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Utah House passes waiver-based fix to prevent Medicaid "cliff" for adults with disabilities
Summary
The House approved House Bill 3 10 to seek a federal waiver that would allow adults with disabilities to retain Medicaid coverage for in‑home services while they increase earnings, aiming to avoid a sudden loss of care as beneficiaries gain income.
The Utah House on Feb. 18 passed House Bill 3 10, disability coverage amendments, sending the measure to the Senate by a 66–5 vote. The bill directs the state to seek a waiver from the Centers for Medicare & Medicaid Services that would let working adults with disabilities keep Medicaid coverage for certain in‑home services while their earnings phase up on a sliding scale.
Representative Jennifer Daley‑Provost, sponsor of the measure, told colleagues the bill is not an expansion of Medicaid. “This is not Medicaid expansion,” she said, and described the proposal as a “ramp” to prevent people from having to limit their income to retain critical services such as help with bathing, dressing and commuting to work. She said the change would allow beneficiaries to pursue higher‑paying jobs without immediately losing supports that enable them to work.
Under the proposal, eligible individuals who obtain employer coverage meeting Affordable Care Act standards would have Medicaid scale down to cover services the private plan does not provide. As private earnings increase, the state’s share would decline until the beneficiary reaches a specified ceiling (the bill referenced an upper target near 800% of the federal poverty level). The bill requires pursuing a federal waiver; if CMS denies the waiver the statutory mechanism would not take effect, the sponsor said.
Supporters described the bill as a way to avoid a severe benefits cliff that can disincentivize work. Representative Ryan D. Wilcox and Representative Hoang Nguyen joined others in describing the change as a way to give people a “hand up” and allow them to build savings and careers while continuing to receive necessary supports. Opponents raised questions about fiscal effects and asked staff to monitor the fiscal note; the sponsor said the bill may trigger a fiscal note because of interactions with premium/coverage credits and cost‑sharing rules.
The House adopted the substitute and approved the bill 66–5. The sponsor said the state will apply to CMS for the waiver that would make the policy operational.
