Update March 20, 2014: The bill was modified in the Assembly, will be sent back to state senate. Also, I’m sorry for the terrible pun on F. Scott Fitzgerald’s name.
On Tuesday, March 18, the Wisconsin State Senate managed to pass a bill that would make chemotherapy drugs in pill form available to cancer patients. Specifically, the proposal would require health plans to offer the same coverage for the oral chemotherapy drugs as is offered for chemotherapy treatment administered through IVs. It passed by a vote of 30-2, presumably because it’s a no-brainer to support a bill that makes cancer treatment more affordable.
I said “managed” to pass it because it had been blocked from being voted on up until Tuesday by State Senate Majority Leader Scott Fitzgerald. Why did the Republican representative try to keep cancer patients from being able to receive a more affordable treatment option? Well, it depends on the day that you ask him.
On Wednesday of last week, he cited a lack of majority support within his caucus. But when the bill did finally come up for vote just six days later, it received majority support among Wisconsin Senate Republicans–and unanimous support from Senate Democrats. The two votes against the proposal were from the GOP ( Senators Leah Vukmir of Wauwatosa and Paul Farrow of Pewaukee) but it turns out 2 people don’t make a majority in a group of 18.
It’s possible that there was at one point a silent majority within the GOP who had expressed their intention behind closed doors to oppose the legislation , but the Milwaukee Journal Sentinel noted that 13 of 18 Republican State Senators had publicly spoke in support of the bill. So, maybe not so much.
Fitzgerald changed his talking point on Friday, March 14 after the facts got in the way. In a stunning display of both total awareness of the situation and a complete lack of giving a shit about it, Fitzgerald switched up his rationale for blocking the bill from reaching the Senate floor.
“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, it is taken on a case-by-case, bill-by-bill basis,” Fitzgerald said in a statement. Presumably if a bill that offered something important to Fitzgerald like legalizing ripping the wings of butterflies or kicking small animals, that’d move to the top of the docket.
So the bill went from being blocked because it didn’t have majority support among Republicans to being blocked because it didn’t have unanimous support among Republicans. Presumably if it had unanimous support, it still would have been blocked because anything that is universally accepted should be questioned and the bill shouldn’t move forward until someone is willing to stand against it. Someone brave enough to stand in front a group of dying cancer patients and tell them, “No, you can’t have affordable costs for this life-saving drug.” Someone like Scott Fitzgerald.
Fitzgerald also added in his statement from Friday that he, “expect[s] a lengthy discussion on this bill in (our GOP) caucus on Tuesday.” No one spoke out against it on the Senate floor according the the Associated Press’ account.
We’re oh-for-2 on Fitzgerald provided excuses for blocking the bill, so perhaps it’s best to look elsewhere.
Now that the bill has passed the Senate, it sits in front of the Wisconsin State Assembly and Assembly Republican Speaker Robin Vos. Vos is in opposition to the bill and, like Fitzgerald, believes a majority of his GOP caucus oppose it as well. He blocked a companion bill and intended to do so until the session ended on April 1. This despite the fact that the bill’s sponsor is Pat Strachota, the second ranking Republican member of the Assembly.
Vos promised to bring it to a vote on Thursday but was considering making changes to the proposal. Altering the bill before the vote would require it to be sent back to the State Senate, which would likely prevent the bill from gaining majority approval before the end of the session. On Thursday he followed through on those considerations and made modifications to the bill, sending it back to the Senate and effectively tabling the proposal until the next session unless Fitzgerald allows a vote before April 1.
So Vos is in on the game. He’s bound to have some insight into the reason why this proposal–did I mention it’s a bill that would provide cancer patients with an affordable treatment?–is being blocked.
According to the Milwaukee Journal Sentinel, Vos said, ”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.”
Now we’re getting somewhere. Vos doesn’t want to place any mandates on the insurance companies for fear of increasing the cost of insurance plans. That sounds valid enough–if not completely misguided given that insurance companies already cover the same treatment when its provided through IV, and the oral chemotherapy pill means less time in the hospital, fewer side effects, and just generally less unpleasantness.
Let’s see how the argument holds up.
29 states have already passed similar legislation, so there is plenty of precedence for the effects on insurance premiums. The Washington Department of Insurance found an increase of 0.2% on insurance premiums as a result of the law. The Department of Insurance in Indiana found no increase. None of the 29 states have reported any sort of significant increase in premiums.
Meanwhile, nearly 25% of all planned anticancer drugs will be orally administered according to a National Comprehensive Cancer Network (NCCN) Task Force report. In clinical tests, oral drugs have shown significant advantages over the IV and injected forms of cancer treatment and in some cases are the only viable option. However, the cost for these drugs can reach over $100,000 per year, a burden that the patient must bear without legislation requiring insurers to help with the cost.
As it turns out, increased insurance premiums aren’t a viable reason for blocking this bill and the only people suffering a financial penalty are those suffering from cancer. But it feels as though there’s something to this “cost for insurers” argument. After all the Wisconsin Association of Health Plans, an HMO trade group, opposes the bill. They probably have a good reason.
Maybe it’s because the contract lobbyist for the Wisconsin Association of Health Plans happened to be Jeff Fitzgerald. That last name isn’t a coincidence; Jeff is the brother of Wisconsin State Senator Scott Fitzgerald. The great mystery has been solved. Scott Fitzgerald doesn’t oppose the proposal because it lacks majority support among state senate Republicans, nor does he oppose it because it isn’t unanimously supported. He opposes it because it doesn’t have the support of his brother.
According to Follow The Money, the two biggest donors to Scott Fitzgerald’s campaigns since 1998 are from the “Health Professionals” and “Insurance” industries. They make up nearly 1/4th of all donations to Fitzgerald, totaling $254,953. That is conceivably the amount of money a cancer patient could end up paying in an effort to simply continue living. Instead, it’s paying for a state senator to block cancer patients from receiving affordable treatment methods.
What is almost equally as frustrating as Fitzgerald’s clearly misplaced loyalties towards donors and a lobbyist family member is that it stems beyond Fitzgerald. Robin Vos used similar tactics in the Assembly and Governor Scott Walker has stated he has no opinion on the bill–No opinion on a piece of legislation that could lessen the financial burden of people suffering from cancer and save lives. (He has since revised his opinion and said he would sign the bill, because, well, duh.)
At the risk of being repetitive, this is a bill that requires health insurers to cover a treatment that they already cover in a different form; a treatment that saves patients time, pain, and trips to the hospital; a treatment that will become increasingly more accessible and prevalent as medical advancements are made and implemented; and a treatment that has little to no impact on insurance premiums.
This is easy. Pass the damn bill.
This is the contact information for the Republican leaders who have done all they can to prevent this bill from becoming law:
Scott Fitzgerald (R-Juneau),
email@example.com, (608) 266-5660