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HR 1598119th CongressIn Committee

Ensuring Access to Medicaid Buy-in Programs Act

Introduced: Feb 26, 2025
Standard Summary
Comprehensive overview in 1-2 paragraphs

The Ensuring Access to Medicaid Buy-in Programs Act would remove the age cap of 65 from the Medicaid “buy-in” eligibility for working adults with disabilities. By amending sections of the Social Security Act, the bill allows individuals who are working and have disabilities to qualify for Medicaid Buy-In programs regardless of being 65 or older, broadening access for older workers with disabilities. It also includes a transitional provision: states that currently offer medical assistance to individuals covered by these buy-in groups will not be deemed out of compliance before January 1, 2027, giving states time to adjust to the new eligibility rules. In essence, the bill expands Medicaid coverage options for working-age and older adults with disabilities by eliminating the age limit that previously restricted eligibility, and it provides a grace period for states to adapt to the change.

Key Points

  • 1Removes the age restriction “but less than 65” from the optional Medicaid buy-in eligibility groups, effectively allowing individuals 65 and older to qualify if they are working and have disabilities.
  • 2Amends two sections of the Social Security Act (1902(a)(10)(A)(ii)(XV) and 1905(v)(1)(A)) to implement this change.
  • 3Adds a transition provision: states that already provide medical assistance to individuals described in these buy-in groups before enactment will not be considered out of compliance before January 1, 2027.
  • 4The bill focuses on the eligibility rules related to Medicaid Buy-In programs, not on funding levels or overall Medicaid financing beyond the statutory modification and transitional compliance window.
  • 5Sponsor information indicates introduction in the House in February 2025; exact fiscal impact and implementation details would depend on subsequent rulemaking and state action.

Impact Areas

Primary group/area affected: Working adults with disabilities aged 65 and older who may qualify for Medicaid Buy-In programs; individuals with disabilities who are employed and rely on Medicaid for healthcare coverage.Secondary group/area affected: State Medicaid programs (governors’ administrations and state health agencies), Medicaid managed care entities, and healthcare providers serving this population; potential interplay with other coverage programs (e.g., Medicare) for dual-eligible individuals.Additional impacts: Potential changes in state budget planning and federal funding requirements for Medicaid, as well as administrative work to modify state plans and eligibility systems; possible effects on enrollment dynamics as more individuals become eligible due to removal of the age cap.
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