MADISON, Wis. — As Wisconsinites continue to struggle with rising costs for food, housing, childcare, and health care, patient advocates are urging lawmakers to take immediate action on Senate Bill 203 and Assembly Bill 173, known as “Cole’s Act,” to provide meaningful affordability relief for patients. Recent listening sessions conducted by the Institute for Reforming Government confirmed that affordability is the number one concern across the state – especially when it comes to essential health care costs. Yet Wisconsin remains an outlier, failing to act as other states move decisively to protect patients from predatory pharmacy benefit manager (PBM) practices.
Wisconsin’s inaction stands in stark contrast to national momentum. Earlier this month, New Jersey became the 26th state to ban copay accumulator adjustment policies – programs that prevent copay assistance from counting toward patient deductibles and out-of-pocket limits – after its legislature passed the reform unanimously. Nationwide, lawmakers have voted overwhelmingly to ban the practice, with more than 3,300 votes cast in favor of protecting patients. 14 states have passed their copay accumulator bans unanimously in both houses of the Legislature. Across all 26 states, the legislation has passed with 95% of state lawmakers voting in favor. In Wisconsin only one vote has been taken on the bills so far this session. The bill passed out of the Senate Health Committee with a unanimous bipartisan vote of 5-0.
A report from The AIDS Institute ranks Wisconsin among the worst states in the nation, with 85.7% of individual-market plans using copay accumulators, earning the state an “F” grade. These policies force patients – often those with chronic or life-threatening conditions – to pay thousands more out of pocket, driving dangerous medication abandonment at a time when affordability pressures are already overwhelming families.
“With inflation squeezing every household budget, no one should be forced to choose between rent, groceries, and lifesaving medication,” said Rob Gundermann, Chair of the Wisconsin All Copays Count Coalition. “Cole’s Act is a straightforward, bipartisan solution that would immediately lower costs for patients by ensuring copay assistance actually counts. Twenty-six states have acted. Wisconsin has the votes and the bipartisan support—what we need now is leadership and action.”
Cole’s Act is named after Cole Schmidtknecht, a 22-year-old Wisconsinite who died after a sudden PBM policy change made his asthma inhaler unaffordable overnight. Research consistently shows that when out-of-pocket costs rise, patients abandon prescriptions—more than 40% at $75 – $125 and over 70% at $250 – putting lives at risk.
Here is the status of the legislation:
- AB 173 was introduced on April 9th, 2025 and referred to the Assembly Committee on Health, Aging and Long Term Care. That committee has met 9 times in the last 8 months and has not yet held a public hearing on AB 173.
- Senate Bill 203 passed the Senate Committee on Health unanimously in August of 2025, but has yet to receive a floor vote even though 20 of 33 state senators are sponsors of the bill.
As the legislative session nears its end, advocates are calling on legislative leadership to immediately schedule floor votes and pass Cole’s Act, delivering long-overdue affordability relief and ensuring Wisconsin patients are protected – not left behind.
The public can contact their state legislators to take action by going to https://www.wi4patients.com/take-action or use this QR code
