Assembly Bill 1153 aims to expand access to health insurance in Wisconsin by creating a purchase option for the BadgerCare program and establishing a state-based health insurance exchange. The bill mandates the Department of Health Services (DHS) to seek federal approval for a new program that allows individuals with incomes above the current eligibility limits to purchase BadgerCare coverage. This program must have a premium rate comparable to what the state pays to managed care contractors and a minimum actuarial value of 87 percent. Additionally, the bill requires DHS to develop a basic health plan for individuals with household incomes not exceeding 200 percent of the federal poverty line and to include options for small groups of 50 employees or fewer.

Furthermore, the bill directs the Office of the Commissioner of Insurance to create and operate a state-based health insurance exchange, which will facilitate enrollment in the new BadgerCare purchase option. The exchange must comply with federal regulations and allow for the use of advanced tax credits and cost-sharing credits for eligible individuals. The bill also includes provisions for DHS to report on the status of federal waiver requests and the necessary actuarial analyses by March 1, 2027. Overall, the legislation seeks to enhance health coverage options for Wisconsin residents while ensuring financial sustainability and continuity of care.