Missouri SB 629: Modifies the Ticket to Work Health Assurance Program

Bill Text

SECOND REGULAR SESSION
SENATE BILL NO. 629
100TH GENERAL ASSEMBLY
INTRODUCED BY SENATOR SIFTON.
Pre-filed December 1, 2019, and ordered printed.
ADRIANE D. CROUSE, Secretary.
3899S.01I
AN ACT
To repeal section 208.146, RSMo, and to enact in lieu thereof one new section relating
to the ticket to work health assurance program.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 208.146, RSMo, is repealed and one new section
2 enacted in lieu thereof, to be known as section 208.146, to read as follows:
208.146. 1. The program established under this section shall be known
2 as the "Ticket to Work Health Assurance Program". Subject to appropriations
3 and in accordance with the federal Ticket to Work and Work Incentives
4 Improvement Act of 1999 (TWWIIA), Public Law 106-170, the medical assistance
5 provided for in section 208.151 may be paid for a person who is employed and
6 who:
7 (1) Except for earnings, meets the definition of disabled under the
8 Supplemental Security Income Program or meets the definition of an employed
9 individual with a medically improved disability under TWWIIA;
10 (2) Has earned income, as defined in subsection 2 of this section;
11 (3) Meets the asset limits in subsection 3 of this section;
12 (4) Has [net] income, as defined in subsection 3 of this section, that does
13 not exceed [the limit for permanent and totally disabled individuals to receive
14 nonspenddown MO HealthNet under subdivision (24) of subsection 1 of section
15 208.151; and
16 (5) Has a gross income of] two hundred fifty percent [or less] of the
17 federal poverty level, excluding any earned income of the worker with a disability
18 between two hundred fifty and three hundred percent of the federal poverty
19 level. [For purposes of this subdivision, "gross income" includes all income of the
EXPLANATION--Matter enclosed in bold-faced brackets [thus] in this bill is not enacted and is
intended to be omitted in the law.

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20 person and the person's spouse that would be considered in determining MO
21 HealthNet eligibility for permanent and totally disabled individuals under
22 subdivision (24) of subsection 1 of section 208.151. Individuals with gross
23 incomes in excess of one hundred percent of the federal poverty level shall pay a
24 premium for participation in accordance with subsection 4 of this section.]
25 2. For income to be considered earned income for purposes of this section,
26 the department of social services shall document that Medicare and Social
27 Security taxes are withheld from such income. Self-employed persons shall
28 provide proof of payment of Medicare and Social Security taxes for income to be
29 considered earned.
30 3. (1) For purposes of determining eligibility under this section, the
31 available asset limit and the definition of available assets shall be the same as
32 those used to determine MO HealthNet eligibility for permanent and totally
33 disabled individuals under subdivision (24) of subsection 1 of section 208.151
34 except for:
35 (a) Medical savings accounts limited to deposits of earned income and
36 earnings on such income while a participant in the program created under this
37 section with a value not to exceed five thousand dollars per year; [and]
38 (b) Independent living accounts limited to deposits of earned income and
39 earnings on such income while a participant in the program created under this
40 section with a value not to exceed five thousand dollars per year. For purposes
41 of this section, an "independent living account" means an account established and
42 maintained to provide savings for transportation, housing, home modification, and
43 personal care services and assistive devices associated with such person's
44 disability; and
45 (c) Retirement accounts, including but not limited to, individual
46 accounts, 401(k) plans, 403(b) plans, Keogh plans, and pension plans;
47 provided, that income from such accounts be calculated as income
48 under subdivision (4) of subsection 1 of this section.
49 (2) To determine [net] income, the following shall be disregarded:
50 (a) [All earned income of the disabled worker;
51 (b)] The first [sixty-five dollars and one-half] fifty thousand dollars of
52 [the remaining] earned income of [a nondisabled spouse's earned income] the
53 person's spouse;
54 [(c)] (b) A twenty dollar standard deduction;
55 [(d)] (c) Health insurance premiums;

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56 [(e)] (d) A seventy-five dollar a month standard deduction for the
57 disabled worker's dental and optical insurance when the total dental and optical
58 insurance premiums are less than seventy-five dollars;
59 [(f)] (e) All Supplemental Security Income payments, and the first fifty
60 dollars of SSDI payments;
61 [(g)] (f) A standard deduction for impairment-related employment
62 expenses equal to one-half of the disabled worker's earned income.
63 4. Any person whose [gross] income exceeds one hundred percent of the
64 f