Assistance for childless adults demonstration project.

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Assistance for childless adults demonstration project.

The department shall request a waiver from the secretary of the federal department of health and human services to permit the department to conduct a demonstration project to provide health care coverage to adults who are under the age of 65, who have family incomes not to exceed 100 percent of the poverty line before application of the 5 percent income disregard under 42 CFR 435.603 (d), and who are not otherwise eligible for medical assistance under this subchapter, the Badger Care health care program under s. 49.665, or Medicare under 42 USC 1395 et seq.

(b)#

If the waiver is granted and in effect, the department may promulgate rules defining the health care benefit plan, including more specific eligibility requirements and cost-sharing requirements. Cost sharing may include an annual enrollment fee, which may not exceed $75 per year. Notwithstanding s. 227.24 (3), the plan details under this subsection may be promulgated as an emergency rule under s. 227.24 without a finding of emergency. If the waiver is granted and in effect, the demonstration project under this subsection shall begin on the effective date of the waiver.

(d)#

In determining income for purposes of eligibility under this subsection, the department shall apply s. 49.471 (7) (d) to the individual to the extent the federal department of health and human services approves, if approval is required.

(e)#

The department shall apply the definition of family income under s. 49.471 (1) (f) and the regulations defining household under 42 CFR 435.603 (f) to determinations of income for purposes of eligibility under this subsection.

(f)#

The department may provide services to individuals who are eligible under this subsection through a medical home initiative under sub. (24j).

(g)#

The department shall submit to the secretary of the federal department of health and human services an amendment to the waiver requested under par. (a) that authorizes the department to do all of the following with respect to the childless adults demonstration project under this subsection: 1. Impose monthly premiums as determined by the department. 2. Impose higher premiums for enrollees who engage in behaviors that increase their health risks, as determined by the department. 3. Require a health risk assessment for all enrollees. 4. Limit an enrollee’s eligibility under the demonstration project to no more than 48 months. The department shall specify the eligibility formula in the waiver amendment. 5. Require, as a condition of eligibility, that an applicant or enrollee submit to a drug screening assessment and, if indicated, a drug test, as specified by the department in the waiver amendment. 6. Provide employment and training services to childless adults receiving Medical Assistance under this subsection.

(g)(1)#

Impose monthly premiums as determined by the department.

(g)(2)#

Impose higher premiums for enrollees who engage in behaviors that increase their health risks, as determined by the department.

(g)(3)#

Require a health risk assessment for all enrollees.

(g)(4)#

Limit an enrollee’s eligibility under the demonstration project to no more than 48 months. The department shall specify the eligibility formula in the waiver amendment.

(g)(5)#

Require, as a condition of eligibility, that an applicant or enrollee submit to a drug screening assessment and, if indicated, a drug test, as specified by the department in the waiver amendment.

(g)(6)#

Provide employment and training services to childless adults receiving Medical Assistance under this subsection.