2021 - 2022 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 233
April 13, 2021 - Offered by Representatives Anderson, Baldeh,
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,
Riemer, S. Rodriguez, Shankland, Shelton, Sinicki, Snodgrass, Spreitzer,
Stubbs, Subeck, Vining and Vruwink.
1An Act to repeal
49.45 (2p) and 49.45 (23); to amend
20.435 (4) (jw), 49.45 (23b) 2
(title), 49.45 (23b) (b), 49.45 (23b) (c), 49.45 (23b) (e), 49.471 (4) (a) 4. b. and 3
49.686 (3) (d); and to create
20.835 (2) (ba), 49.471 (1) (cr), 49.471 (4) (a) 8. and 4
49.471 (4g) of the statutes; relating to: grants for certain small businesses,
5eligibility expansion under the Medical Assistance program, and making an
Analysis by the Legislative Reference Bureau
Small business grants
This bill requires the Department of Revenue to provide grants to businesses
in this state that had total sales in 2019 of less than $7 million and suffered economic
damage as a result of the COVID-19 pandemic. Under the bill, the total amount of
the grants to be awarded to all recipients is $600 million.
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. 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 currently covered under BadgerCare Plus Core and who are
incorporated into BadgerCare Plus in this bill. 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 childless adults under the BadgerCare Plus
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 the 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. The bill eliminates the childless
adults demonstration project, known as BadgerCare Plus Core, as a separate
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
20.005 (3) (schedule) of the statutes: at the appropriate place, insert 2
the following amounts for the purposes indicated:
- See PDF for table
20.435 (4) (jw) of the statutes is amended to read:
(jw) BadgerCare Plus and hospital assessment.
All moneys received
5from 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 7
under par. (jz), and 10 percent of all moneys received from penalty assessments
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 3
Medical Assistance program under s. 49.471,
and for administration of the hospital 4
assessment under s. 50.38.
20.835 (2) (ba) of the statutes is created to read:
(ba) Small business grants
. Biennially, the amounts in the schedule 7
to make the small business grants under 2021 Wisconsin Act .... (this act), section 8
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 16
ending no sooner than December 31, 2023, the department shall do all of the 17
following with regard to the
under sub. (23)
18s. 49.471 (4) (a) 8.
1. Require in each month persons, except exempt individuals, who are eligible 20
to receive Medical Assistance under sub. (23)
s. 49.471 (4) (a) 8.
and who are at least 21
19 years of age but have not attained the age of 50 to participate in, document, and 22
report 80 hours per calendar month of community engagement activities. The 23
department, after finding good cause, may grant a temporary exemption from the 24
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 2
premiums in accordance with par. (c) as a condition of eligibility for Medical 3
Assistance under sub. (23) s. 49.471 (4) (a) 8
3. Require as a condition of eligibility for Medical Assistance under
sub. (23) 5s. 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 8
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 10
months any individual who does not pay a required premium under subd. 2. and any 11
individual who is required under subd. 1. to participate in a community engagement 12
activity but who does not participate for 48 aggregate months in the community 13
49.45 (23b) (c) of the statutes is amended to read:
(c) 1. Persons who are eligible for the demonstration project
under 16sub. (23) s. 49.471 (4) (a) 8.
and who have monthly household income that exceeds 17
50 percent of the poverty line shall pay a monthly premium amount of $8 per 18
household. A person who is eligible to receive an item or service furnished by an 19
Indian health care provider is exempt from the premium requirement under this 20
2. The department may disenroll under par. (b) 5. a person for nonpayment of 22
a required monthly premium only at annual eligibility redetermination after 23
providing notice and reasonable opportunity for the person to pay. If a person who 24
is disenrolled for nonpayment of premiums pays all owed premiums or becomes
exempt from payment of premiums, he or she may reenroll in Medical Assistance 2
under sub. (23) s. 49.471 (4) (a) 8
3. The department shall reduce the amount of the required household premium 4
by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. 5
who does not engage in certain behaviors that increase health risks or who attests 6
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 9
requirements under this subsection may not be withdrawn and the department may 10
not request from the federal government withdrawal, suspension, or termination of 11
the demonstration project
requirements under this subsection unless legislation has 12
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 15
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 18
percent of the poverty line before application of the 5 percent income disregard under
1942 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 24
poverty line, except as provided in sub. (4g).
c. The individual is not otherwise eligible for the Medical Assistance program 2
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 6
comply with all federal requirements to qualify for the highest available enhanced 7
federal medical assistance percentage. The department shall submit any 8
amendment to the state medical assistance plan, request for a waiver of federal 9
Medicaid law, or other approval request required by the federal government to 10
provide services to the individuals described under sub. (4) (a) 8. and qualify for the 11
highest available enhanced federal medical assistance percentage. Sections 20.940 12
and 49.45 (2t) do not apply to a submission to the federal government under this 13
49.686 (3) (d) of the statutes is amended to read:
(d) Has applied for coverage under and has been denied eligibility 16
for medical assistance within 12 months prior to application for reimbursement 17
under sub. (2). This paragraph does not apply to an individual who is eligible for 18
benefits under the demonstration project for childless adults under s. 49.45 (23) or 19to an individual who is eligible for benefits under
BadgerCare Plus under s. 49.471 20(4) (a) 8. or
(1) Childless adults demonstration project.
The department of health 23
services shall submit any necessary request to the federal department of health and 24
human services for a state plan amendment or waiver of federal Medicaid law or to 25
modify or withdraw from any waiver of federal Medicaid law relating to the childless
adults demonstration project under s. 49.45 (23), 2019 stats., to reflect the 2
incorporation of recipients of Medical Assistance under the demonstration project 3
into the BadgerCare Plus program under s. 49.471 and the termination of the 4
demonstration project. Sections 20.940 and 49.45 (2t) do not apply to a submission 5
to the federal government under this subsection.
Small business grants.
(a) Subject to par. (b), the department of revenue shall provide grants to any 9
establishment that has its primary business activity in this state.
An establishment described under par. (a
) may receive a payment under this 11
subsection by filing an application with the department of revenue in the manner 12
determined by the department. An establishment that satisfies all of following 13
criteria is eligible to receive a payment under this subsection:
1. It holds a valid business tax registration certificate issued under s. 73.03 15
2. It had total sales of less than $7,000,000, as reported on its 2019 state sales 17
3. It suffered economic damages in 2020 as a result of the COVID-19 pandemic.
4. It is not on the department of revenue's list of delinquent taxpayers.
5. It is not listed in the certification made by the department of revenue under 21
6. It is not on the department of transportation's debarred contractors list.
(1) Medicaid expansion.
In the schedule under s. 20.005 (3) for the 25
appropriation to the department of health services under s. 20.435 (4) (b), the dollar
amount for fiscal year 2021-22 is decreased by $849,788,000 as a result of expanding 2
eligibility for the Medical Assistance program. In the schedule under s. 20.005 (3) 3
for the appropriation to the department of health services under s. 20.435 (4) (b), the 4
dollar amount for fiscal year 2022-23 is decreased by $841,925,400 as a result of 5
expanding eligibility for the Medical Assistance program.
Effective dates; Health Services. This act takes effect on the
7day after publication, except as follows:
(1) Medicaid expansion.
The treatment of ss. 20.435 (4) (jw), 49.45 (2p), (23), 9
and (23b) (title), (b), (c), and (e), 49.471 (1) (cr), (4) (a) 4. b. and 8. and (4g), and 49.686 10
(3) (d) and Sections
) and 9219 (1) of this act take effect on July 1, 2021.