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2011 - 2012 LEGISLATURE
March 1, 2012 - Introduced by Senators Erpenbach, Carpenter, S. Coggs, T.
Cullen, Hansen, Holperin, Jauch, C. Larson, Lassa, Miller, Risser, Shilling

and Wirch, cosponsored by Representatives Richards, Pasch, Barca,
Berceau, Bewley, Billings, D. Cullen, Grigsby, Hebl, Hulsey, Kessler,
Mason, Milroy, Pocan, Pope-Roberts, Ringhand, Roys, Seidel, Staskunas,
Steinbrink, C. Taylor, Toles, Turner, Young, Zamarripa
and Zepnick.
Referred to Joint Committee on Finance.
SB538,1,10 1An Act to repeal 49.45 (23) (d), 49.471 (13), 49.471 (14), 71.255 (6) (bm), 71.26
2(4) (b) and 71.45 (4) (b); to renumber and amend 71.26 (4) (a) and 71.45 (4)
3(a); to amend 49.45 (2m) (c) (intro.), 49.45 (23) (a), 49.45 (23) (b) and 71.255 (6)
4(a); to create 49.45 (23) (c), 49.45 (23) (d), 49.45 (23) (e), 49.471 (6) (L), 49.471
5(14) and 49.471 (15) of the statutes; and to affect 2011 Wisconsin Act 32, section
69421 (1i), 2011 Wisconsin Act 32, section 1438e, 2011 Wisconsin Act 32, section
71438i and 2011 Wisconsin Act 32, section 1461h; relating to: changes to
8BadgerCare Plus and BadgerCare Plus Core programs by the department of
9health services and by waiver, disallowing certain carry-forward amounts for
10combined reporting purposes, and making an appropriation.
Analysis by the Legislative Reference Bureau
Currently, the Department of Health Services (DHS) administers the Medical
Assistance (MA) program, which is a joint federal and state program that provides
health services to individuals who have limited resources. Some services are
provided through programs that operate under a waiver of federal Medicaid laws,
including services provided through the BadgerCare Plus (BC+) and BadgerCare

Plus Core (BC+ Core) programs. Current law requires DHS to study potential
changes to MA for certain purposes. If DHS determines that revision of existing
statutes or rules would be necessary to advance any of the purposes for which the
study was conducted, DHS may propose a policy to take certain actions including:
modifying existing benefits and offering different benefits packages to different
groups of MA recipients, restricting or eliminating presumptive eligibility, setting
standards for establishing and verifying eligibility requirements; developing
standards and methodologies to assure accurate eligibility determinations and
redetermine continuing eligibility, and reducing income levels for purposes of
determining eligibility. Before implementing a policy that conflicts with a state
statute, DHS must submit to the Joint Committee on Finance (JCF), under the
committee's passive review process, the proposed amendment to the state MA plan
or proposed waiver of federal Medicaid law. If JCF does not reject the proposed plan
amendment or waiver request, DHS must submit the amendment or waiver request
to the federal government, if necessary, to the extent necessary to implement the
policy. If the federal government does not allow the amendment or does not grant
the waiver, DHS may not implement the policy.
Under current law, BC+ provides health and medical services to eligible
recipients and has a standard plan with a larger set of benefits and a Benchmark
plan with fewer benefits. Recipients of standard BC+ benefits may be required to pay
certain copayments for services. BC+ recipients under the standard plan, with some
exceptions, are also required to pay premiums. Recipients of BC+ under the
Benchmark plan have increased copayments and coinsurance for certain services
and higher premiums compared to recipients under the standard plan.
Under current law, the following individuals, among others, are eligible for
benefits under the BC+ standard plan: a pregnant women whose family income does
not exceed 200% of the federal poverty line (FPL); a child meeting certain criteria
whose family income does not exceed 200% of the FPL; a child meeting certain
criteria whose family income exceeds 150% of the FPL but the difference between the
actual family income and 150% of the FPL is expended on behalf of a member of the
child's family or the child for certain medical or health reasons; a parent or caretaker
relative of a child whose family income does not exceed 200% of the FPL; and an
individual who qualifies for a transitional extension of MA benefits even though his
or her income increases above the poverty line. Except for pregnant women and
certain children and other individuals, individuals who are otherwise eligible for
BC+ and are also eligible for a group health plan must apply for the group health
plan. Those individuals are not eligible for BC+ if their family income exceeds 150%
of the FPL and they have, or have had access in the previous 12 months to, health
coverage that is either provided by an employer that pays at least 80% of the
premium or is the state employee health plan. A child whose family income does not
exceed 150% of the FPL, a pregnant woman, and certain others are retroactively
eligible for benefits under BC+ for the three months before applying for BC+. A child
whose family income does not exceed 150% is also presumptively eligible for BC+.
