Wisconsin's DPC Candidate Lost. The DPC Bill's Path May Have Opened.

The candidate running on direct primary care lost Wisconsin’s governor race on Tuesday. That could still turn out well for the state’s DPC bill.

Democrat David Crowley beat Republican Tom Tiffany, who had told the Cap Times that expanding DPC was part of his health platform. The same night, Democrats won both legislative chambers for the first time in 18 years. Unofficial results give them 18-15 in the Senate and 53-46 in the Assembly.

We wrote on Oct. 16 that this race would decide who signs or vetoes the next bill. The legislative results matter more. Through at least three bills, Wisconsin’s fight has been over one list: which patients a DPC practice may not turn away. Republicans in the Senate wouldn’t pass a list naming gender identity. Gov. Tony Evers wouldn’t sign a bill without protections he found sufficient. One side of that standoff just lost its majority.

Three bills, one list

2019. Assembly Bill 26 started with a long list of protected classes, and an amendment cut it down. Evers vetoed the bill in February 2020, objecting that a provider could decline a patient over genetics, national origin, gender identity, citizenship status or being LGBTQ.

2023. Assembly Bill 953 barred turning a patient away on the basis of race, color, national origin, religious belief or affiliation, sex, disability, age, sexual orientation or gender identity. It cleared the Assembly health committee 16-0 and passed the Assembly in February 2024.

The Wisconsin Catholic Conference had already objected. Its Feb. 14 testimony told lawmakers it wasn’t opposed to DPC providers “as such” and that its objection “stems solely from how it embeds gender identity into Wisconsin law.” Wisconsin Family Action opposed it too. The bill never got a Senate vote, and it died that April.

2025. Senate Bill 4 came back without the list and kept a narrower rule against refusing a patient solely because of health status. Democrats tried twice to restore a list. Rep. Lisa Subeck’s amendment to the Assembly companion lost 5-10 in committee. Senate Amendment 1, offered by 14 Senate Democrats, failed 18-14. The same 18 Republicans then passed the bill over the same 14.

Evers vetoed it again that August, saying the Legislature had failed to protect patients “from being discriminated against.” He added: “I welcome the Legislature revisiting this legislation.”

Who moved on Tuesday

All three Senate seats Democrats flipped belonged to yes votes on SB 4. Sen. Howard Marklein lost. Sens. Rob Hutton and Van Wanggaard didn’t run, and both seats went Democratic.

Hutton’s replacement is Rep. Robyn Vining. In 2025 she voted against the Assembly bill in committee and said it was “getting us nowhere helpful” without nondiscrimination language. A coauthor of the bill is leaving, and one of its critics takes the seat.

Rep. Clint Moses, who chaired the Assembly health committee in 2024 and voted against Subeck’s amendment in 2025, also lost. Sen. Rachael Cabral-Guevara, SB 4’s lead author, says she won re-election, but she returns to the minority.

Our read: the Senate that wouldn’t touch the list no longer exists, and the party that voted for it in 2025 now controls every step.

What a list would mean in your practice

Wisconsin still has no DPC statute. After the veto, Husch Blackwell’s read was that these agreements “remain subject to existing insurance laws.” Dr. Wendy Molaska, a Fitchburg family physician, told the Wisconsin Examiner in 2025 that the state had about 100 DPC providers, and that removing the uncertainty could bring in more.

The price of that certainty could be a list, and two parts of it deserve a close read if you might open here.

Senate Amendment 1 went beyond AB 953. It added citizenship status, genetic information and “existence of a preexisting medical condition.” SB 4 let a practice decline a patient whose condition it couldn’t appropriately care for. A future bill would have to say how those two rules fit together.

The second part is conscience. The Catholic Conference argued that Catholic DPC doctors could be accused of discrimination for declining certain hormone prescriptions. A new bill naming gender identity would meet that argument again, this time from outside the majority.

The Counterargument

The strongest case against all of this: DPC isn’t a Democratic priority, and a trifecta doesn’t change that.

It has real support. The Cap Times records no DPC position from Crowley. His health plan is a BadgerCare public option, which he put on his first-30-days list, and his stated aim is an alternative to for-profit insurance. Every SB 4 author was a Republican, so the bill has no Democratic sponsor to inherit it. And Democrats weren’t only waiting on a list. In the 2024 Senate health committee, Sen. LaTonya Johnson voted no on the version that had one.

Republicans could also walk away from a bill with gender identity in it. Then Democrats would have to pass it alone.

That case holds on priority. It’s weaker on opposition. Sen. Tim Carpenter voted yes in that same 2024 committee. Subeck voted for the 2025 bill without her amendment, saying “I think it is a good bill.” The Wisconsin Medical Society and the Wisconsin Academy of Family Physicians registered in favor of SB 4, and no one registered against it at the Senate hearing. The employer group The Alliance said after the veto that it would keep pushing.

So the opening is real and nothing more than that. The 2027 Legislature first meets on Jan. 4, and the sign that matters will be a Democrat’s name at the top of the next bill.