Under current law, if an individual who is required to pay a premium does not
pay or requests termination of coverage under BC+, the coverage is terminated and
the individual is ineligible for BC+ for a specified period. For children, the current
ineligibility period is three months, except for any month in which the child's family
income does not exceed 150 percent of the FPL. With federal DHHS approval, DHS
may apply to children an ineligibility period of up to 12 months. The bill eliminates
the ability for DHS to apply to children an ineligibility period longer than three
months.
If allowed by the federal DHHS, current law allows DHS to provide to certain
adults an alternate benefits package that provides benefits similar to those benefits
provided in a commercial, major medical insurance policy. The bill eliminates the
ability for DHS to provide such an alternate benefits package.
Current law allows DHS to enroll, with federal DHHS approval, a child who is
receiving services though the early intervention program in a special plan. The bill
eliminates the special plan in which DHS may enroll children receiving early
intervention program services.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB365,1 1Section 1. 49.45 (23) (d) of the statutes, as created by 2013 Wisconsin Act 20,
2is repealed.
AB365,2 3Section 2. 49.46 (1) (c) (intro.) of the statutes, as affected by 2013 Wisconsin
4Act 20
, section 1072, is amended to read:
AB365,4,95 49.46 (1) (c) (intro.) Except as provided under par. (co) or (cr), a family that
6becomes ineligible for aid to families with dependent children under s. 49.19 because
7of increased income from employment or increased hours of employment or because
8of the expiration of the time during which the disregards under s. 49.19 (5) (a) 4. or
94m. or (am) apply shall receive medical assistance for:
AB365,3
1Section 3. 49.46 (1) (c) (intro.) of the statutes, as affected by 2013 Wisconsin
2Act 20
, section 1072b and 2013 Wisconsin Act .... (this act), is repealed and recreated
3to read:
AB365,5,94 49.46 (1) (c) (intro.) A family that becomes ineligible for aid to families with
5dependent children under s. 49.19 because of increased income from employment or
6increased hours of employment shall receive medical assistance for 6 calendar
7months, or, if required under federal law, up to 12 months, following the month in
8which a parent, caretaker, or dependent child of the family becomes ineligible for aid
9to families with dependent children if all of the following apply:
AB365,4 10Section 4. 49.46 (1) (cg) of the statutes, as affected by 2013 Wisconsin Act 20,
11is amended to read:
AB365,5,1912 49.46 (1) (cg) Except as provided under par. (cr), medical Medical assistance
13shall be provided to a dependent child, a relative with whom the child is living or the
14spouse of the relative, if the spouse meets the requirements of s. 49.19 (1) (c) 2. a. or
15b., for 4 calendar months beginning with the month in which the child, relative or
16spouse is ineligible for aid to families with dependent children because of the
17collection or increased collection of maintenance or support, if the child, relative or
18spouse received aid to families with dependent children in 3 or more of the 6 months
19immediately preceding the month in which that ineligibility begins.
AB365,5 20Section 5. 49.46 (1) (co) 1. of the statutes, as affected by 2013 Wisconsin Act
2120
, section 1074, is amended to read:
AB365,5,2522 49.46 (1) (co) 1. Except as provided under subd. 2. or par. (cr), medical
23assistance shall be provided to a family for 12 consecutive calendar months following
24the month in which the family becomes ineligible for aid to families with dependent
25children because of increased income from employment.
AB365,6
1Section 6. 49.46 (1) (co) 2. of the statutes, as affected by 2013 Wisconsin Act
220
, section 1075, is amended to read:
AB365,6,63 49.46 (1) (co) 2. If a waiver under subd. 3. is granted and except as provided
4in par. (cr)
, the department may select individuals to receive medical assistance
5benefits as provided under par. (c), rather than under subd. 1., as a control group for
6part or all of the period during which the waiver is in effect.
AB365,7 7Section 7. 49.46 (1) (cr) of the statutes, as affected by 2013 Wisconsin Act 20,
8is repealed.
AB365,8 9Section 8. 49.46 (2) (b) 19. of the statutes, as created by 2013 Wisconsin Act
1020
, is repealed.
AB365,9 11Section 9. 49.46 (2) (br) of the statutes, as created by 2013 Wisconsin Act 20,
12is repealed.
AB365,10 13Section 10. 49.471 (4) (a) 7. of the statutes, as affected by 2013 Wisconsin Act
1420
, section 1100, is amended to read:
AB365,6,1715 49.471 (4) (a) 7. Individuals who qualify for a medical assistance eligibility
16extension under s. 49.46 (1) (c), (cg), or (co) when their income increases above the
17poverty line, except as provided in s. 49.46 (1) (cr).
