2021 - 2022 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 238
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
20.395 (2) (fd), 49.471 (1) (cr), 49.471 (4) (a) 8., 4
49.471 (4g) and 86.313 of the statutes;
relating to: local highways and bridges
5supplement, eligibility expansion under the Medical Assistance program, and
6making an appropriation.
Analysis by the Legislative Reference Bureau
This bill expands eligibility under the state's Medical Assistance program and
creates a local highways and bridges supplement 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. 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
Local highways and bridges supplement
This bill requires the Department of Transportation to administer a local
highways and bridges supplement program. Under the program, DOT awards
grants to municipalities and counties to fund qualifying improvement projects on
highways or bridges under the jurisdiction of the municipality or county. A
qualifying improvement project under the program is a highway or bridge
construction project for which no federal funds are expended and that is any of the
1. Eligible for funding under the local bridge improvement assistance program.
2. Eligible for funding under the local roads improvement discretionary grant
3. A project to increase the load-bearing capacity of a bridge.
The bill appropriates $617,039,600 from the general fund for this program. The
bill provides $288,000,000 for grants to counties. Not more than $4,000,000 of this
amount may be paid to each county. The bill also provides $329,039,600 for grants
to municipalities. Each municipality may be paid no more than the amount
calculated by multiplying the number of miles of highways under the jurisdiction of
the municipality for calendar year 2020 by $4,000. Under the bill, DOT may not
provide grants under the program after December 31, 2024.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
20.395 (2) (fd) of the statutes is created to read:
(fd) Local highways and bridges supplement.
From the general fund, 3
as a continuing appropriation, the amounts in the schedule for the local highways 4
and bridges supplement program under s. 86.313.
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 2
ending no sooner than December 31, 2023, the department shall do all of the 3
following with regard to the
under sub. (23)
4s. 49.471 (4) (a) 8.
1. Require in each month persons, except exempt individuals, who are eligible 6
to receive Medical Assistance under sub. (23)
s. 49.471 (4) (a) 8.
and who are at least 7
19 years of age but have not attained the age of 50 to participate in, document, and 8
report 80 hours per calendar month of community engagement activities. The 9
department, after finding good cause, may grant a temporary exemption from the 10
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 12
premiums in accordance with par. (c) as a condition of eligibility for Medical 13
Assistance under sub. (23) s. 49.471 (4) (a) 8
3. Require as a condition of eligibility for Medical Assistance under
sub. (23) 15s. 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 18
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 20
months any individual who does not pay a required premium under subd. 2. and any 21
individual who is required under subd. 1. to participate in a community engagement 22
activity but who does not participate for 48 aggregate months in the community 23
49.45 (23b) (c) of the statutes is amended to read:
(c) 1. Persons who are eligible
for the demonstration project
under 2sub. (23) s. 49.471 (4) (a) 8.
and who have monthly household income that exceeds 3
50 percent of the poverty line shall pay a monthly premium amount of $8 per 4
household. A person who is eligible to receive an item or service furnished by an 5
Indian health care provider is exempt from the premium requirement under this 6
2. The department may disenroll under par. (b) 5. a person for nonpayment of 8
a required monthly premium only at annual eligibility redetermination after 9
providing notice and reasonable opportunity for the person to pay. If a person who 10
is disenrolled for nonpayment of premiums pays all owed premiums or becomes 11
exempt from payment of premiums, he or she may reenroll in Medical Assistance 12
under sub. (23) s. 49.471 (4) (a) 8
3. The department shall reduce the amount of the required household premium 14
by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. 15
who does not engage in certain behaviors that increase health risks or who attests 16
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 19
requirements under this subsection may not be withdrawn and the department may 20
not request from the federal government withdrawal, suspension, or termination of 21
the demonstration project
requirements under this subsection unless legislation has 22
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 25
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 3
percent of the poverty line before application of the 5 percent income disregard under
442 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 9
poverty line, except as provided in sub. (4g).
c. The individual is not otherwise eligible for the Medical Assistance program 11
under this subchapter or the Medicare program under 42 USC 1395