LRB-1076/2
TJD:kjf
2015 - 2016 LEGISLATURE
May 19, 2015 - Introduced by Representatives Riemer, Kolste, Barca, Barnes,
Berceau, Billings, Bowen, Brostoff, Considine, Danou, Doyle, Genrich,
Goyke, Hebl, Hesselbein, Hintz, Johnson, Kahl, Kessler, Mason, Meyers,
Milroy, Ohnstad, Pope, Sargent, Shankland, Sinicki, Spreitzer, Stuck,
Subeck, C. Taylor, Wachs, Zamarripa and Zepnick, cosponsored by Senators
Erpenbach, Shilling, Carpenter, Bewley, Hansen, Harris Dodd, C. Larson,
Lassa, Miller, Ringhand, Risser, L. Taylor, Vinehout and Wirch. Referred
to Committee on Health.
AB221,1,3 1An Act to amend 49.45 (23) (a) and 49.471 (4) (a) 4. b.; and to create 49.471 (1)
2(cr) and 49.471 (4g) of the statutes; relating to: Medicaid expansion and
3eligibility for BadgerCare Plus and BadgerCare Plus Core.
Analysis by the Legislative Reference Bureau
Currently, the Department of Health Services (DHS) administers the Medical
Assistance (MA) program, which is a joint federal and state program that provides
health services to individuals who have limited financial resources. Some services
are provided through programs that operate under a waiver of federal Medicaid laws,
including services provided through the BadgerCare Plus (BC+) and BadgerCare
Plus Core (BC+ Core) programs.
Under current law, certain parents and caretaker relatives with incomes of not
more than 100 percent of the federal poverty line (FPL), before a 5 percent income
disregard is applied, are eligible for BC+ benefits. Under current law, adults who are
under age 65, who have family incomes that do not exceed 100 percent of the FPL,
before a 5 percent income disregard is applied, and who are not otherwise eligible for
MA, including BC+ (childless adults), are eligible for benefits under BC+ Core.
This bill changes the family income eligibility level to up to 133 percent of the
FPL for parents and caretaker relatives under BC+ and for childless adults under
BC+ Core. The federal Patient Protection and Affordable Care Act allows a state to
receive an enhanced federal medical assistance percentage (FMAP) payment for
providing benefits to certain individuals through a state's MA program. The bill
requires DHS to comply with all federal requirements and to request any

amendment to the state MA plan, waiver of Medicaid law, or other federal approval
necessary to qualify for the highest available enhanced FMAP for parents and
caretaker relatives and childless adults eligible for BC+ Core (collectively
nonpregnant, nonelderly adults). If DHS does not qualify for the enhanced FMAP
or if the FMAP is reduced, DHS is required to submit to the Joint Committee on
Finance (JCF) a fiscal analysis comparing the cost of covering nonpregnant,
nonelderly adults under the MA program at up to 133 percent of the FPL to the cost
of limiting income eligibility to those adults to up to 100 percent of the FPL. DHS
may reduce income eligibility levels for nonpregnant, nonelderly adults to up to 100
percent of the FPL only if JCF approves.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB221,1 1Section 1. 49.45 (23) (a) of the statutes is amended to read:
AB221,2,92 49.45 (23) (a) The department shall request a waiver from the secretary of the
3federal department of health and human services to permit the department to
4conduct a demonstration project to provide health care coverage to adults who are
5under the age of 65, who have family incomes not to exceed 100 133 percent of the
6poverty line before application of the 5 percent income disregard under 42 CFR
7435.603 (d)
, except as provided in s. 49.471 (4g), and who are not otherwise eligible
8for medical assistance under this subchapter, the Badger Care health care program
9under s. 49.665, or Medicare under 42 USC 1395 et seq.
AB221,2 10Section 2. 49.471 (1) (cr) of the statutes is created to read:
AB221,2,1211 49.471 (1) (cr) "Enhanced federal medical assistance percentage" means a
12federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB221,3 13Section 3. 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB221,3,3
149.471 (4) (a) 4. b. The Except as provided in sub. (4g), the individual's family
2income does not exceed 100 133 percent of the poverty line before application of the
35 percent income disregard under 42 CFR 435.603 (d)
.
AB221,4 4Section 4. 49.471 (4g) of the statutes is created to read:
AB221,3,125 49.471 (4g) Medicaid expansion; federal medical assistance percentage. (a)
6For services provided to individuals described under sub. (4) (a) 4. and s. 49.45 (23),
7the department shall comply with all federal requirements to qualify for the highest
8available enhanced federal medical assistance percentage. The department shall
9submit any amendment to the state medical assistance plan, request for a waiver of
10federal Medicaid law, or other approval required by the federal government to
11provide services to the individuals described under sub. (4) (a) 4. and s. 49.45 (23) and
12qualify for the highest available enhanced federal medical assistance percentage.
AB221,3,2313 (b) If the department does not qualify for an enhanced federal medical
14assistance percentage, or if the enhanced federal medical assistance percentage
15obtained by the department is lower than printed in federal law as of July 1, 2013,
16for individuals eligible under sub. (4) (a) 4. or s. 49.45 (23), the department shall
17submit to the joint committee on finance a fiscal analysis comparing the cost to
18maintain coverage for adults who are not pregnant and not elderly at up to 133
19percent of the poverty line to the cost of limiting eligibility to those adults with family
20incomes up to 100 percent of the poverty line. The department may reduce income
21eligibility for adults who are not pregnant and not elderly from up to 133 percent of
22the poverty line to up to 100 percent of the poverty line only if this reduction in income
23eligibility levels is approved by the joint committee on finance.
AB221,5 24Section 5. Fiscal changes.
AB221,4,10
1(1) Medicaid expansion. In the schedule under section 20.005 (3) of the statutes
2for the appropriation to the department of health services under section 20.435 (4)
3(b) of the statutes, as affected by the acts of 2015, the dollar amount for fiscal year
42015-16 is decreased by $108,200,000 to provide Medical Assistance to certain
5adults with incomes up to 133 percent of the federal poverty line. In the schedule
6under section 20.005 (3) of the statutes for the appropriation to the department of
7health services under section 20.435 (4) (b) of the statutes, as affected by the acts of
82015, the dollar amount for fiscal year 2016-17 is decreased by $236,900,000 to
9provide Medical Assistance to certain adults with incomes up to 133 percent of the
10federal poverty line.
AB221,6 11Section 6. Effective date.
AB221,4,1312 (1) Medicaid expansion. This act takes effect on January 1, 2016, or on the day
13after publication, whichever is later.
AB221,4,1414 (End)
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