2021 - 2022 LEGISLATURE
ASSEMBLY AMENDMENT 2,
TO ASSEMBLY BILL 23
March 23, 2021 - Offered by Representatives Riemer, S. Rodriguez, Anderson,
Andraca, Baldeh, Billings, Bowen, Brostoff, Cabrera, Conley, Considine,
Doyle, Drake, Emerson, Goyke, Haywood, Hebl, Hesselbein, Hintz, Hong,
McGuire, B. Meyers, Milroy, Moore Omokunde, L. Myers, Neubauer,
Ohnstad, Ortiz-Velez, Pope, Shankland, Shelton, Sinicki, Snodgrass,
Spreitzer, Stubbs, Subeck, Vining and Vruwink.
20.435 (4) (jw) of the statutes is amended to read:
(jw) BadgerCare Plus and hospital assessment.
All moneys received
7from payment of enrollment fees under the program under s. 49.45 (23), all
transferred under s. 50.38 (9), all moneys transferred from the appropriation account 9
under par. (jz), and 10 percent of all moneys received from penalty assessments 10
under s. 49.471 (9) (c), for administration of the program under s. 49.45 (23),
provide a portion of the state share of administrative costs for the BadgerCare Plus 12
Medical Assistance program under s. 49.471,
and for administration of the hospital 13
assessment under s. 50.38.
49.45 (2p) of the statutes is repealed.
49.45 (23) of the statutes is repealed.
49.45 (23b) (title) of the statutes is amended to read:
(title) Childless adults
demonstration project reform waiver
49.45 (23b) (b) of the statutes is amended to read:
(b) Beginning as soon as practicable after October 31, 2018, and 8
ending no sooner than December 31, 2023, the department shall do all of the 9
following with regard to the
under sub. (23)
10s. 49.471 (4) (a) 8.
1. Require in each month persons, except exempt individuals, who are eligible 12
to receive Medical Assistance under sub. (23)
s. 49.471 (4) (a) 8.
and who are at least 13
19 years of age but have not attained the age of 50 to participate in, document, and 14
report 80 hours per calendar month of community engagement activities. The 15
department, after finding good cause, may grant a temporary exemption from the 16
requirement under this subdivision upon request of a Medical Assistance recipient.
2. Require persons with incomes of at least 50 percent of the poverty line to pay 18
premiums in accordance with par. (c) as a condition of eligibility for Medical 19
Assistance under sub. (23) s. 49.471 (4) (a) 8
3. Require as a condition of eligibility for Medical Assistance under
sub. (23) 21s. 49.471 (4) (a) 8.
completion of a health risk assessment.
4. Charge recipients of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
an $8 copayment for nonemergency use of the emergency department in accordance 24
with 42 USC 1396o-1
(e) (1) and 42 CFR 447.54
5. Disenroll from Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
for 6 2
months any individual who does not pay a required premium under subd. 2. and any 3
individual who is required under subd. 1. to participate in a community engagement 4
activity but who does not participate for 48 aggregate months in the community 5
49.45 (23b) (c) of the statutes is amended to read:
(c) 1. Persons who are eligible
for the demonstration project
under 8sub. (23) s. 49.471 (4) (a) 8.
and who have monthly household income that exceeds 9
50 percent of the poverty line shall pay a monthly premium amount of $8 per 10
household. A person who is eligible to receive an item or service furnished by an 11
Indian health care provider is exempt from the premium requirement under this 12
2. The department may disenroll under par. (b) 5. a person for nonpayment of 14
a required monthly premium only at annual eligibility redetermination after 15
providing notice and reasonable opportunity for the person to pay. If a person who 16
is disenrolled for nonpayment of premiums pays all owed premiums or becomes 17
exempt from payment of premiums, he or she may reenroll in Medical Assistance 18
under sub. (23) s. 49.471 (4) (a) 8
3. The department shall reduce the amount of the required household premium 20
by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. 21
who does not engage in certain behaviors that increase health risks or who attests 22
to actively managing certain unhealthy behaviors.
