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LEGISLATURE
OF
THE
STATE
OF
IDAHO
Sixty-eighth
Legislature
Second
Regular
Session
-
2026
IN
THE
SENATE
SENATE
BILL
NO.
1267
BY
HEALTH
AND
WELFARE
COMMITTEE
AN
ACT
1
RELATING
TO
MEDICAID;
AMENDING
CHAPTER
2,
TITLE
56,
IDAHO
CODE,
BY
THE
AD
-
2
DITION
OF
A
NEW
SECTION
56
-
276,
IDAHO
CODE,
TO
ESTABLISH
PROVISIONS
RE
-
3
GARDING
POLICY
OPTIONS
FOR
MEDICAID
FOR
WORKERS
WITH
DISABILITIES
AND
4
HOME
AND
COMMUNITY
-
BASED
SERVICES;
AND
DECLARING
AN
EMERGENCY.
5
Be
It
Enacted
by
the
Legislature
of
the
State
of
Idaho:
6
SECTION
1.
That
Chapter
2,
Title
56,
Idaho
Code,
be,
and
the
same
is
7
hereby
amended
by
the
addition
thereto
of
a
NEW
SECTION
,
to
be
known
and
des
-
8
ignated
as
Section
56
-
276,
Idaho
Code,
and
to
read
as
follows:
9
56
-
276.
MEDICAID
FOR
WORKERS
WITH
DISABILITIES
AND
HOME
AND
COMMU
-
10
NITY
-
BASED
SERVICES
-
-
POLICY
OPTIONS
STUDY.
1
1
(1)(a)
The
legislature
finds
that:
12
(i)
Idaho
has
a
strong
interest
in
encouraging
work,
self
-
suffi
-
13
ciency,
and
personal
responsibility,
including
through
policies
14
that
allow
individuals
with
disabilities
to
work,
earn
income,
and
15
save
for
their
future;
16
(ii)
Idaho's
medicaid
for
workers
with
disabilities
program
17
is
intended
to
incentivize
work
by
allowing
individuals
with
18
disabilities
to
maintain
medicaid
coverage
while
working
and
ac
-
19
cumulating
assets;
20
(iii)
Many
individuals
who
participate
in
medicaid
programs
21
worked
for
many
years,
contributed
to
their
communities
and
the
22
state
economy,
and
saved
modest
assets
to
support
stable
and
inde
-
23
pendent
living;
24
(iv)
Some
individuals
who
are
enrolled
in
the
medicaid
for
25
workers
with
disabilities
program
later
experience
age
-
related
26
changes
or
progression
of
disability
that
limit
or
prevent
contin
-
27
ued
employment;
28
(v)
Upon
transitioning
from
the
medicaid
for
workers
with
dis
-
29
abilities
program
to
other
medicaid
programs
or
home
and
commu
-
30
nity
-
based
services
waivers,
such
individuals
may
be
required
to
31
give
up
assets
earned
through
work,
which
can
discourage
employ
-
32
ment,
undermine
savings
incentives,
and
increase
the
risk
of
un
-
33
necessary
institutionalization;
34
(vi)
Medicaid
home
and
community
-
based
services
waivers
allow
35
Idahoans
with
disabilities
and
older
adults
to
receive
long
-
term
36
services
and
supports
in
their
homes
and
communities
rather
than
37
in
institutional
settings;
38
(vii)
Some
home
and
community
-
based
services
waiver
participants
39
are
required
to
pay
a
high
share
of
cost,
leaving
limited
income
or
40
resources
to
pay
for
basic
nonmedical
needs
such
as
housing,
util
-
41
ities,
and
transportation;
42
2
(viii)
When
individuals
cannot
afford
these
basic
living
ex
-
1
penses,
they
may
be
forced
into
institutional
settings
even
though
2
they
could
safely
remain
in
their
homes
with
appropriate
supports;
3
and
4
(ix)
Institutional
care
is
often
more
costly
than
home
and
com
-
5
munity
-
based
services
and
may
reduce
independence
and
quality
of
6
life.
7
(b)
It
is
the
intent
of
the
legislature
to
direct
the
department
of
8
health
and
welfare
to
identify
and
evaluate
options
within
existing
9
federal
medicaid
authority
that:
prioritize
continuity
for
individ
-
10
uals
enrolled
in
or
transitioning
from
the
medicaid
for
workers
with
1
1
disabilities
program,
maintain
incentives
for
work
and
saving,
avoid
12
penalizing
individuals
who
worked
and
saved
but
later
require
services,
13
and
support
continued
community
living
in
order
to
reduce
the
risk
of
14
unnecessary
institutional
placement.
