of the state Senate now publicly support a bipartisan bill to help cancer patients get critical treatments, but the measure is still being blocked by the head of that house.
Senate Majority Leader Scott Fitzgerald (R-Juneau) said Wednesday he’s going to unusual steps to block the proposal because a majority of his GOP caucus opposes it, not because his brother is lobbying on behalf of influential insurers to kill the bill.
But a review by the Milwaukee Journal Sentinel shows that as of Friday, at least 13 of the 18 Republicans in the state Senate and all 15 Democrats have taken a public stance in support of the legislation. In the Senate, Fitzgerald is now the main force holding back the bill, drawing on one of his body’s most arcane rules to keep the legislation trapped in the committee he chairs.
“The result of that bill passing would be chemotherapy would be cheaper for many families and people would have healthier lives,” said Senate Minority Leader Chris Larson (D-Milwaukee), asking why Fitzgerald was using the rare maneuver to prevent that. “He and his (Republican) caucus owe families an explanation for why that is.”
The proposal would require health plans to provide the same coverage for expensive chemotherapy drugs taken as pills as they do for the expensive chemotherapy administered through IVs. The bill will be all but dead if it doesn’t reach the floor of the Assembly by Thursday, the day that house is scheduled to adjourn for the year.
In the Assembly, the bill has 18 Republican sponsors and would likely draw support from all or nearly all of the 39 Democrats. That’s more than enough to reach the threshold of 50 votes needed to pass the bill, but it falls short of the 66 votes that supporters would need to force the measure to the floor.
Assembly Speaker Robin Vos (R-Rochester) opposes the bill and on Friday used a procedural move of his own to lock a companion bill in his house in committee until after the session ends. His strongly conservative caucus is unlikely to press him to bring the bill up for a floor vote or even a committee vote in that house, despite the fact that the proposal’s lead sponsor, Republican Pat Strachota of West Bend, ranks second only to Vos in the Assembly.
All that means that the chemotherapy bill appears marked to become one of those proposals that fail to pass the Legislature even though they have the votes.
Twenty-nine states — including neighboring Iowa, Illinois and Minnesota — have passed laws requiring insurance companies to treat oral chemotherapy drugs the same as they do other chemotherapy, with little or no effect on premium costs.
Jim Graven, 63, thinks Wisconsin ought to join them. He had surgery a year ago after being diagnosed with kidney cancer and is now taking oral chemotherapy to keep it from recurring. His pills are covered because he is part of a clinical trial, but he said in other cases a supply could cost up to $10,000 a month.
He said he was frustrated GOP leaders are going to such lengths to stop the bill.
“To a normal person, I just don’t think this makes any sense at all,” he said. “It’s obvious this isn’t the way government should work.”
Health plans typically cover oral chemotherapy under prescription drug plans that can have high copays, and for some health plans, those copays could run into many thousands of dollars. In contrast, when chemotherapy is administered at a hospital or clinic, it is covered as part of a health plan’s standard medical coverage with no additional cost after the deductible is reached.
Supporters say requiring equal coverage for oral chemotherapy hasn’t been shown to lead to big hikes in health insurance premiums.
A review done by the Washington Department of Insurance found an increase of 0.2% as a result of the state’s oral chemotherapy law, according to the International Myeloma Foundation. In Indiana, the Department of Insurance found no increase in premiums after it passed similar legislation in 2010.
A retired financial consultant, Graven lives outside Sheboygan in the Town of Wilson. He said it’s a “no-brainer” that all chemotherapy should be covered the same and noted he was bothered Republicans first arranged and then canceled a phantom hearing Wednesday to prevent the bill from getting to the floor.
“I have really a low tolerance for it,” Graven said. “I hate to see technicalities used in a wrong way. I don’t like a lot of legalism in society, especially when they use it to get an unintended result. I don’t like it at all.”
On Wednesday, Fitzgerald said he was using that unusual blocking technique because the chemotherapy bill had a “majority of the body (of senators supporting the bill) but not a majority of the Republican caucus.”
Fitzgerald dropped that reason Friday after the Journal Sentinel gave his aides a list showing that a majority of GOP senators now publicly support the bill.
“As far as scheduling a bill that doesn’t have unanimous Republican support within the caucus, there is no hard and fast number in terms of senators opposing the bill,” Fitzgerald said in a statement. “It is taken on a case-by-case, bill-by-bill basis. I expect a lengthy discussion on this bill in (our GOP) caucus on Tuesday, and I hope to come out of that with some sort of resolution on the issue, whatever that may be.”
Fitzgerald has said that his actions have nothing to do with the fact that his brother, Jeff Fitzgerald, has served as a contract lobbyist for the Wisconsin Association of Health Plans. That HMO trade group opposes the bill along with individual insurers and another trade group, the Alliance of Health Insurers.
Insurers are major donors and have a history of giving to the Senate Republicans’ campaign committee and to GOP legislators on both sides of the chemotherapy issue, such as Fitzgerald and the proposal’s lead sponsor in the Senate, Republican Alberta Darling of River Hills.