AB365,11 18Section 11. 49.471 (4) (a) 7. of the statutes, as affected by 2013 Wisconsin Act
1920
, section 1100b, and 2013 Wisconsin Act .... (this act), is repealed and recreated to
20read:
AB365,6,2321 49.471 (4) (a) 7. Individuals who qualify for a medical assistance eligibility
22extension under s. 49.46 (1) (c) or (cg) when their income increases above the poverty
23line.
AB365,12 24Section 12. 49.471 (4) (e) of the statutes, as created by 2013 Wisconsin Act 20,
25is repealed.
AB365,13
1Section 13. 49.471 (5) (b) 2. (intro.) of the statutes, as affected by 2013
2Wisconsin Act 20
, is amended to read:
AB365,7,93 49.471 (5) (b) 2. (intro.) Except as provided in sub. (6) (a) 2., a child who is not
4an unborn child is eligible for the benefits described in s. 49.46 (2) (a) and (b) during
5the period beginning on the day on which a qualified entity determines, on the basis
6of preliminary information, that the child's family income does not exceed any of the
7following and ending on the applicable day specified in subd. 3., unless the federal
8department of health and human services approves the department's request to not
9extend eligibility to children during this period
:
AB365,14 10Section 14. 49.471 (5) (b) 3. a. of the statutes, as affected by 2013 Wisconsin
11Act 20
, is amended to read:
AB365,7,1912 49.471 (5) (b) 3. a. If the woman or child applies for benefits under sub. (4)
13within the time required under par. (d), the benefits specified in subd. 1. or 2.,
14whichever is applicable, end on the day on which the department or the county
15department under s. 46.215, 46.22, or 46.23 determines whether the woman or child
16is eligible for benefits under sub. (4), except that a child who is not an unborn child
17is not eligible for benefits described in s. 49.46 (2) (a) and (b) during that time if the
18federal department of health and human services approves the department's request
19not to provide those benefits during that time
.
AB365,15 20Section 15. 49.471 (6) (a) 1. of the statutes, as affected by 2013 Wisconsin Act
2120
, is amended to read:
AB365,7,2522 49.471 (6) (a) 1. Except as provided in subd. 4., any Any pregnant woman,
23including a pregnant woman under sub. (5) (b) 1., is eligible for medical assistance
24under this section for any of the 3 months prior to the month of application if she met
25the eligibility criteria under this section in that month.
AB365,16
1Section 16. 49.471 (6) (a) 2. of the statutes, as affected by 2013 Wisconsin Act
220
, is amended to read:
AB365,8,83 49.471 (6) (a) 2. Except as provided in subd. 3. or 4., any child who is not an
4unborn child, including a child under sub. (5) (b) 2., parent, or caretaker relative
5whose family income is less than 150 percent of the poverty line is eligible for medical
6assistance under this section for any of the 3 months prior to the month of application
7if the individual met the eligibility criteria under this section and had a family
8income of less than 150 percent of the poverty line in that month.
AB365,17 9Section 17. 49.471 (6) (a) 4. of the statutes, as created by 2013 Wisconsin Act
1020
, is repealed.
AB365,18 11Section 18. 49.471 (7) (c) (intro.) of the statutes, as affected by 2013 Wisconsin
12Act 20
, section 1122, is amended to read:
AB365,8,1413 49.471 (7) (c) (intro.) When calculating an individual's family income, the
14department shall do all of the following, subject to par. (d):
AB365,19 15Section 19. 49.471 (7) (d) of the statutes, as created by 2013 Wisconsin Act 20,
16is repealed.
AB365,20 17Section 20. 49.471 (8) (b) (intro.) of the statutes, as affected by 2013 Wisconsin
18Act 20
, is amended to read:
AB365,8,2119 49.471 (8) (b) (intro.) Except as provided in pars. (c), (cg), (cr), (ct), and (d), an
20individual whose family income exceeds 150 percent of the poverty line is not eligible
21for BadgerCare Plus if any of the following applies:
AB365,21 22Section 21. 49.471 (8) (cr) of the statutes, as created by 2013 Wisconsin Act
2320
, is repealed.
AB365,22 24Section 22. 49.471 (8) (ct) of the statutes, as created by 2013 Wisconsin Act
2520
, is repealed.
AB365,23
1Section 23. 49.471 (8) (d) 1. a. of the statutes, as affected by 2013 Wisconsin
2Act 20
, is amended to read:
AB365,9,43 49.471 (8) (d) 1. a. A pregnant woman, except as provided in pars. (cr) 1. c. and
4(fm) 4
.