15
(2)
The
department
of
health
and
welfare
is
directed
to:
16
(a)
Identify
and
evaluate
policy
options
for
individuals
enrolled
in
17
or
transitioning
from
the
medicaid
for
workers
with
disabilities
pro
-
18
gram
due
to
age
-
related
or
disability
-
related
limits
on
continued
em
-
19
ployment
and
medicaid
home
and
community
-
based
services
waiver
partic
-
20
ipants
who:
21
(i)
Have
a
high
share
of
cost
or
similar
financial
participation
22
requirement;
23
(ii)
Are
unable
to
meet
essential
nonmedical
living
expenses
24
needed
for
community
living;
and
25
(iii)
Would
otherwise
be
at
risk
of
placement
in
an
institutional
26
setting;
27
(b)
Examine
options
including
but
not
limited
to:
28
(i)
Options
to
modify,
remove,
or
provide
alternatives
to
age
-
re
-
29
lated
eligibility
limits
in
the
medicaid
for
workers
with
disabil
-
30
ities
program;
31
(ii)
Asset
or
resource
protections
allowed
under
federal
medicaid
32
law;
33
(iii)
Alternative
methods
in
which
income
or
resources
may
be
con
-
34
sidered
for
affected
individuals;
35
(iv)
Limited
exclusions
or
allowances
related
to
housing
stabil
-
36
ity
and
community
living;
37
(v)
Waiver
amendments,
demonstrations,
or
other
federal
authori
-
38
ties
that
support
community
living;
and
39
(vi)
Approaches
used
by
other
states
to
preserve
work
incentives
40
while
reducing
unnecessary
institutionalization;
and
41
(c)
Consider
the
fiscal
impact,
administrative
feasibility,
and
poten
-
42
tial
effects
on
individual
independence,
quality
of
life,
and
long
-
term
43
medicaid
costs
of
options
identified
and
evaluated
pursuant
to
this
44
subsection.
45
(3)
In
evaluating
options
related
to
the
medicaid
for
workers
with
dis
-
46
abilities
program
pursuant
to
subsection
(2)
of
this
section,
the
department
47
of
health
and
welfare
shall
prioritize
approaches
that:
48
(a)
Preserve
incentives
to
work
and
save;
49
(b)
Recognize
assets
earned
through
employment;
50
3
(c)
Support
continuity
of
coverage
and
community
living
when
work
is
no
1
longer
possible
due
to
age
or
disability;
and
2
(d)
Avoid
unintentionally
penalizing
individuals
for
prior
employment
3
or
savings.
4
(4)
In
carrying
out
the
provisions
of
this
section,
the
department
of
5
health
and
welfare
shall:
6
(a)
Consult
and
collaborate,
to
the
extent
practicable,
with
commu
-
7
nity
-
based
organizations,
including
organizations
representing
work
-
8
ers
with
disabilities,
centers
for
independent
living,
provider
orga
-
9
nizations,
consumer
advocacy
groups,
and
other
entities
that
work
di
-
10
rectly
with
individuals
affected
by
medicaid
for
workers
with
disabili
-
1
1
ties
or
medicaid
home
and
community
-
based
services
policies;
12
(b)
Seek
input,
to
the
extent
practicable,
from
individuals
enrolled
13
in
or
transitioning
from
the
medicaid
for
workers
with
disabilities
14
program,
individuals
receiving
home
and
community
-
based
services,
and
15
families
and
caregivers
of
such
individuals;
and
16
(c)
Consider
stakeholder
and
consumer
input
when
evaluating
options
17
and
developing
recommendations.
18
(5)
No
later
than
December
1,
2026,
the
department
of
health
and
wel
-
19
fare
shall
submit
a
written
report
to
the
health
and
welfare
committees
of
20
the
Idaho
senate
and
the
Idaho
house
of
representatives
that
includes:
21
(a)
Options
identified
by
the
department,
with
specific
findings
re
-
22
lated
to
medicaid
for
workers
with
disabilities;
23
(b)
Any
federal
approvals
that
would
be
required;
24
(c)
Estimated
fiscal
impacts,
including
potential
cost
avoidance
from
25
reduced
institutionalization;
26
(d)
Administrative
considerations;
and
27
(e)
Recommendations
for
legislative
or
administrative
action.
28
SECTION
2.
An
emergency
existing
therefor,
which
emergency
is
hereby
29
declared
to
exist,
this
act
shall
be
in
full
force
and
effect
on
and
after
its
30
passage
and
approval.
31