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2021 - 2022 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 233
April 13, 2021 - Offered by Representatives Anderson, Baldeh, Billings, Bowen,
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.
AB233-ASA1,1,6 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
349.686 (3) (d); and to create 20.835 (2) (ba), 49.471 (1) (cr), 49.471 (4) (a) 8. and
449.471 (4g) of the statutes; relating to: grants for certain small businesses,
5eligibility expansion under the Medical Assistance program, and making an
6appropriation.
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.
Medicaid expansion
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
program.
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
program.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB233-ASA1,1 1Section 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
2the following amounts for the purposes indicated: - See PDF for table PDF
AB233-ASA1,2 3Section 2. 20.435 (4) (jw) of the statutes is amended to read:
AB233-ASA1,3,44 20.435 (4) (jw) BadgerCare Plus and hospital assessment. All moneys received
5from payment of enrollment fees under the program under s. 49.45 (23), all
moneys
6transferred under s. 50.38 (9), all moneys transferred from the appropriation account
7under par. (jz), and 10 percent of all moneys received from penalty assessments

1under s. 49.471 (9) (c), for administration of the program under s. 49.45 (23), to
2provide a portion of the state share of administrative costs for the BadgerCare Plus
3Medical Assistance program under s. 49.471, and for administration of the hospital
4assessment under s. 50.38.
AB233-ASA1,3 5Section 3. 20.835 (2) (ba) of the statutes is created to read:
AB233-ASA1,3,86 20.835 (2) (ba) Small business grants. Biennially, the amounts in the schedule
7to make the small business grants under 2021 Wisconsin Act .... (this act), section
89137 (1).
AB233-ASA1,4 9Section 4. 49.45 (2p) of the statutes is repealed.
AB233-ASA1,5 10Section 5. 49.45 (23) of the statutes is repealed.
AB233-ASA1,6 11Section 6. 49.45 (23b) (title) of the statutes is amended to read:
AB233-ASA1,3,1312 49.45 (23b) (title) Childless adults demonstration project reform waiver
13implementation required.
AB233-ASA1,7 14Section 7. 49.45 (23b) (b) of the statutes is amended to read:
AB233-ASA1,3,1815 49.45 (23b) (b) Beginning as soon as practicable after October 31, 2018, and
16ending no sooner than December 31, 2023, the department shall do all of the
17following with regard to the childless adults demonstration project under sub. (23)
18s. 49.471 (4) (a) 8.:
AB233-ASA1,3,2419 1. Require in each month persons, except exempt individuals, who are eligible
20to receive Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. and who are at least
2119 years of age but have not attained the age of 50 to participate in, document, and
22report 80 hours per calendar month of community engagement activities. The
23department, after finding good cause, may grant a temporary exemption from the
24requirement under this subdivision upon request of a Medical Assistance recipient.
AB233-ASA1,4,3
12. Require persons with incomes of at least 50 percent of the poverty line to pay
2premiums in accordance with par. (c) as a condition of eligibility for Medical
3Assistance under sub. (23) s. 49.471 (4) (a) 8.
AB233-ASA1,4,54 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.
AB233-ASA1,4,86 4. Charge recipients of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
7an $8 copayment for nonemergency use of the emergency department in accordance
8with 42 USC 1396o-1 (e) (1) and 42 CFR 447.54.
AB233-ASA1,4,139 5. Disenroll from Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. for 6
10months any individual who does not pay a required premium under subd. 2. and any
11individual who is required under subd. 1. to participate in a community engagement
12activity but who does not participate for 48 aggregate months in the community
13engagement activity.
AB233-ASA1,8 14Section 8. 49.45 (23b) (c) of the statutes is amended to read:
AB233-ASA1,4,2015 49.45 (23b) (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
1750 percent of the poverty line shall pay a monthly premium amount of $8 per
18household. A person who is eligible to receive an item or service furnished by an
19Indian health care provider is exempt from the premium requirement under this
20subdivision.
AB233-ASA1,5,221 2. The department may disenroll under par. (b) 5. a person for nonpayment of
22a required monthly premium only at annual eligibility redetermination after
23providing notice and reasonable opportunity for the person to pay. If a person who
24is disenrolled for nonpayment of premiums pays all owed premiums or becomes

