Sponsors (2)
The bill expands Medicaid buy-in eligibility to disabled seniors—improving access and reducing out-of-pocket costs for that group—while increasing fiscal and administrative burdens for states and allowing temporary, uneven implementation across states.
People with disabilities aged 65 and older can become eligible for a Medicaid buy-in, expanding access to health care for disabled seniors and potentially improving continuity of care.
Older disabled individuals who enroll through the buy-in may face lower out-of-pocket costs compared with pricier private insurance or gaps in Medicare coverage.
States that already cover these groups are protected from being cited for noncompliance until January 1, 2027, giving state governments time to adapt implementation without immediate federal penalties.
States that expand buy-in eligibility may face higher Medicaid costs, creating budget pressure and possible requests for increased federal matching funds.
Including people 65+ in buy-in groups could create coordination and administrative complexity with Medicare benefits, complicating enrollment and benefit management for states and beneficiaries.
The temporary protection from noncompliance findings until 2027 may delay federal oversight and produce short-term variability in eligibility and coverage rules across states.
Based on analysis of 2 sections of legislative text.
Removes the statutory under‑65 cap for certain Medicaid buy‑in groups so States may include individuals 65+ and delays noncompliance findings until Jan 1, 2027.
Official title: To amend title XIX of the Social Security Act to remove certain age restrictions on Medicaid eligibility for working adults with disabilities.
Introduced February 26, 2025 by Juan Ciscomani · Last progress February 26, 2025
Removes the explicit upper-age limit for optional Medicaid "buy-in" groups for working adults with disabilities so that people aged 65 and older can be included; and delays any determination of State noncompliance for States that already cover those groups until January 1, 2027. The change expands who may qualify for these Medicaid buy-in options and gives States time to align existing programs with the new statutory language.