Amendment ASA1-AB235

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AB235-ASA1,5 Section 5 . 49.45 (2p) of the statutes is repealed.

AB235-ASA1,6 Section 6 . 49.45 (23) of the statutes is repealed.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

AB235-ASA1,9,8 (c) Award a grant to a state agency if the corporation determines the state agency's expenditure of the grant moneys will assist economic development in a rural county, subject to all of the following:

AB235-ASA1,9,12 1. Before the corporation makes a grant under this paragraph, the corporation shall notify the joint committee on finance in writing of the corporation's intention to make the grant. The notice shall describe the program and purposes for which the corporation proposes to make the grant.

AB235-ASA1,9,20 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 grant 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 grant only upon approval of the committee.

AB235-ASA1,9,24 (d) Before the corporation expends moneys on an economic development program under par. (a) or (b) or makes a grant under par. (c), the corporation shall consider the economic impact of the program or activity for which the moneys will be used.

AB235-ASA1,10,5 (3g) Grants for revolving loan funds. (a) In this subsection and in sub. (3r), “eligible organization” means each county economic development organization serving a rural county and each regional economic development organization serving a rural county that the corporation determines under par. (d) is eligible for a grant under par. (c).

AB235-ASA1,10,7 (b) From the appropriation under under s. 20.192 (1) (bm), the corporation shall set aside $5,000,000 for grants under this subsection.

AB235-ASA1,10,16 (c) The corporation shall award a onetime grant of $250,000 to each eligible organization, or shall grant a smaller amount if the eligible organization so elects. The corporation may award a onetime grant of more than $250,000 to a consortium of rural counties, or to a consortium of eligible organizations in lieu of a grant to eligible organizations that are members of the consortium. An eligible organization or a consortium receiving a grant under this paragraph shall expend the grant moneys only for the purpose of creating or expanding a revolving loan fund that promotes economic development and entrepreneurial start-ups in a rural county served by the eligible organization or in rural counties served by the consortium.

AB235-ASA1,10,20 (d) In determining whether a county economic development organization serving a rural county or regional economic development organization serving a rural county is eligible for a grant under par. (c), the corporation shall consider all of the following:

AB235-ASA1,10,22 1. Whether the organization has appropriate fiscal and administrative policies and procedures in place.

AB235-ASA1,10,24 2. Whether the organization's staff is sufficient and qualified by education or experience to administer a revolving loan fund.

AB235-ASA1,11,3 3. Whether the organization can provide at least 2 examples of projects financed with public funding that the organization has taken from grant application to project completion.

AB235-ASA1,11,5 4. Whether the organization has experience or a history of serving the community with economic development projects.

AB235-ASA1,11,9 (3r) Grants for program operations and marketing. (a) From the appropriation under under s. 20.192 (1) (bm), the corporation shall award a onetime grant of $50,000 to each eligible organization, or shall grant a smaller amount if the eligible organization so elects, subject to all of the following:

AB235-ASA1,11,12 1. The eligible organization shall expend all grant moneys received under this paragraph only for the purpose of program operations and marketing within a rural county served by the eligible organization.

AB235-ASA1,11,16 2. The eligible organization shall submit a report to the corporation no later than 180 days after the last day of the state fiscal year in which the grant is awarded concerning the organization's use of the grant under this paragraph. The report shall include a description of all marketing efforts undertaken as a result of the grant.

AB235-ASA1,11,19 (b) A rural county served by an eligible organization receiving a grant under par. (a) may not use or depend on grant moneys to supplant existing funding for economic development purposes.

AB235-ASA1,11,23 (4) Reporting requirements. No later than June 30 of each state fiscal year in which the corporation expends moneys from the appropriation under under s. 20.192 (1) (bm), the corporation shall submit a report to the joint committee on finance describing in detail the corporation's use of those moneys in that fiscal year.

AB235-ASA1,12,2 (5) Cooperation of state agencies. All state agencies shall, to the extent needed, as determined by the corporation, cooperate with the corporation concerning the corporation's planning and implementation of its expenditures of moneys under this section.

AB235-ASA1,12,5 (5m) Focus on underserved communities. In administering this section, the corporation shall make every effort to ensure that underserved communities in rural counties are prioritized.

AB235-ASA1,9119 Section 9119. Nonstatutory provisions; Health Services.

AB235-ASA1,12,15 (1) Childless adults demonstration project. The department of health services shall submit any necessary request to the federal department of health and human services for a state plan amendment or waiver of federal Medicaid law or to modify or withdraw from any waiver of federal Medicaid law relating to the childless adults demonstration project under s. 49.45 (23), 2019 stats., to reflect the incorporation of recipients of Medical Assistance under the demonstration project into the BadgerCare Plus program under s. 49.471 and the termination of the demonstration project. Sections 20.940 and 49.45 (2t) do not apply to a submission to the federal government under this subsection.

AB235-ASA1,9137 Section 9137. Nonstatutory provisions; Revenue.

AB235-ASA1,13,2 (1) Farm support grants. From the appropriation under s. 20.835 (2) (ca), the department of revenue shall provide grants to farmers who have experienced financial hardship due to the COVID-19 pandemic. A farmer desiring a grant under this subsection may file an application with the department of revenue in the manner determined by the department. The department of revenue shall consult with the department of agriculture, trade and consumer protection in providing grants under this subsection. In this subsection, “farmer” means a farmer, as defined in s. 102.04 (3), who owns or leases land that is agricultural property, whose gross sales of farm products in 2019 exceeds $35,000 but not does exceed $5,000,000, and who has experienced financial hardship as a result of the COVID-19 pandemic.

AB235-ASA1,9219 Section 9219. Fiscal changes; Health Services.

AB235-ASA1,13,10 (1) Medicaid expansion. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (4) (b), the dollar amount for fiscal year 2021-22 is decreased by $849,788,000 as a result of expanding eligibility for the Medical Assistance program. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (4) (b), the dollar amount for fiscal year 2022-23 is decreased by $841,925,400 as a result of expanding eligibility for the Medical Assistance program.

AB235-ASA1,9419 Section 9419. Effective dates; Health Services. This act takes effect on the day after publication, except as follows:

AB235-ASA1,13,15 (1) Medicaid expansion. The treatment of ss. 20.435 (4) (jw), 49.45 (2p), (23), and (23b) (title), (b), (c), and (e), 49.471 (1) (cr), (4) (a) 4. b. and 8., and (4g), and 49.686 (3) (d) and Sections 9119 (1 ) and 9219 (1) of this act take effect on July 1, 2021.

AB235-ASA1,13,16 (End)