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  • Jason Hahr

Self-Advocates Must Continue to Work on Bringing Medicaid Buy-In to Florida

Floridians with disabilities can still advocate for a Medicaid Buy-In option during the 2024 legislative session and throughout this year even though passage of a bill this session is unlikely.


Currently, the bill introduced by Senator Joe Gruters (SB 212) does not have a companion bill in the state house, and this is the only way for the bill to move forward. Unfortunately, prospective companion House Bill 567 was withdrawn.


Although Floridians with disabilities will not see their hopes of a Medicaid Buy-In program realized this year, legislators still need to hear how important this option is to people with disabilities in Florida. It’s been said it typically takes a viable bill three years to pass; that being said, there is hope that it will pass next year.


Medicaid Buy-In programs in 46 states provide workers with disabilities the option to stay on Medicaid insurance and earn in excess of traditional Medicaid limits by contributing to the cost of their Medicaid. Senate Bill 212 stipulates that the Medicaid buy-in program “must provide full Medicaid benefits to eligible individuals and limit any premiums or cost-sharing to a certain percentage of an individual’s income, as determined by [the Agency for Health Care Administration].”


Medicaid Buy-In prevents the earning potential and economic wellbeing of people with disabilities from being diminished just because they must stay on Medicaid in order to access the essential services and supports they need to live in the community -- services that are not often included in employer-provided health insurance plans.


Suppose you are a person with a disability on the waiver. You often must choose between staying on Medicaid to receive the services you need to function daily or making a living. Luckily, this dilemma in Florida has been partly addressed with the introduction of the Working Peoples with Disabilities program in 2019. Thanks to the hard work of self-advocates, Floridians on the iBudget waiver can now make close to $60,000 a year without losing Home and Community-Based services, including programs such as Consumer Directed Care (CDC Plus). Advocates in Florida will urge legislators to ensure any eventual Medicaid Buy-In limits extend beyond the Working People with Disabilities limits.


Self-advocates can still do things to prepare for the 2025 legislative session. We urge you to contact your legislators and tell them how disappointed you are that Medicaid Buy-In did not advance this session. We also encourage you to keep telling your personal stories to legislators and other decision-makers who can help get this legislation passed. Legislators need to hear how difficult it is for self-advocates to not be able to advance professionally because of Medicaid income limits. Along with your personal story, here are some key points worth mentioning to legislators:


  • While not perfect, a Medicaid Buy-In program would simplify things for all people with disabilities in Florida who work, not just those in the iBudget waiver.

  • People with disabilities want to be gainfully employed and contribute to Florida’s economy through payroll taxes and sharing in the cost of their health insurance. Medicaid Buy-In would also contribute to its enrollees’ dignity by allowing them to share in the cost of their health insurance. Medicaid Buy-In is a win-win for working people with disabilities and the other taxpayers of Florida.

  • Suppose people with disabilities continue to be unemployed or under-employed. In that case, Medicaid pays the entire bill, but if we are allowed to work, the more we earn, the more income we can contribute to our care via Medicaid Buy-In. We could contribute more to our care as our earnings increase and, eventually, we could take on a larger share of the cost.

  • A Medicaid Buy-In program is already available in 46 states.

  • This initiative is supported by prominent state organizations, Florida Self-Advocates Network'D (FL SAND) and Disability Rights Florida.


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