TUE Health Care Report: DHS issues order allowing COVID-19 vaccine without prescription

From WisPolitics.com/WisBusiness.com …

— The Department of Health Services and Office of the Commissioner of Insurance today moved to protect access to the COVID-19 vaccine for Wisconsinites following an executive order from Gov. Tony Evers.

DHS first issued a statewide order allowing most Wisconsinites to get the vaccine at a pharmacy without a prescription. Insurance Commissioner Nathan Houdek then issued a directive to health plans that they cover the cost without passing any of it onto their policyholders.

The moves come as Health and Human Services Secretary Robert F. Kennedy Jr. has taken steps that critics say will restrict access to the vaccine.

Ryan Westergaard, the state’s chief medical office, said actions by the federal government have created confusion about access to the vaccine. But based on the science, DHS continues to recommend the vaccine for those 6 months and older. He also stressed it’s not a mandate to get the vaccine.

 “We want to make sure they can get one without difficulty,” he said.

The bulletin Houdek issued on the heels of the medical order from DHS applies to “all governmental self-funded and fully insured group health plans and individual health plans” under the agency’s purview.

An OCI spokesperson said state health insurance regulations don’t generally apply to federal programs like Medicare and Medicaid, or large-group employer-sponsored self-funded health benefits. 

Governmental self-funded offered to municipal or school district employees, are covered. Meanwhile, the agency recommended others to contact OCI if they have any concerns about a coverage denial or other issue with their insurer.

The Pharmacy Society of Wisconsin in a statement applauded Evers’ order, arguing it shows decisions about health will be guided by medical expertise and peer-reviewed science, not partisan politics.

“As the most accessible health care providers in our communities, pharmacists see firsthand how important it is to make vaccines available without barriers,” Sarah Sorum, pharmacist and CEO of the Pharmacy Society of Wisconsin, said. “This standing order empowers pharmacists to protect more patients, strengthen public health, and ensure that every Wisconsinite, whether in a small town or a big city, can get the vaccines they need when they need them.”

The Medical Society of Wisconsin also praised Evers’ action, but bemoaned the need to assure access to a vaccine that’s been proven safe and effective.

“While we greatly applaud this order, physicians remain frustrated that the debate over proven, life-saving vaccines even exists as it distracts from what we should all be working toward – universal access to vaccines,” former President Dr. Cynthia Hart said.

See the releases below.

— A group of Republican lawmakers also today introduced a resolution to designate October as Vaccine Injury Awareness Month in Wisconsin. 

Authors Sen. Steve Nass, of Whitewater, as well as Reps. Clint Moses, of Menomonie, and Elijah Behnke, of the town of Chase, in the cosponsorship memo argue they’re not debating the importance of vaccines.

Instead, among other things, they’re encouraging awareness of reporting systems such as the Vaccine Adverse Event Reporting System, and supporting families who have experienced vaccine-related injuries.

— U.S. Sen. Tammy Baldwin is urging GOP support for a bill she co-authored to permanently extend Affordable Care Act tax credits, warning a failure to do so will hurt small businesses and raise costs for millions of Americans. 

Baldwin, D-Madison, made the comments at a U.S. Capitol press conference alongside “Health Care Affordability Act”  lead author U.S. Sen. Jeanne Shaheen, D-N.H., Senate Minority Leader Chuck Schumer, D-N.Y., and stakeholders. 

“For small businesses like our restaurants, manufacturers and child care providers, the small group health insurance market isn’t just a huge administrative burden, it’s also expensive,” Baldwin said. “So the open marketplace is the difference between being able to hire, retain and keep the doors open or losing staff to jobs at companies that provide health insurance.” 

The “Health Care Affordability Act” would extend enhanced premium tax credits for insurance bought through the Affordable Care Act marketplace, which are set to expire at the end of the year. The enhanced credits were approved during the COVID-19 pandemic. 

An estimated more than 271,000 Wisconsinites enrolled in the ACA marketplace are receiving the credits, according to KFF data.

Baldwin said the measure should be added to a government funding bill that Congress must approve by Sept. 30 to prevent a government shutdown. 

“Time is of the essence. Families and businesses are planning for next year, and we need to get this done,” Baldwin said. “The only question is whether Republicans will join us and stand for lower costs for families or not.” 

Meanwhile, U.S. Sen. Ron Johnson, R-Oshkosh, in a post on X argued against extending the tax credits. 

“Extending the ‘temporary COVID’ enhanced Obamacare subsidies would perpetuate fraudulent activity, sending billions of dollars to insurance companies for policies that people are unaware they’re enrolled in and do not use,” Johnson said. 

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Press Releases

– BayCare Clinic: Gail’s Law would expand access to breast cancer screenings

– Pharmacy Society of Wisconsin: Applauds state’s commitment to vaccine access

– Dept. of Health Services: Continues to recommend the COVID-19 vaccine for all Wisconsinites 6 months and older 

– Wisconsin Medical Society: State’s largest physician organization praises governor’s action to ensure vaccine access