LRBa0346/1
TJD:wlj
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.
AB23-AA2,1,11 At the locations indicated, amend the bill as follows:
AB23-AA2,1,3 21. Page 1, line 3: after “coronavirus" insert “and eligibility expansion under
3the Medical Assistance program".
AB23-AA2,1,4 42. Page 1, line 4: before that line insert:
AB23-AA2,1,5 5 Section 1c. 20.435 (4) (jw) of the statutes is amended to read:
AB23-AA2,1,136 20.435 (4) (jw) BadgerCare Plus and hospital assessment. All moneys received
7from payment of enrollment fees under the program under s. 49.45 (23), all
moneys
8transferred under s. 50.38 (9), all moneys transferred from the appropriation account
9under par. (jz), and 10 percent of all moneys received from penalty assessments
10under s. 49.471 (9) (c), for administration of the program under s. 49.45 (23), to
11provide a portion of the state share of administrative costs for the BadgerCare Plus
12Medical Assistance program under s. 49.471, and for administration of the hospital
13assessment under s. 50.38.
AB23-AA2,1e
1Section 1e. 49.45 (2p) of the statutes is repealed.
AB23-AA2,1g 2Section 1g. 49.45 (23) of the statutes is repealed.
AB23-AA2,1h 3Section 1h. 49.45 (23b) (title) of the statutes is amended to read:
AB23-AA2,2,54 49.45 (23b) (title) Childless adults demonstration project reform waiver
5implementation required.
AB23-AA2,1j 6Section 1j. 49.45 (23b) (b) of the statutes is amended to read:
AB23-AA2,2,107 49.45 (23b) (b) Beginning as soon as practicable after October 31, 2018, and
8ending no sooner than December 31, 2023, the department shall do all of the
9following with regard to the childless adults demonstration project under sub. (23)
10s. 49.471 (4) (a) 8.:
AB23-AA2,2,1611 1. Require in each month persons, except exempt individuals, who are eligible
12to receive Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. and who are at least
1319 years of age but have not attained the age of 50 to participate in, document, and
14report 80 hours per calendar month of community engagement activities. The
15department, after finding good cause, may grant a temporary exemption from the
16requirement under this subdivision upon request of a Medical Assistance recipient.
AB23-AA2,2,1917 2. Require persons with incomes of at least 50 percent of the poverty line to pay
18premiums in accordance with par. (c) as a condition of eligibility for Medical
19Assistance under sub. (23) s. 49.471 (4) (a) 8.
AB23-AA2,2,2120 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.
AB23-AA2,2,2422 4. Charge recipients of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
23an $8 copayment for nonemergency use of the emergency department in accordance
24with 42 USC 1396o-1 (e) (1) and 42 CFR 447.54.
AB23-AA2,3,5
15. Disenroll from Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. for 6
2months any individual who does not pay a required premium under subd. 2. and any
3individual who is required under subd. 1. to participate in a community engagement
4activity but who does not participate for 48 aggregate months in the community
5engagement activity.
AB23-AA2,1k 6Section 1k. 49.45 (23b) (c) of the statutes is amended to read:
AB23-AA2,3,127 49.45 (23b) (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
950 percent of the poverty line shall pay a monthly premium amount of $8 per
10household. A person who is eligible to receive an item or service furnished by an
11Indian health care provider is exempt from the premium requirement under this
12subdivision.
AB23-AA2,3,1813 2. The department may disenroll under par. (b) 5. a person for nonpayment of
14a required monthly premium only at annual eligibility redetermination after
15providing notice and reasonable opportunity for the person to pay. If a person who
16is disenrolled for nonpayment of premiums pays all owed premiums or becomes
17exempt from payment of premiums, he or she may reenroll in Medical Assistance
18under sub. (23) s. 49.471 (4) (a) 8.
AB23-AA2,3,2219 3. The department shall reduce the amount of the required household premium
20by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
21who does not engage in certain behaviors that increase health risks or who attests
22to actively managing certain unhealthy behaviors.
AB23-AA2,1m 23Section 1m. 49.45 (23b) (e) of the statutes is amended to read:
AB23-AA2,4,324 49.45 (23b) (e) Before December 31, 2023, the demonstration project
25requirements under this subsection may not be withdrawn and the department may

