SB 451: RELATING TO PERSONS WITH DISABILITIES.

A BILL FOR AN ACT

RELATING TO PERSONS WITH DISABILITIES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§346-    Medicaid buy-in program for workers with disabilities.  (a)  The department shall adopt the option made available under section 1902(a)(10)(A)(ii)(XIII) of the federal Social Security Act.

     (b)  To be eligible for benefits under this section, an individual shall:

     (1)  Have a net countable income greater than two hundred fifty per cent of the federal poverty level for one person or, if the deeming of spousal income applies to the individual, the individual shall have a net countable income greater than two hundred fifty per cent of the federal poverty level for two persons;

     (2)  Be disabled under title II or XVI or section 1902(v) of the federal Social Security Act; provided that an individual shall be determined to be eligible under this section without regard to the individual's ability to engage in, or actual engagement in, substantial gainful activity, as defined in section 223(d)(4) of the federal Social Security Act; and

     (3)  Except as otherwise provided in this section, have net nonexempt resources, which shall be determined in accordance with the methodology used under title XVI of the federal Social Security Act, that are not in excess of the limits provided for under those provisions.

     Countable income shall be determined under section 1612 of the federal Social Security Act, except that the individual's disability income, including all federal and state disability benefits and private disability insurance, shall be exempted.  Resources excluded under section 1613 of the federal Social Security Act shall be disregarded.

     Resources in the form of employer or individual retirement arrangements authorized under the Internal Revenue Code shall be exempted as authorized by section 1902(r) of the federal Social Security Act.

     (c)  Individuals eligible for benefits under this section shall be subject to the payment of premiums determined under this subsection.  The department shall:

     (1)  Establish sliding-scale premiums that are based on countable income, with a minimum premium of $20 per month and a maximum premium of $250 per month; and

     (2)  By rule, annually adjust the premiums.

Before adjustment of any premiums determined pursuant to this subsection, the department shall submit a report of proposed premium adjustments to the legislature no later than twenty days prior to the convening of each regular session.

     (d)  In order to implement the collection of premiums under this section, the department may:

     (1)  Develop and execute a contract with a public or private entity to collect premiums; or

     (2)  Amend any existing or future premium-collection contract that it has executed.

     (e)  The department shall adopt rules pursuant to chapter 91 necessary for the purposes of this section, including specifying the process for discontinuance of eligibility under this section for nonpayment of premiums for more than two months by a beneficiary.

     (f)  Notwithstanding any other provision of law, this section shall be implemented only if, and to the extent that, the department determines that federal financial participation is available pursuant to title XIX of the federal Social Security Act."

     SECTION 2.  New statutory material is underscored.

     SECTION 3.  This Act shall take effect on December 31, 2050.

Report Title:

DHS; Workers with Disabilities; Medicaid; Buy-In Program

Description:

Requires the Department of Human Services to establish a Medicaid buy-in program for workers with disabilities.  Effective 12/31/2050.  (SD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

Relating to persons with DISABILITIES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§346-     Medicaid buy-in program for workers with disabilities.  (a)  The department shall adopt the option made available under section 1902(a)(10)(A)(ii)(XIII) of the federal Social Security Act.

     (b)  To be eligible for benefits under this section, an individual shall:

     (1)  Have a net countable income greater than two hundred fifty per cent of the federal poverty level for one person or, if the deeming of spousal income applies to the individual, the individual shall have a net countable income greater than two hundred fifty per cent of the federal poverty level for two persons;

     (2)  Be disabled under title II or XVI or section 1902(v) of the federal Social Security Act; provided that an individual shall be determined to be eligible under this section without regard to the individual's ability to engage in, or actual engagement in, substantial gainful activity, as defined in section 223(d)(4) of the federal Social Security Act; and

     (3)  Except as otherwise provided in this section, have net nonexempt resources, which shall be determined in accordance with the methodology used under title XVI of the federal Social Security Act, that are not in excess of the limits provided for under those provisions.

     Countable income shall be determined under section 1612 of the federal Social Security Act, except that the individual's disability income, including all federal and state disability benefits and private disability insurance, shall be exempted.  Resources excluded under section 1613 of the federal Social Security Act shall be disregarded.

     Resources in the form of employer or individual retirement arrangements authorized under the Internal Revenue Code shall be exempted as authorized by section 1902(r) of the federal Social Security Act.

     (c)  Individuals eligible for benefits under this section shall be subject to the payment of premiums determined under this subsection.  The department shall:

     (1)  Establish sliding-scale premiums that are based on countable income, with a minimum premium of $20 per month and a maximum premium of $250 per month; and

     (2)  By rule, annually adjust the premiums.

Before adjustment of any premiums determined pursuant to this subsection, the department shall submit a report of proposed premium adjustments to the legislature no later than twenty days prior to the convening of each regular session.

     (d)  In order to implement the collection of premiums under this section, the department may:

     (1)  Develop and execute a contract with a public or private entity to collect premiums; or

     (2)  Amend any existing or future premium-collection contract that it has executed.

     (e)  The department shall adopt rules pursuant to chapter 91 necessary for the purposes of this section, including specifying the process for discontinuance of eligibility under this section for nonpayment of premiums for more than two months by a beneficiary.

     (f)  Notwithstanding any other provision of law, this section shall be implemented only if, and to the extent that, the department determines that federal financial participation is available pursuant to title XIX of the federal Social Security Act."

     SECTION 2.  New statutory material is underscored.

     SECTION 3.  This Act shall take effect upon its approval.

Report Title:

DHS; Workers with Disabilities; Medicaid; Buy-in Program

Description:

Requires the Department of Human Services to establish a Medicaid buy-in program for workers with disabilities.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

STAND. COM. REP. NO. 531

Honolulu, Hawaii

RE:    S.B. No. 451

       S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was referred S.B. No. 451 entitled:

"A BILL FOR AN ACT RELATING TO PERSONS WITH DISABILITIES,"

begs leave to report as follows:

     The purpose and intent of this measure is to require the Department of Human Services to establish a Medicaid buy-in program for workers with disabilities.

     Your Committee received testimony in support of this measure from the State Council on Developmental Disabilities, Hawaii Disability Rights Center, and one individual.

     Your Committee received comments on this measure from the Department of Human Services.

     Your Committee finds that it is advantageous for economic development in the State and in the best interests of its citizens with disabilities to establish programs and policies that encourage their employment.  Your Committee further finds that a Medicaid buy-in program allows individuals with disabilities to maintain Medicaid coverage while working and earning above the federal poverty level.  By expanding access to Medicaid, this measure helps individuals with disabilities achieve greater financial independence and access to essential health care services, without the fear of losing coverage as they increase their earnings.

     Your Committee has amended this measure by inserting

an effective date of December 31, 2050, to encourage further discussion.

     As affirmed by the record of votes of the members of your Committee on Health and Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 451, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 451, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committee on Health and Human Services,