AB365,24 5Section 24. 49.471 (8) (fm) of the statutes, as created by 2013 Wisconsin Act
620
, is repealed.
AB365,25 7Section 25. 49.471 (8) (g) (intro.) of the statutes, as affected by 2013 Wisconsin
8Act 20
, is amended to read:
AB365,9,109 49.471 (8) (g) (intro.) Any of the following is a good cause reason for purposes
10of pars. par. (f) and (fm):
AB365,26 11Section 26. 49.471 (10) (b) 2. of the statutes, as affected by 2013 Wisconsin Act
1220
, is amended to read:
AB365,9,1713 49.471 (10) (b) 2. Except as provided in subds. 3m. and subd. 4., a recipient who
14is a child whose family income is greater than 200 percent of the poverty line shall
15pay a premium for coverage of the benefits described in sub. (11) that does not exceed
16the full per member per month cost of coverage for a child with a family income of
17300 percent of the poverty line.
AB365,27 18Section 27. 49.471 (10) (b) 3m. of the statutes, as created by 2013 Wisconsin
19Act 20
, is repealed.
AB365,28 20Section 28. 49.471 (10) (b) 4. (intro.) of the statutes, as affected by 2013
21Wisconsin Act 20
, is amended to read:
AB365,9,2322 49.471 (10) (b) 4. (intro.) None of the following shall pay a premium, except as
23provided in subd. 3m.
:
AB365,29 24Section 29. 49.471 (10) (b) 5. of the statutes, as affected by 2013 Wisconsin Act
2520
, section 1151, is amended to read:
AB365,10,14
149.471 (10) (b) 5. If a recipient who is required to pay a premium under this
2paragraph or under sub. (2m) or (4) (c) either does not pay a premium when due or
3requests that his or her coverage under this section be terminated, the recipient's
4coverage terminates. If the recipient is an adult, the recipient is not eligible for
5BadgerCare Plus for 12 consecutive calendar months following the date on which the
6recipient's coverage terminated, except for any month during that 12-month period
7when the recipient's family income does not exceed 133 percent of the poverty line.
8If the recipient is a child, the recipient is not eligible for BadgerCare Plus for 3
9consecutive calendar months, or up to 12 consecutive calendar months if the federal
10department of health and human services approves,
following the date on which the
11recipient's coverage terminated, except for any month during that period when the
12recipient's family income does not exceed 150 percent of the poverty line. This period
13of ineligibility for a child does not apply to any child who has paid the outstanding
14premiums.
AB365,30 15Section 30. 49.471 (10) (b) 5. of the statutes, as affected by 2013 Wisconsin Act
161152
, and 2013 Wisconsin Act .... (this act), is repealed and recreated to read:
AB365,11,317 49.471 (10) (b) 5. If a recipient who is required to pay a premium under this
18paragraph or under sub. (2m) either does not pay a premium when due or requests
19that his or her coverage under this section be terminated, the recipient's coverage
20terminates. If the recipient is an adult, the recipient is not eligible for BadgerCare
21Plus for 12 consecutive calendar months following the date on which the recipient's
22coverage terminated, except for any month during that 12-month period when the
23recipient's family income does not exceed 133 percent of the poverty line. If the
24recipient is a child, the recipient is not eligible for BadgerCare Plus for 3 consecutive
25calendar months following the date on which the recipient's coverage terminated,

1except for any month during that period when the recipient's family income does not
2exceed 150 percent of the poverty line. This period of ineligibility for a child does not
3apply to any child who has paid the outstanding premiums.
AB365,31 4Section 31. 49.471 (11) (intro.) of the statutes, as affected by 2013 Wisconsin
5Act 20
, is amended to read:
AB365,11,96 49.471 (11) Benchmark plan benefits and copayments. (intro.) Except as
7provided in sub. (11r) and s. 49.45 (24j), recipients who are not eligible for the benefits
8described in s. 49.46 (2) (a) and (b) shall have coverage of the following benefits and
9pay the following copayments:
AB365,32 10Section 32. 49.471 (11r) of the statutes, as created by 2013 Wisconsin Act 20,
11is repealed.
AB365,33 12Section 33. Effective dates. This act takes effect on the day after publication,
13except as follows:
AB365,11,1614 (1) The repeal and recreation of sections 49.46 (1) (c) (intro.) and 49.471 (4) (a)
157. and (10) (b) 5. of the statutes takes effect on January 1, 2014, or the day after
16publication, whichever is later.
AB365,11,1717 (End)
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