AB 966

BadgerCare Plus (BC+) is a Medical Assistance (MA) program, administered

by the Department of Health Services, that provides health care benefits under two

different plans, depending on the basis for a recipient's eligibility, to recipients who

satisfy financial and nonfinancial eligibility criteria. The first plan provides the

same benefits that are provided under regular MA. The second plan, called the

Benchmark Plan, provides specified benefits, including, but not limited to, coverage

for prescription drugs; physicians' services; inpatient and outpatient hospital

services; home health services; physical, occupational, and speech therapy;

treatment for nervous and mental disorders and alcoholism and other drug abuse

problems; durable medical equipment; and transportation to obtain emergency

medical care. Individuals eligible for BC+ benefits under the Benchmark Plan

include, among others, a pregnant woman whose family income exceeds 200 percent,

but does not exceed 300 percent, of poverty; any child whose family income exceeds

200 percent, but does not exceed 300 percent, of poverty; and an individual whose

family income does not exceed 200 percent of poverty and who is the parent or

caretaker relative of a child who is, generally, living in the home of the parent or

caretaker relative. In addition, some individuals may purchase coverage under the

Benchmark Plan at the full per member per month cost of the coverage. These

individuals include: 1) any child whose family income exceeds 300 percent of poverty

and 2) any individual (who may purchase coverage for his or her spouse and

dependent children, also) who is under age 65, who lost his or her

employer-sponsored health care coverage as a result of his or her former employer's

bankruptcy, and who, after losing his or her employer-sponsored health care

coverage, received health care coverage through a voluntary employment benefit

association established before August 2006. This bill makes another group of

individuals eligible to purchase coverage for himself or herself and his or her spouse

and dependent children under the Benchmark Plan at the full per member per

month cost of the coverage. The individual must be under age 65; must be an

employee or a former employee of Allied Systems, Ltd., (Allied) in Janesville; must

have been receiving health care coverage through Allied immediately before July 1,

2010; will lose that coverage on July 1, 2010, due to the closing of Allied; and is not

eligible for any other employer-sponsored health care coverage.