AB397: Bill Text

LRB-2942/2

TAY:cmh:mrc

1999 - 2000 LEGISLATURE

1999 Assembly BILL 397

July 6, 1999 - Introduced by Representatives Black, Miller, Hasenohrl, Bock, Richards, Pocan, La Fave, Turner, Berceau, Plale, Reynolds, J. Lehman, Kreuser, Boyle and Plouff, cosponsored by Senators Risser, Darling and Erpenbach. Referred to Committee on Health.

AB397,1,5 An Act to renumber and amend 49.665 (1) (c); to amend 20.435 (5) (bc), 20.435 (5) (jz), 20.435 (5) (o), 20.435 (5) (p), 49.665 (3), 49.665 (4) (b), 49.665 (4) (c) and 49.665 (5); and to create 49.665 (1) (bq), 49.665 (1) (c) 2. and 49.665 (4) (am) of the statutes; relating to: extending badger care to low-income child care workers, granting rule-making authority and making an appropriation.

Analysis by the Legislative Reference Bureau

Currently, under the badger care program, families with incomes below 185% of the federal poverty line who meet certain criteria are eligible for partially or wholly subsidized coverage of the same health services and benefits offered under the medical assistance program. "Family" is defined as at least one dependent child and his or her custodial parent or parents.

This bill expands the badger care program to cover individuals who are child care workers who meet the income and nonfinancial eligibility requirements. Under the bill, child care workers need not be parents to qualify for the health care coverage.

For further information see the state and local 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:

AB397, s. 1 Section 1. 20.435 (5) (bc) of the statutes is amended to read:

AB397,2,5 20.435 (5) (bc) Health care for low-income families and eligible individuals. As a continuing appropriation, the amounts in the schedule A sum sufficient for the badger care health care program for low-income families and eligible individuals under s. 49.665.

AB397, s. 2 Section 2. 20.435 (5) (jz) of the statutes is amended to read:

AB397,2,9 20.435 (5) (jz) Badger care premiums. All moneys received from payments under s. 49.665 (5) to be used for the badger care health care program for low-income families and eligible individuals under s. 49.466 49.665.

AB397, s. 3 Section 3. 20.435 (5) (o) of the statutes is amended to read:

AB397,2,13 20.435 (5) (o) Federal aid; medical assistance. All federal moneys received for meeting costs of medical assistance administered under ss. s. 49.45 and, to the extent permitted under federal law, s. 49.665.

AB397, s. 4 Section 4. 20.435 (5) (p) of the statutes is amended to read:

AB397,2,19 20.435 (5) (p) Federal aid; health care for low-income families. All federal moneys received for the badger care health care program for low-income families under s. 49.665, to be used for that the purpose of providing health care coverage to low-income families that are eligible under s. 49.665 (4) (a) for the badger care health care program.

AB397, s. 5 Section 5. 49.665 (1) (bq) of the statutes is created to read:

AB397,2,22 49.665 (1) (bq) "Eligible individual" means an individual who is eligible under sub. (4) (am) for health care coverage under this section.

AB397, s. 6 Section 6. 49.665 (1) (c) of the statutes is renumbered 49.665 (1) (c) (intro.) and amended to read:

AB397,3,2 49.665 (1) (c) (intro.) "Employer-subsidized health care coverage" means one of the following:

AB397,3,6 1. With respect to a family eligible under sub. (4) (a), family coverage under a group health insurance plan offered by an employer for which the employer pays at least 80% of the cost, excluding any deductibles or copayments that may be required under the plan.

AB397, s. 7 Section 7. 49.665 (1) (c) 2. of the statutes is created to read:

AB397,3,12 49.665 (1) (c) 2. With respect to an eligible individual, coverage under a group health insurance plan offered by the eligible individual's employer, or by the employer of a family member of the eligible individual, for which the eligible individual qualifies and for which the employer pays at least 80% of the cost, excluding any deductibles or copayments that may be required under the plan.

AB397, s. 8 Section 8. 49.665 (3) of the statutes is amended to read:

AB397,3,25 49.665 (3) Administration. The department shall administer a program to provide the health services and benefits described in s. 49.46 (2) to families that meet the eligibility requirements specified in sub. (4) and to eligible individuals. The department shall promulgate rules setting forth the application procedures and appeal and grievance procedures. The department may promulgate rules limiting access to the program under this section to defined enrollment periods. The department may also promulgate rules establishing a method by which the department may purchase family coverage offered by the employer of a member of an eligible family, or individual coverage offered by the employer of an eligible individual, under circumstances in which the department determines that purchasing that coverage would not be more costly than providing the coverage under this section.

AB397, s. 9 Section 9. 49.665 (4) (am) of the statutes is created to read:

AB397,4,3 49.665 (4) (am) An individual if eligible for health care coverage under this section if the individual meets all of the following requirements:

AB397,4,5 1. The individual is employed by a child care provider as a child care worker for at least 30 hours per week.

AB397,4,9 2. The individual's income does not exceed 185% of the poverty line, except that an individual who is already receiving health care coverage under this section may have an income that does not exceed 200% of the poverty line. The department shall establish by rule the criteria to be used to determine income.

AB397,4,14 3. The individual does not have access to employer-subsidized health care coverage and has not had access to employer-subsidized health care coverage within the time period established by the department by rule, but not to exceed 18 months, immediately preceding application for health care coverage under this section. The department may establish exceptions to this subdivision by rule.

AB397,4,17 4. The individual meets all other requirements established by the department by rule. The department may not require that an individual under this paragraph be a parent as a condition of eligibility.

AB397, s. 10 Section 10. 49.665 (4) (b) of the statutes is amended to read:

AB397,4,21 49.665 (4) (b) Notwithstanding fulfillment of the eligibility requirements under this subsection, a family or eligible individual is not entitled to health care coverage under this section.

AB397, s. 11 Section 11. 49.665 (4) (c) of the statutes is amended to read:

AB397,5,2 49.665 (4) (c) No family may be denied health care coverage under this section solely because of a health condition of any family member and no eligible individual may be denied health care coverage under this section solely because of a health condition of that individual.

AB397, s. 12 Section 12. 49.665 (5) of the statutes is amended to read:

AB397,5,23 49.665 (5) Liability for cost. (a) Except as provided in par. (b), a family that or eligible individual who receives health care coverage under this section shall pay a percentage of the cost of that coverage in accordance with a schedule established by the department by rule. If the schedule established by the department requires a family or eligible individual to contribute more than 3% of the family's or of the eligible individual's income towards the cost of the health care coverage provided under this section, the department shall submit the schedule to the joint committee on finance for review and approval of the schedule. If the cochairpersons of the joint committee on finance do not notify the department within 14 working days after the date of the department's submittal of the schedule that the committee has scheduled a meeting to review the schedule, the department may implement the schedule. If, within 14 days after the date of the department's submittal of the schedule, the cochairpersons of the committee notify the department that the committee has scheduled a meeting to review the schedule, the department may not require a family or eligible individual to contribute more than 3% of the family's or of the eligible individual's income unless the joint committee on finance approves the schedule. The joint committee on finance may not approve and the department may not implement a schedule that requires a family or eligible individual to contribute more than 3.5% of the family's or of the eligible individual's income towards the cost of the health care coverage provided under this section.

AB397,6,3 (b) The department may not require a family or eligible individual with an income below 143% of the poverty line to contribute to the cost of health care coverage provided under this section.

AB397,6,6 (c) The department may establish by rule requirements for wage withholding as a means of collecting the family's or eligible individual's share of the cost of the health care coverage under this section.

AB397,6,7 (End)