AB 255

Generally, this bill implements the federal Medicaid expansion under the

federal Patient Protection and Affordable Care Act and increases reimbursement

rates under the Medical Assistance program for personal care services.

The 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 under BadgerCare Plus Core. 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. 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 parents and caretaker relatives and

childless adults under the BadgerCare Plus and BadgerCare Plus Core programs.

If DHS does not qualify for the enhanced federal medical assistance percentage or

if the percentage is reduced, DHS is required to submit to the Joint Committee on

Finance a fiscal analysis comparing the cost of covering parents and caretaker

relatives and childless adults under the Medical Assistance program at up to 133

percent of the federal poverty line to the cost of limiting income eligibility to those

adults to up to 100 percent of the federal poverty line. DHS may reduce income

eligibility levels for those adults to up to 100 percent of the federal poverty line only

if the Joint Committee on Finance approves.

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 a 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 also requires DHS to increase the reimbursement rates by 2.5 percent

for personal care services provided under the Medical Assistance program in each

fiscal year of the current fiscal biennium. To receive an increased reimbursement

rate, a person who provides personal care services shall pay the reimbursement rate

increase to employees or contractors who provide personal care services directly to

a Medical Assistance recipient.