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AB 604

Relating to: coverage under the Medical Assistance program for incarcerated individuals. (FE)

2025-2026 Regular Session Introduced by Clint Anderson and 23 co-sponsors

The bill would seek a federal Medicaid waiver to provide pre‑release limited health coverage and services for incarcerated individuals to improve post‑release care.

Published 4-9-2026
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WeVote Research Nonpartisan
Bill Summary · AB 604

AB 604 — Summary (Medical Assistance coverage for incarcerated individuals)

Note: Materials provided include a fiscal estimate (Wisconsin LRB 25-5196/1 / AB‑0604) describing pre‑release Medicaid coverage. This summary synthesizes that material: the bill would require the state Department of Health Services to pursue a federal Medicaid waiver to allow pre‑release coverage for incarcerated people.

Main purpose

AB 604 directs the Department of Health Services (DHS) to seek a federal Medicaid (Medical Assistance) waiver to run a demonstration that provides limited Medicaid coverage and services to Medicaid‑eligible individuals while they are still incarcerated in the period before release. The objective is to improve care transitions and health outcomes after release (reduce gaps in treatment, support re‑entry).

Key provisions

  • Requires DHS to submit a waiver request to the federal Department of Health and Human Services no later than January 1, 2027.
  • The waiver would authorize a demonstration project to provide pre‑release coverage under Medical Assistance for selected services for soon‑to‑be‑released incarcerated individuals.
  • Covered elements (as proposed in the fiscal estimate) would include:
    • Case management services prior to release.
    • Medication‑assisted treatment (MAT) for substance use disorders (the estimate contemplates MAT for opioid treatment and assumes up to 25% participation among enrolled individuals).
    • A 30‑day supply of prescription medications prior to release.
  • The demonstration could provide coverage for up to 90 days before release (the fiscal estimate models both one‑month and three‑month pre‑release participation scenarios).
  • If the state replaces services previously funded by state/local funds with federal Medicaid matching dollars, federal rules require reinvestment of any state/local savings in activities that expand access to or improve quality of health care for incarcerated individuals.

Who would be affected

  • Medicaid‑eligible incarcerated individuals in state correctional facilities who are nearing release (participants in the demonstration).
  • The Department of Health Services (state agency) — responsible for preparing and submitting the waiver and administering the demonstration if approved.
  • Potentially counties/localities if they currently fund services that would become federally matched (subject to reinvestment rules).
  • Medicaid program budgets and providers delivering case management, MAT and pharmacy services.

Estimated fiscal impact

  • DHS estimates increased Medicaid expenditures of about $9.6 million All Funds annually at full implementation (estimated $3.7 million General Purpose Revenue). This is based on projected participation (estimated ~5,400 inmates/year for three‑month coverage and ~3,400 inmates for one‑month coverage) and modeled per‑member costs for limited services.
  • Some costs might be offset over time if the demonstration reduces higher‑cost care (for example, inpatient stays), but such savings are indeterminate in the estimate.
  • The fiscal note indicates it may be possible to absorb increased costs within agency budgets but flags appropriation and fund code considerations.

Timing & procedural status (from provided materials)

  • Bill introduced Oct 29, 2025 (listed as AB‑0604 / LRB 25‑5196/1 in the fiscal estimate).
  • DHS required to submit waiver by January 1, 2027.
  • Fiscal estimates and public hearing entries in November 2025 are included in the record.

If you want, I can:
- Draft a short explanation of how the federal Medicaid waiver process works and likely approval issues;
- List potential implementation steps DHS would need to take if the waiver is approved; or
- Prepare a one‑page brief for stakeholders summarizing operational impacts on correctional health services.

Compiled from official sources — confirm details with the bill’s official record.

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