2021 - 2022 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 239
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., 49.686 3
(3) (d) and 196.504 (2) (a); and to create
20.155 (3) (a), 49.471 (1) (cr), 49.471 4
(4) (a) 8. and 49.471 (4g) of the statutes; relating to: eligibility expansion under
5the Medical Assistance program, broadband expansion grants, and making an
Analysis by the Legislative Reference Bureau
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
Broadband expansion grants
The bill also provides $1,000,000,000 in general purpose revenue funding for
the broadband expansion grant program administered by the Public Service
Commission. Under current law, the PSC makes grants to eligible applicants for
constructing broadband infrastructure in underserved areas designated by the PSC.
The bill's appropriation is in addition to appropriations from the universal service
fund for the grants under current law.
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
20.155 (3) (a) of the statutes is created to read:
(a) Broadband expansion grants; general purpose revenue.
As a 2
continuing appropriation, the amounts in the schedule for broadband expansion 3
grants under s. 196.504 (2).
20.435 (4) (jw) of the statutes is amended to read:
(jw) BadgerCare Plus and hospital assessment.
All moneys received
6from 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 8
under par. (jz), and 10 percent of all moneys received from penalty assessments 9
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 11
Medical Assistance program under s. 49.471,
and for administration of the hospital 12
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 20
ending no sooner than December 31, 2023, the department shall do all of the 21
following with regard to the
under sub. (23)
22s. 49.471 (4) (a) 8.
1. Require in each month persons, except exempt individuals, who are eligible 24
to receive Medical Assistance under sub. (23)
s. 49.471 (4) (a) 8.
and who are at least 25
19 years of age but have not attained the age of 50 to participate in, document, and
report 80 hours per calendar month of community engagement activities. The 2
department, after finding good cause, may grant a temporary exemption from the 3
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 5
premiums in accordance with par. (c) as a condition of eligibility for Medical 6
Assistance under sub. (23) s. 49.471 (4) (a) 8
3. Require as a condition of eligibility for Medical Assistance under
sub. (23) 8s. 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 11
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 13
months any individual who does not pay a required premium under subd. 2. and any 14
individual who is required under subd. 1. to participate in a community engagement 15
activity but who does not participate for 48 aggregate months in the community 16
49.45 (23b) (c) of the statutes is amended to read:
(c) 1. Persons who are eligible for the demonstration project
under 19sub. (23) s. 49.471 (4) (a) 8.
and who have monthly household income that exceeds 20
50 percent of the poverty line shall pay a monthly premium amount of $8 per 21
household. A person who is eligible to receive an item or service furnished by an 22
Indian health care provider is exempt from the premium requirement under this 23
2. The department may disenroll under par. (b) 5. a person for nonpayment of 25
a required monthly premium only at annual eligibility redetermination after
providing notice and reasonable opportunity for the person to pay. If a person who 2
is disenrolled for nonpayment of premiums pays all owed premiums or becomes 3
exempt from payment of premiums, he or she may reenroll in Medical Assistance 4
under sub. (23) s. 49.471 (4) (a) 8
3. The department shall reduce the amount of the required household premium 6
by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. 7
who does not engage in certain behaviors that increase health risks or who attests 8
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 11
requirements under this subsection may not be withdrawn and the department may 12
not request from the federal government withdrawal, suspension, or termination of 13
the demonstration project
requirements under this subsection unless legislation has 14
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 17
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 20
percent of the poverty line before application of the 5 percent income disregard under
2142 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 2
poverty line, except as provided in sub. (4g).
c. The individual is not otherwise eligible for the Medical Assistance program 4
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 8
comply with all federal requirements to qualify for the highest available enhanced 9
federal medical assistance percentage. The department shall submit any 10
amendment to the state medical assistance plan, request for a waiver of federal 11
Medicaid law, or other approval request required by the federal government to 12
provide services to the individuals described under sub. (4) (a) 8. and qualify for the 13
highest available enhanced federal medical assistance percentage. Sections 20.940 14
and 49.45 (2t) do not apply to a submission to the federal government under this 15
49.686 (3) (d) of the statutes is amended to read:
(d) Has applied for coverage under and has been denied eligibility 18
for medical assistance within 12 months prior to application for reimbursement 19
under sub. (2). This paragraph does not apply to an individual who is eligible for 20
benefits under the demonstration project for childless adults under s. 49.45 (23) or 21to an individual who is eligible for benefits under
BadgerCare Plus under s. 49.471 22(4) (a) 8. or
196.504 (2) (a) of the statutes is amended to read: