Amendment ASA1-AB235

LRBs0066/1

MPG&JK:cjs

2021 - 2022 LEGISLATURE

ASSEMBLY SUBSTITUTE AMENDMENT 1, TO ASSEMBLY BILL 235

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.

AB235-ASA1,1,7 An Act to repeal 49.45 (2p) and 49.45 (23); to amend 20.435 (4) (jw), 49.45 (23b) (title), 49.45 (23b) (b), 49.45 (23b) (c), 49.45 (23b) (e), 49.471 (4) (a) 4. b. and 49.686 (3) (d); and to create 20.192 (1) (bm), 20.835 (2) (ca), 49.471 (1) (cr), 49.471 (4) (a) 8., 49.471 (4g) and 238.18 of the statutes; relating to: rural economic development programs administered by the Wisconsin Economic Development Corporation, farm support grants, eligibility expansion under the Medical Assistance program, and making an appropriation.

Analysis by the Legislative Reference Bureau

Rural economic development

This bill appropriates $200,000,000 in general purpose revenue for the Wisconsin Economic Development Corporation to do all of the following:

1. Expend moneys for any economic development program WEDC is administering as of the date on which the bill becomes law if the expenditure assists economic development in a rural county.

2. Expend moneys for any economic development program WEDC begins administering after the date on which the bill becomes law if the expenditure assists economic development in a rural county. The bill requires passive review by the Joint Committee on Finance before WEDC first expends moneys under the bill on each such program and requires WEDC to adopt policies and procedures establishing, to the extent feasible, matching requirements for any such expenditure.

3. Subject to passive review by JCF, award grants to state agencies, including other authorities, if WEDC determines that a state agency's expenditure of the grant moneys will assist economic development in a rural county.

4. Award onetime grants to certain county and regional economic development organizations serving rural counties for the purpose of creating or expanding revolving loan funds that promote economic development and entrepreneurial start-ups in rural counties. The bill additionally authorizes WEDC to award limited onetime grants to such organizations for the organizations' program operations and marketing in rural counties.

With respect to WEDC's administration of all of the programs described above, the bill requires WEDC to make every effort to ensure that underserved communities in rural counties are prioritized. Additionally, under the bill, WEDC must submit a report to JCF no later than June 30 of each fiscal year in which WEDC expends moneys under the bill that describes in detail WEDC's use of those moneys in that fiscal year.

Farm support grants

The bill also requires the Department of Revenue to provide grants to farmers. The total amount of the grants is $100,000,000. Under the bill, a farmer is eligible for a grant if the farmer's gross sales of farm products for 2019 exceeds $35,000 but not does exceed $5,000,000 and the farmer has experienced financial hardship as a result of the COVID-19 pandemic. The bill directs DOR to consult with the Department of Agriculture, Trade and Consumer Protection in providing the grants.

Eligibility expansion under the Medical Assistance 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 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:

AB235-ASA1,1 Section 1 . 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table - See PDF for table

AB235-ASA1,2 Section 2 . 20.192 (1) (bm) of the statutes is created to read:

AB235-ASA1,3,6 20.192 (1) (bm) Rural economic development. The amounts in the schedule for rural economic development programs and grants to authorities and state agencies under s. 238.18.

AB235-ASA1,3 Section 3 . 20.435 (4) (jw) of the statutes is amended to read:

AB235-ASA1,4,5 20.435 (4) (jw) BadgerCare Plus and hospital assessment. All moneys received from payment of enrollment fees under the program under s. 49.45 (23), all moneys transferred under s. 50.38 (9), all moneys transferred from the appropriation account under par. (jz), and 10 percent of all moneys received from penalty assessments under s. 49.471 (9) (c), for administration of the program under s. 49.45 (23), to provide a portion of the state share of administrative costs for the BadgerCare Plus Medical Assistance program under s. 49.471, and for administration of the hospital assessment under s. 50.38.

AB235-ASA1,4 Section 4. 20.835 (2) (ca) of the statutes is created to read:

AB235-ASA1,4,8 20.835 (2) (ca) Farm support grants. The amounts in the schedule to make the farm support grants under section 9137 (1 ) of 2021 Wisconsin Act .... (this act).

AB235-ASA1,5 Section 5 . 49.45 (2p) of the statutes is repealed.

AB235-ASA1,6 Section 6 . 49.45 (23) of the statutes is repealed.

AB235-ASA1,7 Section 7 . 49.45 (23b) (title) of the statutes is amended to read:

AB235-ASA1,4,13 49.45 (23b) (title) Childless adults demonstration project reform waiver implementation required.

AB235-ASA1,8 Section 8 . 49.45 (23b) (b) of the statutes is amended to read:

AB235-ASA1,4,18 49.45 (23b) (b) Beginning as soon as practicable after October 31, 2018, and ending no sooner than December 31, 2023, the department shall do all of the following with regard to the childless adults demonstration project under sub. (23) s. 49.471 (4) (a) 8.:

AB235-ASA1,4,24 1. Require in each month persons, except exempt individuals, who are eligible to receive Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. and who are at least 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 department, after finding good cause, may grant a temporary exemption from the requirement under this subdivision upon request of a Medical Assistance recipient.

AB235-ASA1,5,3 2. Require persons with incomes of at least 50 percent of the poverty line to pay premiums in accordance with par. (c) as a condition of eligibility for Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.

AB235-ASA1,5,5 3. Require as a condition of eligibility for Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. completion of a health risk assessment.

AB235-ASA1,5,8 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 with 42 USC 1396o-1 (e) (1) and 42 CFR 447.54.

AB235-ASA1,5,13 5. Disenroll from Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. for 6 months any individual who does not pay a required premium under subd. 2. and any individual who is required under subd. 1. to participate in a community engagement activity but who does not participate for 48 aggregate months in the community engagement activity.

AB235-ASA1,9 Section 9 . 49.45 (23b) (c) of the statutes is amended to read:

AB235-ASA1,5,20 49.45 (23b) (c) 1. Persons who are eligible for the demonstration project under sub. (23) s. 49.471 (4) (a) 8. and who have monthly household income that exceeds 50 percent of the poverty line shall pay a monthly premium amount of $8 per household. A person who is eligible to receive an item or service furnished by an Indian health care provider is exempt from the premium requirement under this subdivision.

AB235-ASA1,6,2 2. The department may disenroll under par. (b) 5. a person for nonpayment of a required monthly premium only at annual eligibility redetermination after providing notice and reasonable opportunity for the person to pay. If a person who 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 under sub. (23) s. 49.471 (4) (a) 8.

AB235-ASA1,6,6 3. The department shall reduce the amount of the required household premium by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. who does not engage in certain behaviors that increase health risks or who attests to actively managing certain unhealthy behaviors.

AB235-ASA1,10 Section 10 . 49.45 (23b) (e) of the statutes is amended to read:

AB235-ASA1,6,12 49.45 (23b) (e) Before December 31, 2023, the demonstration project requirements under this subsection may not be withdrawn and the department may not request from the federal government withdrawal, suspension, or termination of the demonstration project requirements under this subsection unless legislation has been enacted specifically allowing for the withdrawal, suspension, or termination.

AB235-ASA1,11 Section 11 . 49.471 (1) (cr) of the statutes is created to read:

AB235-ASA1,6,15 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a federal medical assistance percentage described under 42 USC 1396d (y) or (z).

AB235-ASA1,12 Section 12 . 49.471 (4) (a) 4. b. of the statutes is amended to read:

AB235-ASA1,6,19 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133 percent of the poverty line before application of the 5 percent income disregard under 42 CFR 435.603 (d).

AB235-ASA1,13 Section 13 . 49.471 (4) (a) 8. of the statutes is created to read:

AB235-ASA1,6,21 49.471 (4) (a) 8. An individual who meets all of the following criteria:

AB235-ASA1,6,22 a. The individual is an adult under the age of 65.

AB235-ASA1,6,24 b. The individual has a family income that does not exceed 133 percent of the poverty line, except as provided in sub. (4g).

AB235-ASA1,7,2 c. The individual is not otherwise eligible for the Medical Assistance program under this subchapter or the Medicare program under 42 USC 1395 et seq.

AB235-ASA1,14 Section 14 . 49.471 (4g) of the statutes is created to read:

AB235-ASA1,7,13 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For services provided to individuals described under sub. (4) (a) 8., the department shall comply with all federal requirements to qualify for the highest available enhanced federal medical assistance percentage. The department shall submit any amendment to the state medical assistance plan, request for a waiver of federal Medicaid law, or other approval request required by the federal government to provide services to the individuals described under sub. (4) (a) 8. and qualify for the highest available enhanced federal medical assistance percentage. Sections 20.940 and 49.45 (2t) do not apply to a submission to the federal government under this subsection.

AB235-ASA1,15 Section 15 . 49.686 (3) (d) of the statutes is amended to read:

AB235-ASA1,7,20 49.686 (3) (d) Has applied for coverage under and has been denied eligibility for medical assistance within 12 months prior to application for reimbursement under sub. (2). This paragraph does not apply to an individual who is eligible for benefits under the demonstration project for childless adults under s. 49.45 (23) or to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471 (4) (a) 8. or (11).

AB235-ASA1,16 Section 16 . 238.18 of the statutes is created to read:

AB235-ASA1,7,22 238.18 Rural economic development. (1) Definition. In this section:

AB235-ASA1,8,2 (a) “State agency" means an office, department, agency, institution of higher education, association, society, or other body in state government created or authorized to be created by the constitution or any law that is entitled to expend moneys appropriated by law, including any authority created in subch. II of ch. 114 or in ch. 231, 233, 234, or 279.

AB235-ASA1,8,4 (b) “Rural county” means a county with a population density of less than 155 residents per square mile.

AB235-ASA1,8,6 (2) Economic development programs benefiting rural counties. From the appropriation under under s. 20.192 (1) (bm), the corporation may do the following:

AB235-ASA1,8,9 (a) Expend moneys for any economic development program the corporation is administering on the effective date of this paragraph .... [LRB inserts date], if that expenditure assists economic development in a rural county.

AB235-ASA1,8,13 (b) Expend moneys for any economic development program the corporation begins administering after the effective date of this paragraph .... [LRB inserts date], if that expenditure assists economic development in a rural county, subject to all of the following:

AB235-ASA1,8,18 1. Before the corporation first expends moneys on each program under this paragraph, the corporation shall notify the joint committee on finance in writing of the corporation's intention to expend the moneys on the program. The notice shall describe the program and purposes for which the corporation proposes to expend the moneys under this paragraph.

AB235-ASA1,9,2 2. If, within 14 working days after the date of the corporation's notice under subd. 1., the cochairpersons of the joint committee on finance do not notify the corporation that the committee has scheduled a meeting to review the corporation's proposal, the corporation may make the expenditures as proposed in the corporation's notice. If, within 14 working days after the date of the corporation's notice under subd. 1., the cochairpersons of the committee notify the corporation that the committee has scheduled a meeting to review the corporation's proposal, the corporation may make the proposed expenditures only upon approval of the committee.

AB235-ASA1,9,5 3. The corporation shall adopt policies and procedures establishing, to the extent feasible, matching requirements for the corporation's expenditures under this paragraph.