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2025 ASSEMBLY BILL 97
February 28, 2025 - Introduced by Representatives SNYDER, RODRIGUEZ, ALLEN,
ANDERSON, ANDRACA, ARNEY, BARE, BEHNKE, BILLINGS, BROWN, CLANCY,
CRUZ, DESMIDT, DITTRICH, DONOVAN, DOYLE, DUCHOW, EMERSON,
FITZGERALD, FRANKLIN, GOODWIN, GUNDRUM, GUSTAFSON, HONG, HYSELL, J.
JACOBSON, JOERS, JOHNSON, KAUFERT, KIRSCH, KITCHENS, KREIBICH, KRUG,
KURTZ, MADISON, MAXEY, MAYADEV, MCCARVILLE, MELOTIK, MIRESSE,
MOORE OMOKUNDE, MURSAU, NEUBAUER, NEYLON, NOVAK, PALMERI,
PETERSEN, PHELPS, PRADO, RIVERA-WAGNER, ROE, SHEEHAN, SINICKI,
SNODGRASS, SPAUDE, STEFFEN, STROUD, STUBBS, SUBECK, TAYLOR, TENORIO,
TUSLER, UDELL, VINING, WICHGERS, WITTKE and SUMMERFIELD, cosponsored
by Senators JAMES, FELZKOWSKI, BRADLEY, DASSLER-ALFHEIM, DRAKE, FEYEN,
HABUSH SINYKIN, HESSELBEIN, KEYESKI, LARSON, MARKLEIN, PFAFF, QUINN,
RATCLIFF, ROYS, SPREITZER, TOMCZYK, WALL, WANGGAARD, WIMBERGER,
WIRCH and CARPENTER. Referred to Committee on Regulatory Licensing
Reform.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to amend 49.46 (1) (a) 1m., 49.46 (1) (j), 49.47 (4) (ag) 2., 49.471 (6) (b)
and 49.471 (7) (b) 1. of the statutes; relating to: extension of eligibility under
the Medical Assistance program for postpartum women.
Analysis by the Legislative Reference Bureau
This bill requires the Department of Health Services to seek approval from
the federal Department of Health and Human Services to extend until the last day
of the month in which the 365th day after the last day of the pregnancy falls
Medical Assistance benefits to women who are eligible for those benefits when
pregnant. Currently, postpartum women are eligible for Medical Assistance
benefits until the last day of the month in which the 60th day after the last day of
the pregnancy falls. 2021 Wisconsin Act 58 required DHS to seek approval from the
federal Department of Health and Human Services to extend these postpartum
Medical Assistance benefits until the last day of the month in which the 90th day
after the last day of the pregnancy falls. On June 3, 2022, DHS filed a Section 1115
Demonstration Waiver application with the federal Centers for Medicare &
Medicaid Services to extend postpartum coverage for eligible Medical Assistance
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recipients, as required by 2021 Wisconsin Act 58. The Medical Assistance program
is a joint federal and state program that provides health services to individuals who
have limited financial resources.
For further information see the state 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:
SECTION 1. 49.46 (1) (a) 1m. of the statutes is amended to read:
49.46 (1) (a) 1m. Any pregnant woman whose income does not exceed the
standard of need under s. 49.19 (11) and whose pregnancy is medically verified.
Eligibility continues to the last day of the month in which the 60th day or, if
approved by the federal government, the 90th 365th day after the last day of the
pregnancy falls.
SECTION 2. 49.46 (1) (j) of the statutes is amended to read:
49.46 (1) (j) An individual determined to be eligible for benefits under par. (a)
9. remains eligible for benefits under par. (a) 9. for the balance of the pregnancy and
to the last day of the month in which the 60th day or, if approved by the federal
government, the 90th 365th day after the last day of the pregnancy falls without
regard to any change in the individual[s family income.
SECTION 3. 49.47 (4) (ag) 2. of the statutes is amended to read:
49.47 (4) (ag) 2. Pregnant and the woman[s pregnancy is medically verified.
Eligibility continues to the last day of the month in which the 60th day or, if
approved by the federal government, the 90th 365th day after the last day of the
pregnancy falls.
SECTION 4. 49.471 (6) (b) of the statutes is amended to read:
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49.471 (6) (b) A pregnant woman who is determined to be eligible for benefits
under sub. (4) remains eligible for benefits under sub. (4) for the balance of the
pregnancy and to the last day of the month in which the 60th day or, if approved by
the federal government, the 90th 365th day after the last day of the pregnancy falls
without regard to any change in the woman[s family income.
SECTION 5. 49.471 (7) (b) 1. of the statutes is amended to read:
49.471 (7) (b) 1. A pregnant woman whose family income exceeds 300 percent
of the poverty line may become eligible for coverage under this section if the
difference between the pregnant woman[s family income and the applicable income
limit under sub. (4) (a) is obligated or expended for any member of the pregnant
woman[s family for medical care or any other type of remedial care recognized
under state law or for personal health insurance premiums or for both. Eligibility
obtained under this subdivision continues without regard to any change in family
income for the balance of the pregnancy and to the last day of the month in which
the 60th day or, if approved by the federal government, the 90th 365th day after the
last day of the woman[s pregnancy falls. Eligibility obtained by a pregnant woman
under this subdivision extends to all pregnant women in the pregnant woman[s
family.
(END)
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