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AB 1087

Relating to: special enrollment period for pregnancy.

2025-2026 Regular Session Introduced by Margaret Arney and 11 co-sponsors

Establishes a pregnancy-specific special enrollment period allowing enrollment in health plans or state programs outside the usual open enrollment window.

Failed to pass pursuant to Senate Joint Resolution 1
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WeVote Research Nonpartisan
Bill Summary · AB 1087

Summary of Wisconsin Assembly Bill 1087 (2025)

Title

Relating to: special enrollment period for pregnancy.

Purpose and Intent

AB 1087 aims to establish or modify a special enrollment period related to pregnancy. The bill’s primary focus is to adjust health coverage enrollment timelines to accommodate pregnancy-related needs, ensuring access to insurance or benefits during a pregnancy through a designated enrollment window outside the standard open enrollment period.

Key Provisions and Changes

  • Establishment/Modification of Special Enrollment Period (SEP): The bill creates or elaborates a pregnancy-specific SEP, allowing individuals who become pregnant (or who are pregnant) to enroll in a health plan or benefits program outside the typical annual open enrollment window.
  • Trigger and Eligibility: The SEP is tied to pregnancy status. The bill would define eligibility criteria (e.g., proof of pregnancy or a declarative eligibility standard) and specify when the enrollment period begins and ends.
  • Coverage Options: The SEP would apply to health plans or state-funded benefit programs (the exact programs covered would be specified in the statutory text; the summary notes implication for pregnancy-related enrollment).
  • Coordination with Existing Programs: The bill would outline how the pregnancy SEP interacts with existing state health coverage rules, including any coordination with Medicaid, CHIP, private plans, or state health exchange processes.
  • Administrative Procedures: The bill may specify notification requirements, documentation standards, and timelines for processing SEP enrollments, including any retroactive coverage considerations if applicable.

Note: The available materials do not include the full statutory text, so the summary focuses on the logical structure and typical elements of pregnancy-related SEPs as described in the bill’s title and related summaries.

Who would be Affected

  • Pregnant individuals seeking health coverage or enrollment in related benefit programs outside standard enrollment periods.
  • Health plans, insurers, and state programs that administer coverage or subsidies (e.g., state health exchanges, Medicaid/CHIP programs) would implement the SEP rules.
  • Employers offering plans subject to state insurance requirements may need to adjust enrollment processes to accommodate the SEP.

Procedural and Timeline Aspects

  • Introduction and Sponsorship: The bill was introduced by a cohort of representatives and co-sponsored by multiple legislators (details include initial coauthors listed in February 2026 and later additions in March 2026).
  • Referral: The bill was referred to the Committee on Health, Aging and Long-Term Care for review and committee action.
  • Governing Process: As a bill in the Wisconsin Legislature, passage would require committee hearings, passage by both the Assembly and Senate, and signature by the Governor (or enactment through other constitutional processes if applicable).

Status Notes

  • The provided material indicates the bill was introduced and assigned to committee, with multiple coauthors and sponsors from both chambers (Senate co-sponsors listed as well).
  • The “Action History” shows activity in March 2026, including coauthor additions and the committee referral.

Practical Considerations

  • If enacted, individuals who become pregnant could enroll in coverage outside normal periods, potentially reducing gaps in coverage during pregnancy.
  • Plan administrators and state agencies would need to implement processes for SEP determinations, eligibility verification, and enrollment processing.
  • The impact depends on the exact definitions of pregnancy eligibility, the start/end dates of the SEP, and which programs are covered by the SEP.

If you’d like, I can refine this with the bill’s exact statutory language once available, or compare AB 1087 to existing SEP rules in Wisconsin to highlight differences.

Compiled from official sources — confirm details with the bill’s official record.

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