LRB-2668/1
TJD:emw
2017 - 2018 LEGISLATURE
November 30, 2017 - Introduced by Senators Erpenbach, Johnson, Bewley,
Carpenter, Hansen, Larson, Miller, Ringhand, Risser, Shilling, L. Taylor,
Vinehout and Wirch, cosponsored by Representatives Riemer, Kolste,
Anderson, Barca, Berceau, Billings, Bowen, Brostoff, Considine, Crowley,
Doyle, Fields, Genrich, Goyke, Hebl, Hesselbein, Hintz, Kessler, Mason,
Meyers, Milroy, Ohnstad, Pope, Sargent, Shankland, Sinicki, Spreitzer,
Stuck, Subeck, C. Taylor, Wachs, Zamarripa and Zepnick. Referred to
Committee on Health and Human Services.
SB606,1,3 1An Act to amend 49.45 (23) (a) and 49.471 (4) (a) 4. b.; and to create 49.471 (1)
2(cr) and 49.471 (4g) of the statutes; relating to: Medicaid expansion and
3eligibility for BadgerCare Plus and BadgerCare Plus Core.
Analysis by the Legislative Reference Bureau
This bill changes the family income eligibility level to up to 133 percent of the
federal poverty line for parents and caretaker relatives under BadgerCare Plus and
for childless adults under BadgerCare Plus Core. BadgerCare Plus and BadgerCare
Plus Core are programs under the state's Medical Assistance program, which
provides health services to individuals who have limited financial resources. The
federal Patient Protection and Affordable Care Act allows a state to receive an
enhanced federal medical assistance percentage payment for providing benefits to
certain individuals through a state's Medical Assistance program. The bill requires
the Department of Health Services to comply with all federal requirements and to
request any amendment to the state Medical Assistance plan, waiver of Medicaid
law, or other federal approval necessary to qualify for the highest available enhanced
federal medical assistance percentage for parents and caretaker relatives and
childless adults under the BadgerCare Plus and BadgerCare Plus Core programs.
If DHS does not qualify for the enhanced federal medical assistance percentage or
if the percentage is reduced, DHS is required to submit to the Joint Committee on
Finance a fiscal analysis comparing the cost of covering parents and caretaker
relatives and childless adults under the Medical Assistance program at up to 133
percent of the federal poverty line to the cost of limiting income eligibility to those

adults to up to 100 percent of the federal poverty line. DHS may reduce income
eligibility levels for those adults to up to 100 percent of the federal poverty line only
if the Joint Committee on Finance approves.
Under current law, certain parents and caretaker relatives with incomes of not
more than 100 percent of the federal poverty line, before a 5 percent income disregard
is applied, are eligible for BadgerCare Plus benefits. Under current law, childless
adults who 1) are under age 65; 2) have family incomes that do not exceed 100 percent
of the federal poverty line, before a 5 percent income disregard is applied; and 3) are
not otherwise eligible for Medical Assistance, including BadgerCare Plus, are
eligible for benefits under BadgerCare Plus Core.
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:
SB606,1 1Section 1. 49.45 (23) (a) of the statutes is amended to read:
SB606,2,92 49.45 (23) (a) The department shall request a waiver from the secretary of the
3federal department of health and human services to permit the department to
4conduct a demonstration project to provide health care coverage to adults who are
5under the age of 65, who have family incomes not to exceed 100 133 percent of the
6poverty line before application of the 5 percent income disregard under 42 CFR
7435.603 (d)
, except as provided in s. 49.471 (4g), and who are not otherwise eligible
8for medical assistance under this subchapter, the Badger Care health care program
9under s. 49.665, or Medicare under 42 USC 1395 et seq.
SB606,2 10Section 2. 49.471 (1) (cr) of the statutes is created to read:
SB606,2,1211 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
12federal medical assistance percentage described under 42 USC 1396d (y) or (z).
SB606,3 13Section 3. 49.471 (4) (a) 4. b. of the statutes is amended to read:
SB606,3,3
149.471 (4) (a) 4. b. The Except as provided in sub. (4g), the individual's family
2income does not exceed 100 133 percent of the poverty line before application of the
35 percent income disregard under 42 CFR 435.603 (d)
.
SB606,4 4Section 4. 49.471 (4g) of the statutes is created to read:
SB606,3,125 49.471 (4g) Medicaid expansion; federal medical assistance percentage. (a)
6For services provided to individuals described under sub. (4) (a) 4. and s. 49.45 (23),
7the department shall comply with all federal requirements to qualify for the highest
8available enhanced federal medical assistance percentage. The department shall
9submit any amendment to the state medical assistance plan, request for a waiver of
10federal Medicaid law, or other approval required by the federal government to
11provide services to the individuals described under sub. (4) (a) 4. and s. 49.45 (23) and
12qualify for the highest available enhanced federal medical assistance percentage.
SB606,3,2413 (b) If the department does not qualify for an enhanced federal medical
14assistance percentage, or if the enhanced federal medical assistance percentage
15obtained by the department is lower than printed in federal law as of July 1, 2013,
16for individuals eligible under sub. (4) (a) 4. or s. 49.45 (23), the department shall
17submit to the joint committee on finance a fiscal analysis comparing the cost to
18maintain coverage for adults who are not pregnant and not elderly with family
19incomes up to 133 percent of the poverty line to the cost of limiting eligibility to those
20adults with family incomes up to 100 percent of the poverty line. The department
21may reduce income eligibility for adults who are not pregnant and not elderly from
22family incomes of up to 133 percent of the poverty line to family incomes of up to 100
23percent of the poverty line only if this reduction in income eligibility levels is
24approved by the joint committee on finance.
SB606,5 25Section 5. Effective date.
SB606,4,3
1(1) Medicaid expansion. The treatment of sections 49.45 (23) (a) and 49.471 (1)
2(cr), (4) (a) 4. b., and (4g) of the statutes takes effect on January 1, 2018, or on the day
3after publication, whichever is later.
SB606,4,44 (End)
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