The following individuals, among others, are eligible for benefits under the BC+
Benchmark plan, under current law: a pregnant woman whose family income

exceeds 200%, but does not exceed 300%, of the FPL; a pregnant woman and everyone
in her family if her family income exceeds 300% of the FPL but the difference between
her actual family income and 300% of the FPL is expended for any family member's
or her medical or health care; a child whose family income exceeds 200%, but does
not exceed 300%, of the FPL; and a parent or caretaker of a child whose income
includes self-employment income but does not exceed 200% of the FPL after
depreciation is deducted. A child whose family income exceeds 300% of the FPL and
an adult who meets certain criteria are eligible to purchase benefits at the full per
member per month cost of coverage through the BC+ Benchmark plan. A pregnant
woman whose family income does not exceed 200% of the FPL is presumptively
eligible for ambulatory prenatal care benefits under the BC+ standard plan. A
pregnant woman whose family income exceeds 200%, but does not exceed 300%, of
the FPL is presumptively eligible for ambulatory prenatal care benefits under the
BC+ Benchmark plan.
Under current law, DHS also administers BC+ Core, which provides basic
primary and preventive care to eligible individuals. Adults who are under age 65,
who have family incomes that do not exceed 200% of the FPL, and who are not
otherwise eligible for MA, including BC+, are eligible for benefits under BC+ Core.
This bill eliminates the authority of DHS to modify aspects of the BC+ and BC+
Core programs through a policy. If DHS seeks to verify the residency in the state of
an applicant for BC+ or BC+ Core as a condition of eligibility, the bill requires that
DHS accept any document or other source that reasonably verifies residency in the
state. DHS may not require a specific source of verification of residency and may not
require as the sole method of verification a government-issued identification card
containing a photograph. The bill prohibits DHS from requesting or implementing
a waiver of federal Medicaid laws or an amendment to the state MA plan to do any
of the following: disqualify from eligibility for BC+ or BC+ Core any individual who
has access to employer-sponsored health insurance that does not require a premium
exceeding 9.5% of the individual's household income; disqualify from eligibility for
BC+ or BC+ Core an adult who has not attained the age of 26 and who has access to
coverage under a parent's employer-sponsored health insurance; apply premiums
and copayment contributions for BC+ or BC+ Core that are different from or in
addition to those required under current law; discontinue transitional MA benefits
for those who exceed the income eligibility threshold; restrict eligibility for BC+ or
BC+ Core for 12 months to anyone who has refused to pay or has been terminated
for nonpayment of a premium for BC+ or BC+ Core; eliminate retroactive or
presumptive eligibility; consider the income of all adults living in the household,
except for grandparents not receiving MA, for purposes of eligibility for BC+ or BC+
Core; terminate or reduce eligibility within 10 days of a notice to the recipient of BC+
or BC+ Core benefits; reduce the benefits under the BC+ Benchmark plan; or require
all non-pregnant individuals who have incomes exceeding 100% of the FPL to enroll
in the BC+ Benchmark plan instead of the standard plan. The bill also prohibits
DHS from reducing income levels for the purposes of determining eligibility for BC+
or BC+ Core to 133% of the FPL for adults who are not pregnant and not disabled.

Under current law, for each taxable year that a corporation that is a member
of a combined group has net business loss carry-forward from a taxable year
beginning before January 1, 2009, the corporation may, for 20 taxable years, use up
to five percent of the net business loss carry-forward to offset the income of all other
members of the combined group. The bill eliminates this provision.
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:
SB538, s. 1 1Section 1. 49.45 (2m) (c) (intro.) of the statutes, as affected by 2011 Wisconsin
2Act 32
, section 1423k, is amended to read:
SB538,4,73 49.45 (2m) (c) (intro.) Subject to par. (d), if the department determines, as a
4result of the study under par. (b), that revision of existing statutes or rules would be
5necessary to advance a purpose described in par. (b) 1. to 7., the department may
6propose a policy that makes any of the following changes related to Medical
7Assistance programs, except for the programs under sub. (23) or s. 49.471:
SB538, s. 2 8Section 2. 49.45 (23) (a) of the statutes, as affected by 2011 Wisconsin Act 32,
9section 1438d, is amended to read:
SB538,4,1810 49.45 (23) (a) The department shall request a waiver from the secretary of the
11federal department of health and human services to permit the department to
12conduct a demonstration project to provide health care coverage for basic primary
13and preventive care to adults who are under the age of 65, who have family incomes
14not to exceed 200 percent of the poverty line, and who are not otherwise eligible for
15medical assistance under this subchapter, the Badger Care health care program
16under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department creates
17a policy under sub. (2m) (c) 10., this paragraph does not apply to the extent that it
18conflicts with the policy.
SB538, s. 3
1Section 3. 49.45 (23) (b) of the statutes, as affected by 2011 Wisconsin Act 32,
21438h, is amended to read:
SB538,5,123 49.45 (23) (b) If the waiver is granted and in effect, the department may
4promulgate rules defining the health care benefit plan, including more specific
5eligibility requirements and cost-sharing requirements. Unless otherwise provided
6by the department by a policy created under sub. (2m) (c), cost
Cost sharing may
7include an annual enrollment fee, which may not exceed $75 per year.
