“Poison pill” amendment added to WI cancer treatment parity bill

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Photo credit: Doug Wheller

“Any change could create the proverbial poison pill because both houses must pass identical versions. The Senate plans to meet one final time April 1.” 

Janesville Gazette March 19 editorial

 

An amendment written by Rep. Pat Strachota was added to the cancer treatment parity bill SB300 last night after midnight in the Wisconsin Assembly.

The amendment was added to SB300 despite the fact that 28 state senators out of 30 very recently passed the bill with no amendment and that a bipartisan majority of at least 66 of the 99 Wisconsin Assembly members were signifying support for what members called “The Clean Bill”.

 

LINK TO LIST OF ASSEMBLY REPS. WHO VOTED TO REJECT THE AMENDMENT AND THOSE WHO VOTED TO ACCEPT IT.

Republican Assembly members said that SB300 with its amendment would pass with flying colors in the state senate but Dem. members mistrusted their promises, reminding them over and over that Rep. Robin Vos and Scott Fitzgerald were trying to kill the bill days ago.

Rep. Fred Clark told his Assembly colleagues they could “take this vote and feel good and tell people what you did” but “you’ll be putting your trust in leaders that have demonstrated that they don’t like this bill and they want to kill it and I think that’s stupid”.

The bill’s new amendment seems positive on its face since it limits a co-pay for chemotherapy in pill form to $100 per 30 days of treatment. However Rep. Chris Taylor referred to an analysis of the amendment from Legislative Council which stated that a Wisconsin cancer victim with a high deductible health insurance plan will need to pay in full the high deductible BEFORE gaining the beneficial $100 monthly cap mandated by Strachota’s amendment.

Rep. Taylor called the lack of parity a “fatal flaw” in the amendment and said the original bill was much better since it requires parity in co-payments, deductibles, and coinsurance between oral chemotherapy and IV chemo.  

Doctor uses stethoscope to listen to elderly man's heart beat.

As today’s Associated Press article on the bill and amendment states, intravenous chemo treatment at a hospital or clinic typically costs only $20 in co-payment to the patient. Parity with that very low entry price to treatment is what the original bill provided.

Rep. Taylor also cited a study that says cancer victims that are forced to pay over $500 in cost-sharing have a four-fold increase in likelihood of abandoning treatment as compared to those who have a cost-sharing of under $100.

Cost-sharing under high deductible plans is in the thousands.

Therefore, the “clean bill” literally gave Wisconsin the power to keep more cancer victims alive.

In reply to a query from Rep. Gary Hebl, the amendment’s author, Rep. Pat Strachota, explained that she picked a $100 max. co-payment for 30 days of tretment of oral chemo. after learning that 10% of people forced to pay more than $100/month quit treatment.

Rep. Strachota said her amendment is an improvement on similar legislation in California which has a $200 cap but she neglected to clearly state that her amendment’s protections for a cancer victim might not kick in until after that victim first pays out thousands of dollars for a deductible.

Rep. Strachota said in times past she herself bought a high deductible plan so that she could have low monthly insurance payments while she put money aside in a Health Savings Account for surprise expenses.

At that point in Strachota’s speech a friend messaged me to say, “How could a person put enough into an HSA if they’re on minimum wage?!”

Rep. Gary Hebl replied to Rep. Strachota that he was “truly embarrassed for this body” after seeing its leader shushing discussion of the bill at an earlier press conference.  He said he didn’t want one person in Wisconsin to give up treatment “for any amount over $1.00” and “If we reject this amendment, the bill is guaranteed to pass. We can guarantee to our cancer victims in this state that they can get the treatment of oral chemotherapy if we reject this amendment and pass it like we planned to on Tuesday – and we should have done. We’ve got a Governor ready to sign it.”

Rep. Hebl also chided Rep. Strachota for referring to California when Wisconsin’s nearby states of Illinois, Iowa, and Indiana have a zero copay for the same treatment.  He lambasted the Assembly’s close-but-no-cigar performance.

“You know we’ll say ‘We tried.’ Well that’s bogus….Stop playing politics. Stop playing theater.  Do the right thing. Reject this amendment.”

Near to that point in the evening, another friend commented on facebook, “As usual, this is an attack on low income people”.