1not request from the federal government withdrawal, suspension, or termination of
2the demonstration project requirements under this subsection unless legislation has
3been enacted specifically allowing for the withdrawal, suspension, or termination.
AB23-AA2,1p 4Section 1p. 49.471 (1) (cr) of the statutes is created to read:
AB23-AA2,4,65 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
6federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB23-AA2,1q 7Section 1q. 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB23-AA2,4,108 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133
9percent of the poverty line before application of the 5 percent income disregard under
1042 CFR 435.603 (d)
.
AB23-AA2,1r 11Section 1r. 49.471 (4) (a) 8. of the statutes is created to read:
AB23-AA2,4,1212 49.471 (4) (a) 8. An individual who meets all of the following criteria:
AB23-AA2,4,1313 a. The individual is an adult under the age of 65.
AB23-AA2,4,1514 b. The individual has a family income that does not exceed 133 percent of the
15poverty line, except as provided in sub. (4g).
AB23-AA2,4,1716 c. The individual is not otherwise eligible for the Medical Assistance program
17under this subchapter or the Medicare program under 42 USC 1395 et seq.
AB23-AA2,1s 18Section 1s. 49.471 (4g) of the statutes is created to read:
AB23-AA2,5,319 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
20services provided to individuals described under sub. (4) (a) 8., the department shall
21comply with all federal requirements to qualify for the highest available enhanced
22federal medical assistance percentage. The department shall submit any
23amendment to the state medical assistance plan, request for a waiver of federal
24Medicaid law, or other approval request required by the federal government to
25provide services to the individuals described under sub. (4) (a) 8. and qualify for the

1highest available enhanced federal medical assistance percentage. Sections 20.940
2and 49.45 (2t) do not apply to a submission to the federal government under this
3subsection.
AB23-AA2,1t 4Section 1t. 49.686 (3) (d) of the statutes is amended to read:
AB23-AA2,5,105 49.686 (3) (d) Has applied for coverage under and has been denied eligibility
6for medical assistance within 12 months prior to application for reimbursement
7under sub. (2). This paragraph does not apply to an individual who is eligible for
8benefits 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 (11).”.
AB23-AA2,5,11 113. Page 2, line 4: after that line insert:
AB23-AA2,5,12 12 Section 3. Nonstatutory provisions.
AB23-AA2,5,21 13(1) Childless adults demonstration project. The department of health
14services shall submit any necessary request to the federal department of health and
15human services for a state plan amendment or waiver of federal Medicaid law or to
16modify or withdraw from any waiver of federal Medicaid law relating to the childless
17adults demonstration project under s. 49.45 (23), 2019 stats., to reflect the
18incorporation of recipients of Medical Assistance under the demonstration project
19into the BadgerCare Plus program under s. 49.471 and the termination of the
20demonstration project. Sections 20.940 and 49.45 (2t) do not apply to a submission
21to the federal government under this subsection.
AB23-AA2,6,2 22(2) Funding for health care. The department of health services shall ensure
23that any increased funding that results from this act is used to improve access to and

1affordability of health care and to support health care quality for residents of this
2state.
AB23-AA2,4 3Section 4. Fiscal changes.
AB23-AA2,6,104 (1) Medicaid expansion. In the schedule under s. 20.005 (3) for the
5appropriation to the department of health services under s. 20.435 (4) (b), the dollar
6amount for fiscal year 2021-22 is decreased by $849,788,000 as a result of expanding
7eligibility for the Medical Assistance program. In the schedule under s. 20.005 (3)
8for the appropriation to the department of health services under s. 20.435 (4) (b), the
9dollar amount for fiscal year 2022-23 is decreased by $841,925,400 as a result of
10expanding eligibility for the Medical Assistance program.
AB23-AA2,5 11Section 5. Effective dates. This act takes effect on the day after publication,
12except as follows:
AB23-AA2,6,15 13(1) Medicaid expansion. The treatment of ss. 20.435 (4) (jw), 49.45 (2p), (23),
14and (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.”.
AB23-AA2,6,1616 (End)
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