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LRB-1235/5

PJK:jld&kjf:rs

2015 - 2016 LEGISLATURE

DOA:......Dombrowski, BB0430 - MA childless adult program requirements

For 2015-2017 Budget -- Not Ready For Introduction

An Act ...; relating to: the budget.

Analysis by the Legislative Reference Bureau

Health and human services

Medical Assistance

Under current law, DHS administers a demonstration project under the Medical Assistance (MA) program that provides health care coverage to low-income adults under the age of 65 who do not have children and who are not otherwise eligible for MA. The demonstration project operates under an approved waiver of federal law. DHS may impose an annual enrollment fee of up to $75.

This bill requires DHS to submit to the secretary of the federal Department of Health and Human Services an amendment to the waiver that was already approved for the operation of the demonstration project that would authorize DHS to do all of the following under the demonstration project: 1) impose monthly premiums as determined by DHS; 2) impose higher premiums for enrollees who engage in behaviors that increase their health risks, as determined by DHS; 3) require a health risk assessment for all enrollees; 4) limit eligibility to no more than 48 months; and 5) require a drug screening assessment and, if indicated, a drug test as a condition of eligibility. DHS must implement any changes under the amendment that are approved. If the amendment is approved, in whole or in part, in the 2015-17 fiscal biennium, DHS must identify any costs incurred or savings resulting from the new requirements in the quarterly report on MA changes that DHS must submit to JCF under current law, as well as address any future fiscal impact resulting from the requirements in its biennial budget request for the 2017-19 biennium.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

Section 1. 49.45 (23) (c) of the statutes is repealed.

Section 2. 49.45 (23) (g) of the statutes is created to read:

49.45 (23) (g) 1. The department shall submit to the secretary of the federal department of health and human services an amendment to the waiver requested under par. (a) that authorizes the department to do all of the following with respect to the childless adults demonstration project under this subsection:

a. Impose monthly premiums as determined by the department.

b. Impose higher premiums for enrollees who engage in behaviors that increase their health risks, as determined by the department.

c. Require a health risk assessment for all enrollees.

d. Limit an enrollee's eligibility under the demonstration project to no more than 48 months. The department shall specify the eligibility formula in the waiver amendment.

e. Require, as a condition of eligibility, that an applicant or enrollee submit to a drug screening assessment and, if indicated, a drug test, as specified by the department in the waiver amendment.

2. If the secretary of the federal department of health and human services approves the amendment to the waiver under par. (a), in whole or in part, the department shall implement the changes to the demonstration project under this subsection specified in subd. 1. a. to e. that are approved by the secretary, consistent with the approval.

Section 9118. Nonstatutory provisions; Health Services.

(1) Requirements for assistance for childless adults demonstration project. If, during the 2015-17 fiscal biennium, the secretary of the federal department of health and human services approves, in whole or in part, the amendment to the waiver under section 49.45 (23) (a) of the statutes that is requested under section 49.45 (23) (g) 1. of the statutes, as created by this act, the department of health services shall do all of the following:

(a) Identify, in its quarterly report to the joint committee on finance under section 49.45 (2n) of the statutes, any costs incurred or savings realized in the 2015-17 fiscal biennium as a result of actions taken under section 49.45 (23) (g) 1. a. to e. of the statutes, as created by this act, as approved by the secretary of the federal department of health and human services.

(b) Address, in the department's biennial budget request under section 16.42 of the statutes for the 2017-19 fiscal biennium, any future fiscal impact resulting from actions taken under section 49.45 (23) (g) 1. a. to e. of the statutes, as created by this act, as approved by the secretary of the federal department of health and human services.

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