A bill for an act relating to the establishment of the work without worry program under the medical assistance program for employed individuals with disabilities, and including effective date provisions.
This bill establishes a new Medicaid-related program called the “work without worry” program for employed individuals with disabilities. The program is intended to reduce barriers to employment by allowing eligible adults with disabilities to receive medical assistance coverage while working, even if they have income or resources that would otherwise affect eligibility. It also preserves access to traditional Medicaid services and, where applicable, long-term services and supports, community-based services, and waiver services.
The bill sets out eligibility rules, premium requirements, and administrative duties for the Department of Health and Human Services. Eligible participants must be at least 18 and under 65, have a qualifying disability, be employed, and otherwise qualify for Medicaid under chapter 249A. The bill prohibits the department from using income, resource limits, or receipt of federal disability benefits as eligibility barriers, and it automatically enrolls SSI recipients. Monthly premiums are set at 6 percent of verified countable income, with a six-month coverage grace period for temporary job loss or a health crisis, and termination allowed after four consecutive months of unpaid premiums. The department must adopt rules and seek any necessary federal waiver or state plan amendment to implement the program, and current Medicaid for employed persons with disabilities enrollees would be transferred into the new program.
The bill’s impact on state law would be significant because it replaces the current Medicaid for employed persons with disabilities framework with a broader, more flexible eligibility structure. It directs the state Medicaid agency to administer the program, coordinate benefits with employer coverage, and align the program with federal Medicaid authorities under the Social Security Act. It also changes how premiums are calculated and removes income and resource tests that currently limit access for working people with disabilities.
Overall sentiment appears supportive and policy-driven, with the bill framed as an effort to promote employment and reduce “worry” about losing health coverage. The bill text and explanation emphasize expanding access and simplifying enrollment, especially for SSI recipients and people who temporarily lose work due to illness. No committee transcript or vote record is available here, so there is no documented opposition or recorded vote sentiment in the provided materials.
The main points of potential contention are the removal of income and resource limits, the state’s obligation to seek federal approval, and the premium structure tied to income. Questions could also arise about administrative complexity, coordination with private employer coverage, and the fiscal impact of expanding eligibility and maintaining coverage during employment interruptions. These issues would likely be of interest to Medicaid administrators, disability advocates, employers, and budget policymakers.
The bill would create a new chapter-based Medicaid program for employed individuals with disabilities and effectively supersede the existing Medicaid for employed persons with disabilities approach by transferring current participants into the new work without worry program. It would require the Department of Health and Human Services to adopt rules, coordinate with federal Medicaid authorities, and seek any needed waiver or state plan amendment. The bill also changes eligibility and premium administration by eliminating income and resource tests, setting a 6 percent income-based premium, and preserving access to Medicaid and related long-term services and supports for qualifying participants.
The bill’s overall tone is favorable toward expanding access to health coverage for working people with disabilities and encouraging employment without fear of losing Medicaid. The stated purpose is to remove barriers to work, and the structure of the bill reflects a policy choice to broaden eligibility and stabilize coverage. Because no committee discussion or vote history is provided, there is no direct evidence of recorded opposition or support beyond the bill’s text and explanation.
Likely areas of contention include the elimination of income and resource limits, which could increase program eligibility and state costs, and the requirement that the department obtain federal approval before implementation. The 6 percent premium formula, the six-month grace period after job loss or a health crisis, and the automatic eligibility for SSI recipients may also prompt debate over affordability, program integrity, and administrative burden. Stakeholders most likely to focus on these issues would be fiscal conservatives, Medicaid administrators, disability advocates, and employers coordinating coverage with the state program.