Two conservative GOP senators have come out vocally against the bill — Paul Farrow of the Village of Pewaukee and Leah Vukmir of Wauwatosa.
“I have a consistent record of opposing insurance mandates,” Vukmir said in a statement. “A state mandate would only impact the insurance companies regulated by Wisconsin and not those regulated at the federal level, creating an uneven playing field and driving up costs for consumers.”
Farrow expressed similar concerns.
“It’s a mandate,” he said. “If we’re going to say we’re going to mandate this one area, what’s the next area we’re going to mandate?”
Insurance industry groups also have said the law is not needed because many health plans cover oral chemo and the Affordable Care Act caps out-of-pocket expenses at $6,350 for an individual this year. That’s a big change from past years in which even some insured patients could face tens of thousands of dollars in costs for their oral chemotherapy.
Earlier this session, Scott Fitzgerald allowed a bill to get to the floor that divided the GOP caucus. That measure — which would create a regional transit authority in the Fox Valley — passed 25-7, with 11 Republicans joining all Democrats in favor of it.
Fitzgerald can also point to the chemotherapy bill’s slim chances in the Assembly as one reason not to bring it up in his house.
Vos said he believes his Republican caucus opposes the bill, even if the Assembly as a whole supports it when the votes of Democrats are counted.
“In the past, I have not voted for any mandates that would increase the cost of insurance plans in the private sector that’s already too expensive. So I guess I will wait to see what happens in the Senate, but I have serious concerns,” Vos said.
The Wisconsin Health Plans Association has also stressed that the bill would raise premiums, but so far opponents have not backed up those statements with specific figures.
Gov. Scott Walker has heard more about the chemotherapy proposal in recent days but is focused on his “worker training bill and his Blueprint for Prosperity” — the governor’s $541 million tax cut bill, spokeswoman Jocelyn Webster said. He will consider the chemotherapy measure “when and if” it reaches his desk, she said.
Walker’s Democratic challenger, Mary Burke, said as governor she would sign the bill “as soon as it reached” her.
“This should be an easy, common sense decision. Unfortunately, it seems like once again we see special interests taking precedence over the needs of the people of Wisconsin,” she said in a statement.
On Friday, Vos made a move to effectively kill an Assembly companion bill to the chemotherapy measure in the Senate, transferring the proposal from the health committee to the insurance committee. Because of that transfer, it will take a two-thirds vote to bring that Assembly bill to the floor, something the bill’s opponents currently can’t muster.
If Vos did move the bill forward, Assembly Minority Leader Peter Barca (D-Kenosha), a sponsor of the measure, believes he could deliver the great majority of his 39 Democrats and perhaps all of them.
“It probably has as strong of bipartisan support as anything we’ve done this session,” Barca said of the bill. “It’s one of those issues whose time has come.”
Sen. Tim Cullen agrees. The Janesville Democrat is a cancer survivor, former Blue Cross Blue Shield health insurance executive and a former Senate majority leader — the post Fitzgerald now holds. Cullen doesn’t believe Scott Fitzgerald is holding up the bill to benefit his brother, but Cullen doesn’t believe that Fitzgerald is right, either.
“The bill ought to become law. The insurance industry’s problem is a technical one and I think they can solve it,” Cullen said.
But as a former leader, Cullen sees why neither Fitzgerald nor Vos would want to take floor votes on the bill and see it pass. Doing so, Cullen said, would deprive Republicans in their house of the credit — and potential campaign support — they could receive from opponents for killing the bill.
Jeff Fitzgerald isn’t alone in lobbying for the Wisconsin Association of Health Plans. These people are also listed by G.A.B. as lobbying for W.A.H.P. and they are likely echoing what Jeff Fitz. is telling legislators.:
Nathan Berken, according to G.A.B., ceased lobbying efforts for Paladin in 2013.
Below you’ll see a graphic depicting the health plans represented by W.A.H.P. according to their web site.
Wisconsin Assoc. of Health Plans doesn’t list board names but for several years running the name Phil Dougherty has been appearing on their documents:
Here are the people on the board of directors of A.H.I. as listed on the organization’s web site:
Larry Schreiber, President, Anthem Blue Cross and Blue Shield in Wisconsin
Dennis Brown, President and CEO, Delta Dental of Wisconsin, Inc.
Kristine Seymour, President, Humana, Inc.
Sherry Husa, President & CEO, Managed Health Services Insurance Corp.
Andy Bhugra, President, Molina HealthCare of Wisconsin
Linda Hoff, President, Physicians Plus Insurance Corporation
Mark Moody, President & CEO, WEA Insurance Corporation
Mike Hamerlik, President & CEO, WPS Health Insurance
Wendy Arnone, CEO, UnitedHealthcare of Wisconsin
Board Officers for 2013:
President: Mike Hamerlik
Vice-President: Wendy Arnone
Secretary: Andy Bhugra
Treasurer: Larry Schreiber