SESSION WATCH
Died SENATE · SESSION 2026

No. SB 1408

Medical Coverage Assistance Program for Working Individuals with Disabilities
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SPONSOR
Smith
FILED BY
Carlos Guillermo Smith — District 17, Democrat [search donations]
EFFECTIVE
Upon becoming a law
DIED IN
Health Policy

Filed under Healthcare.

PROVIDED SUMMARY

Medical Coverage Assistance Program for Working Individuals with Disabilities; Citing this act as the "Economic Self-Sufficiency for Working Individuals with Disabilities Act"; contingent upon federal approval, requiring the Agency for Health Care Administration to implement and administer a Medicaid buy-in program for specified individuals with disabilities under certain circumstances; requiring the agency to determine the income eligibility level for the program; specifying requirements for the program; requiring the agency to seek federal approval through a Medicaid waiver or state plan amendment by a specified date, etc.

Full bill text →

Plain English Summary

AI-GENERATED
Lets working individuals with disabilities buy into Medicaid coverage.

Creates a Medicaid buy-in program letting working individuals with disabilities, ages 18 to 64, keep Medicaid coverage even after their income rises above the usual eligibility limit, contingent on federal approval of the change.

The agency sets the new, higher income cutoff itself, and the program must cover full Medicaid benefits while capping premiums or cost-sharing at a percentage of income the agency also gets to set.

The agency must ask the federal government for approval by October 1, 2026, but nothing in the program exists for anyone unless and until that federal approval actually comes through.

KEY PROVISIONS
§ 1 Creates a Medicaid buy-in program for working individuals with disabilities majors. 409.9141

AIThe agency must implement and administer a Medicaid buy-in program under federal Ticket to Work authority for people with disabilities, ages 18 to 64, who work but earn too much for standard Medicaid eligibility.

“the agency shall implement and administer a Medicaid buy-in program, authorized under the Ticket to Work and Work Incentives Improvement Act of 1999” bill text, line 26 →
§ 2 Agency alone sets the new income eligibility ceiling majors. 409.9141

AIRather than a fixed income limit written into the statute, the agency itself determines the new, higher income eligibility level that lets a working person with a disability qualify for the buy-in program.

“The agency shall determine the new income eligibility level for such individuals” bill text, line 33 →
§ 3 Guarantees full Medicaid benefits with income-based cost-sharing majors. 409.9141

AIThe buy-in program must provide the same full scope of Medicaid benefits as regular Medicaid, and any premium or cost-sharing charged to participants must be limited to a percentage of the individual's income, set by the agency.

“must provide full Medicaid benefits to eligible individuals and limit any premium or cost sharing to a percentage of an individual's income” bill text, line 36 →
§ 4 Program only takes effect if the federal government approves it majors. 409.9141

AIThe agency's duty to actually implement and administer the buy-in program is triggered only once federal approval is granted; nothing in the act requires the program to operate absent that approval.

“The agency shall implement and administer the Medicaid buy-in program upon receiving federal approval” bill text, line 43 →
§ 5 Sets an October 2026 deadline to seek federal approval moderates. 409.9141

AIThe agency must formally request federal approval for the program, through a Medicaid waiver or state plan amendment, no later than October 1, 2026.

“By October 1, 2026, the agency shall seek federal approval through a Medicaid waiver or state plan amendment” bill text, line 40 →
TIMELINE
3/13/2026
Died in Health Policy
1/22/2026
Introduced
1/16/2026
Referred to Health Policy; Appropriations Committee on Health and...
1/8/2026
Filed
STATUTES IT CHANGES
s. 409.9141
+16 / −0
s. 409.9141
+186 / −0