2021 - 2022 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 243
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
20.370 (6) (ca), 49.471 (1) (cr), 49.471 (4) (a) 8., 4
49.471 (4g) and 281.73 of the statutes;
relating to: medical assistance
5eligibility, well testing, lead service line replacement, nonpoint source water
6pollution abatement, well compensation grants, granting rule-making
7authority, and making an appropriation.
Analysis by the Legislative Reference Bureau
Eligibility for medical assistance
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
Lead service line replacement
Under current law, the Department of Administration and the Department of
Natural Resources administer the Safe Drinking Water Loan Program (SDWLP),
which provides low-interest loans and grants in the form of principal forgiveness to
municipalities for drinking water infrastructure projects to help them comply with
federal drinking water standards. DNR establishes a funding list for SDWLP
projects, and DOA allocates funding for those projects. The current program does not
provide financial assistance to private users of public water systems.
The bill appropriates $80,000,000 to DOA in fiscal year 2021-22 to provide
principal forgiveness to municipalities to cover up to 50 percent of the costs of lead
service line replacement on private property or principal forgiveness to
municipalities to provide grants to private users of public water systems to cover up
to 50 percent of the costs of lead service line replacement on private property.
Urban nonpoint source program
Under current law, DNR administers a program to provide financial assistance
for projects that manage urban storm water and runoff. The bill appropriates
$24,000,000 to DNR for this program.
Rural nonpoint source program
Under current law, DNR administers a program to provide financial assistance
for projects that control pollution that comes from diffuse sources, rather than from
a single concentrated discharge of pollution, in areas that qualify as high priority due
to water quality problems. The bill appropriates $13,000,000 to DNR for this
Well compensation grant program
Under the well compensation grant program under current law, certain
individual owners or renters of certain contaminated private wells may apply for a
grant from DNR to cover a portion of the costs to treat the water, reconstruct the well,
construct a new well, connect to a public water supply, or fill and seal the well. The
bill appropriates $4,000,000 to DNR for this program.
Grants for well testing and public education
The bill requires DNR to create and administer a program to provide grants to
counties to either 1) test and map privately owned wells to assess groundwater
quality and determine the extent and type of any contamination and study and map
geologic characteristics and well construction practices in the county to determine
any correlation between water quality, geology, and well construction; or 2) if a
county has completed this type of study, notify the public of the results of the study
and notify private well owners whose wells may be contaminated based on the results
of the completed study. Under the bill, DNR may not provide more than $10,000 to
any single county for testing and study under the first type of grant nor more than
$2,500 per county for notifications under the second type of grant. Counties may
apply for a grant individually or as a group. The bill requires a county that receives
a grant under this program to provide an equal amount of matching funds. The
county must also share the results of its testing with the Center for Watershed
Science and Education, but may not include any personally identifiable information
with the submitted results. The bill appropriates $1,000,000 to DNR for this
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
20.370 (6) (ca) of the statutes is created to read:
(ca) Environmental aids
— county grants for testing wells.
As a 5
continuing appropriation, the amounts in the schedule to provide grants to counties 6
for testing privately owned wells and providing education under s. 281.73.
20.435 (4) (jw) of the statutes is amended to read:
(jw) BadgerCare Plus and hospital assessment.
All moneys received
2from 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 4
under par. (jz), and 10 percent of all moneys received from penalty assessments 5
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 7
Medical Assistance program under s. 49.471,
and for administration of the hospital 8
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 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: