2021 - 2022 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 234
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
49.471 (1) (cr), 49.471 (4) (a) 8. and 49.471 (4g) of 4
the statutes; relating to: tourism industry grants, eligibility expansion under
5the Medical Assistance program, and making an appropriation.
Analysis by the Legislative Reference Bureau
Tourism promotion and development organization grants
This bill requires the Department of Tourism to award grants to nonprofit
organizations whose primary purpose is the promotion and development of tourism
in Wisconsin to assist those organizations to remain operational in the wake of the
COVID-19 global pandemic. The bill further requires the Department of Tourism
to award grants to such nonprofit organizations and to certain governmental
organizations also having that same primary purpose for purposes of tourism
marketing in connection with Wisconsin's recovery from the COVID-19 global
A nonprofit or governmental organization receiving a grant under the bill, as
specified above, may not receive grants totalling more than $1,000,000 or 50 percent
of the organization's average annual tourism marketing budget over the previous
three years, not including 2020. The bill appropriates $100,000,000 in general
purpose revenue for the grants.
Amusement industry grants
The bill requires the Department of Tourism to award grants to organizations
that own or operate amusement or theme parks in Wisconsin for purposes of
short-term tourism marketing in connection with the organization's recovery from
the COVID-19 global pandemic. The bill limits each grant to 50 percent of the
organization's average annual tourism marketing budget over the previous three
years, not including 2020. The bill appropriates $50,000,000 in general purpose
revenue for the grants.
Eligibility expansion under the Medical Assistance program
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 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 the 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:
20.435 (4) (jw) of the statutes is amended to read:
(jw) BadgerCare Plus and hospital assessment.
All moneys received
3from 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 2
under par. (jz), and 10 percent of all moneys received from penalty assessments 3
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 5
Medical Assistance program under s. 49.471,
and for administration of the hospital 6
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 14
ending no sooner than December 31, 2023, the department shall do all of the 15
following with regard to the
under sub. (23)
16s. 49.471 (4) (a) 8.
1. Require in each month persons, except exempt individuals, who are eligible 18
to receive Medical Assistance under sub. (23)
s. 49.471 (4) (a) 8.
and who are at least 19
19 years of age but have not attained the age of 50 to participate in, document, and 20
report 80 hours per calendar month of community engagement activities. The 21
department, after finding good cause, may grant a temporary exemption from the 22
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 24
premiums in accordance with par. (c) as a condition of eligibility for Medical 25
Assistance under sub. (23) s. 49.471 (4) (a) 8
3. Require as a condition of eligibility for Medical Assistance under sub. (23) 2s. 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. 4
an $8 copayment for nonemergency use of the emergency department in accordance 5
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 7
months any individual who does not pay a required premium under subd. 2. and any 8
individual who is required under subd. 1. to participate in a community engagement 9
activity but who does not participate for 48 aggregate months in the community 10
49.45 (23b) (c) of the statutes is amended to read:
(c) 1. Persons who are eligible for the demonstration project
under 13sub. (23) s. 49.471 (4) (a) 8.
and who have monthly household income that exceeds 14
50 percent of the poverty line shall pay a monthly premium amount of $8 per 15
household. A person who is eligible to receive an item or service furnished by an 16
Indian health care provider is exempt from the premium requirement under this 17
2. The department may disenroll under par. (b) 5. a person for nonpayment of 19
a required monthly premium only at annual eligibility redetermination after 20
providing notice and reasonable opportunity for the person to pay. If a person who 21
is disenrolled for nonpayment of premiums pays all owed premiums or becomes 22
exempt from payment of premiums, he or she may reenroll in Medical Assistance 23
under sub. (23) s. 49.471 (4) (a) 8
3. The department shall reduce the amount of the required household premium 25
by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
who does not engage in certain behaviors that increase health risks or who attests 2
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 5
requirements under this subsection may not be withdrawn and the department may 6
not request from the federal government withdrawal, suspension, or termination of 7
the demonstration project
requirements under this subsection unless legislation has 8
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 11
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 14
percent of the poverty line before application of the 5 percent income disregard under
1542 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 20
poverty line, except as provided in sub. (4g).
c. The individual is not otherwise eligible for the Medical Assistance program 22
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
comply with all federal requirements to qualify for the highest available enhanced 2
federal medical assistance percentage. The department shall submit any 3
amendment to the state medical assistance plan, request for a waiver of federal 4
Medicaid law, or other approval request required by the federal government to 5
provide services to the individuals described under sub. (4) (a) 8. and qualify for the 6
highest available enhanced federal medical assistance percentage. Sections 20.940 7
and 49.45 (2t) do not apply to a submission to the federal government under this 8
49.686 (3) (d) of the statutes is amended to read:
(d) Has applied for coverage under and has been denied eligibility 11
for medical assistance within 12 months prior to application for reimbursement 12
under sub. (2). This paragraph does not apply to an individual
who is eligible for
13benefits under the demonstration project for childless adults under s. 49.45 (23) or
14to an individual
who is eligible for benefits under BadgerCare Plus under s. 49.471 15(4) (a) 8. or