AB 745

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 the 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 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 eliminates the childless

adults demonstration project, known as BadgerCare Plus Core, as a separate

program as of October 1, 2023.

2017 Wisconsin Act 370

requires by statute that DHS implement the

BadgerCare Reform waiver as it relates to childless adults as approved by the federal

Department of Health and Human Services effective October 31, 2018. The 2015-17

and 2017-19 biennial budget acts required DHS to submit a waiver request to the

federal Department of Health and Human Services authorizing DHS to take certain

actions, including imposing premiums on, requiring a health risk assessment of, and

limiting the time of eligibility for recipients of BadgerCare Plus under the childless

adults demonstration project waiver. Act 370 required DHS to implement the

childless adults BadgerCare Reform waiver by no later than November 1, 2019. If

the Joint Committee on Finance determines that DHS has not complied with the

implementation deadline, has not made sufficient progress in implementing the

BadgerCare Reform waiver, or has not complied with other requirements relating to

approved waiver implementation, Act 370 allows JCF to reduce from moneys

allocated for state operations or administrative functions DHS's appropriation or

expenditure authority, whichever is applicable, or change the authorized level of

full-time equivalent positions for DHS related to the Medical Assistance program.