Peter Barca directed an emotional and pleading speech to his GOP colleagues after listing the names of the cancer survivors who testified at a SB300 public hearing, saying, “I would get down on my hands and knees and plead with you if I thought it would make a difference”.

After the amendment was adopted with a 54 to 40 vote, Robin Vos gave a long speech about how he honors family members at a cancer “Hope Walk”. He said many people on his side are “philosophically opposed to mandates on insurance policies” regardless of the discussion because they think more options leads to cheaper prices and he called Strachota’s amendment changes “reasonable”.

Vos called what Dems. said about the GOP during the session, “way beyond the pale” and he reduced their criticism of Strachota’s amendment to pure politics saying, “Some people decided to use this as an opportunity to score political points. I think that’s sad.”

Rep. Pasch then stepped up to the mic exuding a rage she seemed barely able to contain.

I have transcribed her speech.:

“It always bothers me when people think they’ve done enough for cancer when they light the dome pink or purple or… whatever cancer month color it is. ‘Look how much i care. I lit a dome’. Or ‘I’ve gone on a walk’. Or ‘I lit a candle’. Or ‘I’ve posed for pictures’…That’s not showing how much you care. That’s showing how much you care about political points,” said Rep. Pasch.

“I can not believe what this body is doing today. We had the possibility to get something done for the people in the State of Wisconsin.”

“Today. A clean bill.”

“I talked to cancer groups. They said this is an “Unhappy compromise.” An unhappy compromise. They felt that they had nothing that they COULD do – that they had nothing to bargain with. Other than their lives. This is such hypocracy i can’t stand it. If there was true intent on getting a good bill passed we could have had an executive hearing in the health committee where we could have debated alternatives and looked at how to make this bill better. But this bill never had a hearing in the executive health committee. We had an incredibly moving public hearing. Where people talked about the impact of not being able to afford treatment. … that did not move the executive committee to have have an executive committee hearing about it because the intent was “Let’s just shuffle this thing around”. Again. Let’s not have revisionist history. The real history is that the intent from the leaders of BOTH HOUSES – the majority in both houses – was to shuffle this bill around and try to kill it.”

“And look how good we are. We passed a bill in one house that’s different than the bill in the other house and maybe – just maybe – the Senate will take it up and change it in the exact same form and we can do something besides light candles.”

“Don’t hold your breath on it. Don’t hold your breath on it. The only sure way to get this thing done is by passing a clean bill.”

Rep. Pasch concluded:

“I keep waiting for the profiles in courage moments in this house. I keep waiting for it. For somebody to break away from the man behind the curtain who tells everyone how to vote. For somebody to say, ‘You know what? Enough of that. I’m going to do what’s right for my constituents. I’m going to do what’s right for the people of Wisconsin. I’m going to save some lives tonight.”

Following, Rep. Danou told the Republican Assembly members, “The only reason you are voting on this bill is because you were shamed into doing this.”

That accusation drove several Republican Assembly members to emotion. Rep. Tom Larson from Colfax was moved to anger and tears and denied that he was shamed into action. He told the Assembly he saw his own daughter die from cancer six years ago.

Story after story of cancer misery, cancer survival, and cancer grief were then told by Assembly members on both sides of the aisle – authentic, heartfelt stories. Their rhetoric eventually softened as they came to empathize with each other’s shared experience. Their shared pain.

Yet their genuine compassion does not change the prospects of Wisconsin’s people if it does not make its way into Wisconsin’s legislation.

The fact remains that Strachota’s amendment is less helpful to cancer victims than the clean bill.

The amendment opens the door to yet more misery – and death. The Assembly was so close to ignoring the “man behind the curtain”. A majority in the Wisconsin Assembly could not do it. A majority of the members in that body are Republican.

This is their legacy.

The bill and its amendment will next proceed to the state senate on April 1st.

 

Text of Amendment 1 to Senate Bill 300

Text of Senate Bill 300

All activity on the bill as recorded by the legislature

 

Last night’s Assembly session is archived at Wisconsin Eye

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2 thoughts on ““Poison pill” amendment added to WI cancer treatment parity bill

  1. Let’s hope the senate does the right thing and doesn’t play an April Fools’ joke on the citizens of Wisconsin.

  2. I am sorry Rep. Larson lost his daughter to cancer. Hopefully she didn’t lose her battle because she couldn’t afford access to treatment.

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