House Bill No. introduced by M. Caferro aims to revise the Medicaid buy-in program to expand access to healthcare services for children with disabilities. The bill includes an appropriation and grants rulemaking authority to the Department of Public Health and Human Services. Key amendments include the insertion of "buy-in" related to the Medicaid program, allowing children with disabilities to be included under the eligibility criteria. It also specifies that the department cannot apply financial criteria below $15,000 for resources other than income when determining eligibility for children under 19 years of age. Additionally, the bill ensures that individuals in the Medicaid buy-in program are not penalized for having individual retirement accounts and mandates Medicaid coverage for both workers and children with disabilities in compliance with federal regulations.

Furthermore, the bill enhances eligibility and support for individuals with disabilities, particularly children, by allowing them to qualify for Medicaid even if their income exceeds standard limits. It outlines criteria for children under 19 years of age to participate, including being considered disabled and having a family income within specified limits. The legislation also provides for continuous eligibility for medical assistance to infants and pregnant women, grants Medicaid coverage for individuals undergoing treatment for breast or cervical cancer, and establishes a framework for cooperation with nonprofit organizations to provide healthcare benefits to children ineligible for Medicaid. Financial contributions from families in the Medicaid buy-in program are regulated to ensure that premiums and cost-sharing do not exceed certain income percentages, with funding appropriated for fiscal years 2026 and 2027 and an effective date of July 1, 2025.

Statutes affected:
LC Text: 53-6-113, 53-6-131, 53-6-195
HB0881_1(1): 53-6-113, 53-6-131, 53-6-195
HB0881_1(2): 53-6-113, 53-6-131, 53-6-195
HB0881_1: 53-6-113, 53-6-131, 53-6-195