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Advocates urge codifying Medicaid buy‑in after CMS approval; Senate committee defers HB 16‑68
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Summary
Advocates and beneficiaries told the committee HB 16‑68 should codify recent Medicaid buy‑in changes — CMS approved a state plan amendment noted in testimony — but the committee deferred the bill, citing the recent federal action and budget implications if federal support changed.
Advocates and people with disabilities urged the Senate Health and Human Services Committee on March 20 to codify a Medicaid buy‑in and remove income and asset limits, telling lawmakers the changes allow people to work without losing essential services.
"We would like it codified in law," Jay Silver of the Hawaii State Council on Developmental Disabilities said, explaining a codified statutory requirement would protect program changes in future administrations. Testifiers said the program strengthens employment supports and that changing program rules could disrupt trust built over years.
Meredith from the Department of Human Services told the committee that the department "just received word on the seventeenth" that the Centers for Medicare & Medicaid Services approved the state plan amendment to remove income and resource limits and make the change retroactive to Jan. 1, 2026. Meredith said that if federal support were to end, the state would need a subsequent appropriation to continue the program.
Multiple beneficiaries described how Medicaid attendant services allow them to live and work in the community. Janelle Fiesta said she relies on caregiving services to work and live independently; Kylie Swan, who works part‑time, said she fears losing services if limits return and asked the committee to pass the amendment.
Despite support, the chair said the committee would defer HB 16-68 because CMS has already approved the requested change and the committee was reluctant to pass a bill now that could tie the legislature to future funding obligations. The record shows the committee deferred the bill rather than passing it at this session.
Why it matters: Testimony framed the bill as protecting newly approved program rules from administrative rollback and ensuring program continuity for people with disabilities who rely on Medicaid services to work and live in the community.
What's next: The committee deferred HB 16-68; proponents and the Department of Human Services may return with budget language or other clarifying statutory language in a future session.
