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SB 1408

Medical Coverage Assistance Program for Working Individuals with Disabilities

2026 Regular Session

Creates a Florida Medicaid Buy-In allowing employed individuals with disabilities to receive full Medicaid benefits with income above current limits, pending federal approval.

Died in Health Policy
#socialwelfare
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Bill Summary · SB 1408

Summary of Bill: SB 1408 (2026) – Medical Coverage Assistance Program for Working Individuals with Disabilities

Purpose and intent

  • Establishes a Medicaid buy-in program for working individuals with disabilities in Florida.
  • Aims to promote economic self-sufficiency by allowing certain employed people with disabilities to gain access to full Medicaid benefits even if their income exceeds existing eligibility limits for standard Medicaid coverage.
  • Contingent on federal approval (via a Medicaid waiver or state plan amendment).

Key provisions

  • Program creation and authority

    • Creates new Section 409.9141, Florida Statutes: Medicaid Buy-In Program for Individuals with Disabilities.
    • Program authorized under federal frameworks: Ticket to Work and Work Incentives Improvement Act of 1999 and the Balanced Budget Act of 1997.

  • Eligibility and scope

    • Target population: Individuals with disabilities aged 18 to 64 who are employed and have incomes above the current Medicaid initial enrollment income threshold.
    • Florida Agency: Agency for Health Care Administration (AHCA) would implement and administer the program, once federal approval is obtained.
    • Income determination: AHCA to determine a new, higher income eligibility level for these individuals to qualify for Medicaid coverage through the buy-in program.

  • Benefits and cost sharing

    • Eligible participants would receive full Medicaid benefits.
    • Premiums and cost sharing (e.g., premiums, copayments) would be limited to a percentage of the participant’s income, as set by AHCA. The exact proportion is not specified in the bill text but would be determined by the agency.

  • Administrative timeline

    • By October 1, 2026: AHCA must seek federal approval (via a waiver or state plan amendment) necessary to implement the buy-in program.
    • Only after receiving federal approval would the program be implemented and administered.

  • Effective date

    • The act would take effect upon becoming law.

Who would be affected

  • Primary beneficiaries: Working individuals with disabilities aged 18–64 whose income exceeds the current Medicaid eligibility threshold for initial enrollment but who seek access to full Medicaid benefits while employed.
  • Administrative bodies: Florida Agency for Health Care Administration (AHCA) would design, seek federal approval for, and administer the program if approved.
  • State fiscal/health policy: The program would operate under federal waivers or amendments, aligning with federal programs intended to support work incentives for people with disabilities.

Procedural and timeline notes

  • The bill requires federal approval before implementation.
  • AHCA is tasked with:
    • Determining the new income eligibility level for participation.
    • Seeking federal approval by October 1, 2026.
    • Implementing the program promptly after federal approval.
  • Status in the 2026 session: Introduced January 8, 2026; referred to committees; died in Health Policy on March 13, 2026 (no further action noted in the record provided).

Potential impact (high-level)

  • Expands Medicaid access to a subset of working individuals with disabilities who currently fall above standard income limits.
  • Encourages employment by offering health coverage with capped cost sharing.
  • Requires coordination with federal authorities and potential changes to Florida’s Medicaid waiver/state plan to enable enrollment and funding.

Note: Passage would depend on approval of the requested federal waivers or state plan amendments and subsequent state implementation.

Compiled from official sources — confirm details with the bill’s official record.

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