8Notwithstanding s. 227.24 (3), the plan details under this subsection may be
9promulgated as an emergency rule under s. 227.24 without a finding of emergency.
10If the waiver is granted and in effect, the demonstration project under this subsection
11shall begin on January 1, 2009, or on the effective date of the waiver, whichever is
12later.
SB538, s. 4 13Section 4. 49.45 (23) (c) of the statutes is created to read:
SB538,5,2014 49.45 (23) (c) If the department elects to request verification of residency in this
15state as a condition of eligibility for the demonstration project under this subsection,
16the department shall accept any document or other source that reasonably verifies
17residency in this state. The department may not require a specific source of
18verification of residency. The department may not require as the sole method of
19verification of residency a government-issued identification card with a photograph
20of the individual.
SB538, s. 5 21Section 5. 49.45 (23) (d) of the statutes is created to read:
SB538,5,2422 49.45 (23) (d) The department may not create a policy under sub. (2m) (c) that
23alters the requirements or provisions under the demonstration project described in
24this subsection.
SB538, s. 6
1Section 6. 49.45 (23) (d) of the statutes, as created by 2011 Wisconsin Act ....
2(this act), is repealed.
SB538, s. 7 3Section 7. 49.45 (23) (e) of the statutes is created to read:
SB538,6,64 49.45 (23) (e) The department may not request or implement a waiver of federal
5Medicaid laws to do any of the actions described in s. 49.471 (15) (a) 1. to 8. or (b) with
6respect to the demonstration project described in this subsection.
SB538, s. 8 7Section 8. 49.471 (6) (L) of the statutes is created to read:
SB538,6,148 49.471 (6) (L) If the department elects to request verification of residency in
9the state as a condition of eligibility for the program under this section, the
10department shall accept any document or other source that reasonably verifies
11residency in the state. The department may not require a specific source of
12verification of residency. The department may not require as the sole method of
13verification of residency a government-issued identification card with a photograph
14of the individual.
SB538, s. 9 15Section 9. 49.471 (13) of the statutes, as affected by 2011 Wisconsin Act 32,
16section 1461g, is repealed.
SB538, s. 10 17Section 10. 49.471 (14) of the statutes is created to read:
SB538,6,1918 49.471 (14) Program changes. The department may not create a policy under
19s. 49.45 (2m) (c) that alters the requirements or provisions under this section.
SB538, s. 11 20Section 11. 49.471 (14) of the statutes, as created by 2011 Wisconsin Act ....
21(this act), is repealed.
SB538, s. 12 22Section 12. 49.471 (15) of the statutes is created to read:
SB538,6,2523 49.471 (15) Prohibited actions. (a) The department may not request or
24implement a waiver of federal Medicaid laws or an amendment to the state Medical
25Assistance plan to do any of the following:
SB538,7,3
11. Disqualify from eligibility for the program under this section any individuals
2who have access to employer-sponsored health insurance that does not require a
3premium exceeding 9.5 percent of the individual's household income.
SB538,7,54 2. Disqualify from eligibility an adult who has not attained the age of 26 and
5who has access to coverage under a parent's employer-sponsored health insurance.
SB538,7,86 3. Apply premiums and copayment contributions to receipt of benefits different
7from or in addition to premiums and copayment contributions required or allowed
8under this section.
SB538,7,109 4. Discontinue transitional Medical Assistance benefits for recipients who
10exceed the income eligibility threshold.
SB538,7,1311 5. Restrict eligibility for Medical Assistance for 12 months to anyone who has
12refused to pay or has been terminated for nonpayment of a premium for the program
13under this section.
SB538,7,1414 6. Eliminate retroactive or presumptive eligibility.
SB538,7,1615 7. Consider for eligibility purposes the income of all adults, except
16grandparents not receiving Medical Assistance benefits, living in a household.
SB538,7,1817 8. Terminate or reduce eligibility within 10 days of a notice to the recipient of
18a termination or reduction.
SB538,7,1919 9. Reduce the benefits of the plan under sub. (11).
SB538,7,2120 10. Require all non-pregnant individuals who have incomes above 100 percent
21of the federal poverty line to enroll in the plan under sub. (11).
SB538,7,2422 (b) The department may not reduce income levels for the purposes of
23determining eligibility for the program under this section to 133 percent of the
24federal poverty line for adults who are not pregnant and not disabled.
SB538, s. 13
1Section 13. 71.255 (6) (a) of the statutes, as affected by 2011 Wisconsin Act 32,
2is amended to read:
SB538,8,113 71.255 (6) (a) Except as provided in pars. (b), (bm), and (c) no tax credit,
4Wisconsin net business loss carry-forward, or other post-apportionment deduction
5earned by one member of the combined group, but not fully used by or allowed to that
6member, may be used in whole or in part by another member of the combined group
7or applied in whole or in part against the total income of the combined group. A
8member of a combined group may use a carry-forward of a credit, Wisconsin net
9business loss carry-forward, or other post-apportionment deduction otherwise
10allowable under s. 71.26 or 71.45, that was incurred by that same member in a
11taxable year beginning before January 1, 2009.
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