1exempt from payment of premiums, he or she may reenroll in Medical Assistance
2under sub. (23) s. 49.471 (4) (a) 8.
AB233-ASA1,5,63 3. The department shall reduce the amount of the required household premium
4by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
5who does not engage in certain behaviors that increase health risks or who attests
6to actively managing certain unhealthy behaviors.
AB233-ASA1,9 7Section 9. 49.45 (23b) (e) of the statutes is amended to read:
AB233-ASA1,5,128 49.45 (23b) (e) Before December 31, 2023, the demonstration project
9requirements under this subsection may not be withdrawn and the department may
10not request from the federal government withdrawal, suspension, or termination of
11the demonstration project requirements under this subsection unless legislation has
12been enacted specifically allowing for the withdrawal, suspension, or termination.
AB233-ASA1,10 13Section 10. 49.471 (1) (cr) of the statutes is created to read:
AB233-ASA1,5,1514 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
15federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB233-ASA1,11 16Section 11. 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB233-ASA1,5,1917 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133
18percent of the poverty line before application of the 5 percent income disregard under
1942 CFR 435.603 (d)
.
AB233-ASA1,12 20Section 12. 49.471 (4) (a) 8. of the statutes is created to read:
AB233-ASA1,5,2121 49.471 (4) (a) 8. An individual who meets all of the following criteria:
AB233-ASA1,5,2222 a. The individual is an adult under the age of 65.
AB233-ASA1,5,2423 b. The individual has a family income that does not exceed 133 percent of the
24poverty line, except as provided in sub. (4g).
AB233-ASA1,6,2
1c. The individual is not otherwise eligible for the Medical Assistance program
2under this subchapter or the Medicare program under 42 USC 1395 et seq.
AB233-ASA1,13 3Section 13. 49.471 (4g) of the statutes is created to read:
AB233-ASA1,6,134 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
5services provided to individuals described under sub. (4) (a) 8., the department shall
6comply with all federal requirements to qualify for the highest available enhanced
7federal medical assistance percentage. The department shall submit any
8amendment to the state medical assistance plan, request for a waiver of federal
9Medicaid law, or other approval request required by the federal government to
10provide services to the individuals described under sub. (4) (a) 8. and qualify for the
11highest available enhanced federal medical assistance percentage. Sections 20.940
12and 49.45 (2t) do not apply to a submission to the federal government under this
13subsection.
AB233-ASA1,14 14Section 14. 49.686 (3) (d) of the statutes is amended to read:
AB233-ASA1,6,2015 49.686 (3) (d) Has applied for coverage under and has been denied eligibility
16for medical assistance within 12 months prior to application for reimbursement
17under sub. (2). This paragraph does not apply to an individual who is eligible for
18benefits 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 (11).
AB233-ASA1,9119 21Section 9119. Nonstatutory provisions; Health Services
AB233-ASA1,7,522 (1) Childless adults demonstration project. The department of health
23services shall submit any necessary request to the federal department of health and
24human services for a state plan amendment or waiver of federal Medicaid law or to
25modify or withdraw from any waiver of federal Medicaid law relating to the childless

1adults demonstration project under s. 49.45 (23), 2019 stats., to reflect the
2incorporation of recipients of Medical Assistance under the demonstration project
3into the BadgerCare Plus program under s. 49.471 and the termination of the
4demonstration project. Sections 20.940 and 49.45 (2t) do not apply to a submission
5to the federal government under this subsection.
AB233-ASA1,9137 6Section 9137. Nonstatutory provisions; Revenue.
AB233-ASA1,7,77 (1) Small business grants.
AB233-ASA1,7,98 (a) Subject to par. (b), the department of revenue shall provide grants to any
9establishment that has its primary business activity in this state.
AB233-ASA1,7,1310 (b) An establishment described under par. (a ) may receive a payment under this
11subsection by filing an application with the department of revenue in the manner
12determined by the department. An establishment that satisfies all of following
13criteria is eligible to receive a payment under this subsection:
AB233-ASA1,7,15 141. It holds a valid business tax registration certificate issued under s. 73.03
15(50).
AB233-ASA1,7,17 162. It had total sales of less than $7,000,000, as reported on its 2019 state sales
17tax returns.
AB233-ASA1,7,18 183. It suffered economic damages in 2020 as a result of the COVID-19 pandemic.
AB233-ASA1,7,19 194. It is not on the department of revenue's list of delinquent taxpayers.
AB233-ASA1,7,21 205. It is not listed in the certification made by the department of revenue under
21s. 77.66.
AB233-ASA1,7,22 226. It is not on the department of transportation's debarred contractors list.
AB233-ASA1,9219 23Section 9219. Fiscal changes; Health Services.
AB233-ASA1,8,524 (1) Medicaid expansion. In the schedule under s. 20.005 (3) for the
25appropriation to the department of health services under s. 20.435 (4) (b), the dollar

1amount for fiscal year 2021-22 is decreased by $849,788,000 as a result of expanding
2eligibility for the Medical Assistance program. In the schedule under s. 20.005 (3)
3for the appropriation to the department of health services under s. 20.435 (4) (b), the
4dollar amount for fiscal year 2022-23 is decreased by $841,925,400 as a result of
5expanding eligibility for the Medical Assistance program.
AB233-ASA1,9419 6Section 9419. Effective dates; Health Services. This act takes effect on the
7day after publication, except as follows:
AB233-ASA1,8,108 (1) Medicaid expansion. The treatment of ss. 20.435 (4) (jw), 49.45 (2p), (23),
9and (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 9119 (1 ) and 9219 (1) of this act take effect on July 1, 2021.
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