Idaho § 56-209n - Medicaid for workers with disabilities

§ 56-209n. Medicaid for workers with disabilities

(1) The legislature finds that many individuals with disabilities would like to work but cannot afford to enter the workforce due to the fear of losing necessary medical services received through medicaid. Idaho hereby seeks to avail itself of the opportunity available through the federal ticket to work and work incentives improvement act of 1999, which allows states to establish new medicaid eligibility categories for working people with disabilities whose income or resources would otherwise make them ineligible for medicaid. Eliminating barriers to health care and other needed services and supports and creating financial incentives to work will greatly improve the short and long-term financial independence and well-being of people with disabilities. Medicaid for workers with disabilities will serve to increase the productivity of Idaho residents with disabilities and thereby enhance the economic and fiscal status of this state.

(2) An individual is eligible to participate in the medicaid for workers with disabilities program if the individual:

(a) Is at least sixteen (16) years of age and not more than sixty-four (64) years of age;

(b) Has a disability as defined in title XVI of the federal social security act, as amended. An individual shall be determined to be eligible under this section without regard to his or her ability to engage in, or actual engagement in, substantial gainful activity, as defined in section 223(d)(4) of the social security act (42 U.S.C. section 423(d)(4));

(c) Is employed, including self-employment, and has provided the department of health and welfare with satisfactory written proof of employment. Hourly wage or hours worked shall not be used to determine employment;

(d) Has countable resources of ten thousand dollars ($10,000) or less. In calculating resources the following items shall be excluded: a second car, life insurance policies, retirement accounts, beneficial trusts, and any other resources excluded under current rules promulgated by the department of health and welfare for aid to aged, blind and disabled (AABD); and

(e) Has countable income, after exclusions and disregards as set forth in rules promulgated by the department of health and welfare for participants receiving AABD benefits, which do not exceed five hundred percent (500%) of the federal poverty level.

(3) An eligible individual who has an income as determined pursuant to subsection (2)(e) of this section less than one hundred thirty-three percent (133%) of the federal poverty level shall not be required to pay a premium for medicaid.

(4) The department of health and welfare may require an eligible individual who has an income as determined pursuant to subsection (2)(e) of this section of one hundred thirty-three percent (133%) to two hundred fifty percent (250%) of the federal poverty level to pay a monthly premium as set forth in rules promulgated by the department of health and welfare.

(5) An eligible individual who has an income as determined pursuant to subsection (2)(e) of this section in excess of two hundred fifty percent (250%) of the federal poverty level shall pay to the department of health and welfare a monthly premium as a condition for continued eligibility for medicaid. The monthly premium shall be calculated by multiplying seven and one-half percent (7.5%) by the amount of the individual’s income as determined pursuant to subsection (2)(e) of this section which is above two hundred fifty percent (250%) of the federal poverty level.

[56-209n, added 2006, ch. 174, sec. 1, p. 533.]