Committee endorses waiver plan to let some working adults with disabilities keep Medicaid for in‑home supports

A sponsor (identified in the transcript only as "the representative" for this agenda item) told the committee HB 310 is intended to help adults with long‑term physical disabilities who can work but rely on Medicaid to pay for in‑home services — personal assistance for bathing, dressing and getting out the door — that employer or marketplace insurance typically does not cover.

The bill would require the Utah Department of Health to seek federal approval for a program (a waiver) that preserves Medicaid coverage only for those wrap‑around in‑home supports while the individual keeps their employer-sponsored minimum essential coverage. The proposal includes a sliding contribution structure so that as an individual’s gross income rises the state share of wrap‑around coverage is reduced and eventually phases out when a beneficiary’s gross income reaches $125,000 per year, the sponsor said. Witnesses from the disability community, including a college student who said she has declined promotions to remain under the income threshold, and disability-law advocates urged support; one witness cited Tennessee’s recently enacted similar program.

Committee members asked about fiscal impacts, how insurance referrals interact with licensing, and how sliding-scale premiums would be calculated. The fiscal note referenced in committee estimated modest state costs (the sponsor and a fiscal summary noted that a cohort example would amount to a relatively small number of individuals and a per-person cost), and advocates argued the program would increase employment opportunities for people with disabilities. Representative Ivory moved that the committee favorably recommend HB 310; the committee approved the motion (one member recorded an opposition during voice calls earlier) and the bill passed out of committee on that recommendation.