Wisconsin Passes 'Gail's Law' for Breast Cancer Screening and Postpartum Coverage

Governor Tony Evers recently announced the enactment of "Gail’s Law," a pivotal piece of legislation for Wisconsin's healthcare landscape. This law mandates that health insurance providers cover medically necessary supplemental breast screenings and diagnostic exams for women with dense breast tissue or those at heightened risk of breast cancer. The coverage extends to BadgerCare, following the governor's signing of Senate Bill 264, now designated as 2025 Wisconsin Act 103. The legislation honors Gail Zeamer, who succumbed to undiagnosed breast cancer.

Additionally, 2025 Wisconsin Act 102, formerly Senate Bill 23, extends postpartum Medicaid coverage from 60 days to one year for eligible women. This extension, effective July 1, 2026, aims to enhance maternal health outcomes, pending federal approval from the Centers for Medicare & Medicaid Services. With nearly half of pregnancy-associated fatalities occurring postpartum, this legislation targets improved healthcare support during this critical period.

Insurance Coverage and Compliance

"Gail’s Law" requires insurers to provide essential cancer screenings without imposing extra financial burdens on women, according to Governor Evers. Wisconsin Commissioner of Insurance Nathan Houdek emphasized that this law ensures insurance policies more effectively address women's health needs. By January 1, 2027, all health plans, including government and small group plans, must comply with this new regulation.

The Wisconsin Department of Health Services (DHS) has reported that nearly all postpartum deaths are preventable. DHS Secretary Kirsten Johnson expressed the department's intention to improve healthcare access for new mothers, further supporting them during the postpartum period. DHS plans to communicate these legislative changes to Medicaid members and healthcare providers in the near future.