49.45 (23b) (e) of the statutes is amended to read:
(e) Before December 31, 2023, the
demonstration project 25
requirements under this subsection may not be withdrawn and the department may
not request from the federal government withdrawal, suspension, or termination of 2
the demonstration project
requirements under this subsection unless legislation has 3
been enacted specifically allowing for the withdrawal, suspension, or termination.
49.471 (1) (cr) of the statutes is created to read:
(cr) “Enhanced federal medical assistance percentage" means a 6
federal medical assistance percentage described under 42 USC 1396d
(y) or (z).
49.471 (4) (a) 4. b. of the statutes is amended to read:
(a) 4. b. The individual's family income does not exceed 100 133 9
percent of the poverty line before application of the 5 percent income disregard under
1042 CFR 435.603 (d)
49.471 (4) (a) 8. of the statutes is created to read:
(a) 8. An individual who meets all of the following criteria:
a. The individual is an adult under the age of 65.
b. The individual has a family income that does not exceed 133 percent of the 15
poverty line, except as provided in sub. (4g).
c. The individual is not otherwise eligible for the Medical Assistance program 17
under this subchapter or the Medicare program under 42 USC 1395
49.471 (4g) of the statutes is created to read:
49.471 (4g) Medicaid expansion; federal medical assistance percentage.
services provided to individuals described under sub. (4) (a) 8., the department shall 21
comply with all federal requirements to qualify for the highest available enhanced 22
federal medical assistance percentage. The department shall submit any 23
amendment to the state medical assistance plan, request for a waiver of federal 24
Medicaid law, or other approval request required by the federal government to 25
provide services to the individuals described under sub. (4) (a) 8. and qualify for the
highest available enhanced federal medical assistance percentage. Sections 20.940 2
and 49.45 (2t) do not apply to a submission to the federal government under this 3
49.686 (3) (d) of the statutes is amended to read:
(d) Has applied for coverage under and has been denied eligibility 6
for medical assistance within 12 months prior to application for reimbursement 7
under sub. (2). This paragraph does not apply to an individual who is eligible for 8
benefits under the demonstration project for childless adults under s. 49.45 (23) or 9to an individual who is eligible for benefits under
BadgerCare Plus under s. 49.471 10(4) (a) 8. or
13(1) Childless adults demonstration project.
The department of health 14
services shall submit any necessary request to the federal department of health and 15
human services for a state plan amendment or waiver of federal Medicaid law or to 16
modify or withdraw from any waiver of federal Medicaid law relating to the childless 17
adults demonstration project under s. 49.45 (23), 2019 stats., to reflect the 18
incorporation of recipients of Medical Assistance under the demonstration project 19
into the BadgerCare Plus program under s. 49.471 and the termination of the 20
demonstration project. Sections 20.940 and 49.45 (2t) do not apply to a submission 21
to the federal government under this subsection.
22(2) Funding for health care.
The department of health services shall ensure 23
that any increased funding that results from this act is used to improve access to and
affordability of health care and to support health care quality for residents of this 2
(1) Medicaid expansion.
In the schedule under s. 20.005 (3) for the 5
appropriation to the department of health services under s. 20.435 (4) (b), the dollar 6
amount for fiscal year 2021-22 is decreased by $849,788,000 as a result of expanding 7
eligibility for the Medical Assistance program. In the schedule under s. 20.005 (3) 8
for the appropriation to the department of health services under s. 20.435 (4) (b), the 9
dollar amount for fiscal year 2022-23 is decreased by $841,925,400 as a result of 10
expanding eligibility for the Medical Assistance program.
This act takes effect on the day after publication, 12
except as follows:
13(1) Medicaid expansion.
The treatment of ss. 20.435 (4) (jw), 49.45 (2p), (23), 14
and (23b) (title), (b), (c), and (e), 49.471 (1) (cr), (4) (a) 4. b. and 8. and (4g), and 49.686 15
(3) (d) and Sections
3 and 4 of this act take effect on July 1, 2021.”.