North Carolina SB 448: Remove Employment Barriers/Ppl w Disabilities.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 448

Short Title: Remove Employment Barriers/Ppl w Disabilities. (Public)
Sponsors: Senators Lee and Grafstein (Primary Sponsors).
Referred to: Rules and Operations of the Senate
March 25, 2025
*S448-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO REMOVE BARRIERS TO EMPLOYMENT FOR PEOPLE WITH 2
DISABILITIES BY REMOVING THE UNEARNED INCOME LIMIT AND THE 3
RESOURCE LIMIT FROM THE HEALTH COVERAGE FOR WORKERS WITH 4
DISABILITIES ACT UNDER THE MEDICAID PROGRAM. 5
The General Assembly of North Carolina enacts: 6
SECTION 1. No later than 90 days after this act becomes law, the Department of 7
Health and Human Services, Division of Health Benefits, shall submit the necessary 8
documentation to the Centers for Medicare and Medicaid Services (CMS) for approval to remove 9
the unearned income limit and the resource limit from the eligibility requirements for the Health 10
Coverage for Workers with Disabilities Medicaid eligibility category. Upon approval by CMS 11
of the removal of the unearned income and resource limits, the Secretary of the Department of 12
Health and Human Services shall notify the Revisor of Statutes of the effective date approved by 13
CMS for the removal. 14
SECTION 2.(a) G.S. 108A-66.1 reads as rewritten: 15
"§ 108A-66.1. Medicaid buy-in for workers with disabilities. 16
(a) Title. – This section may be cited as the Health Coverage for Workers With 17
Disabilities Act. The Department shall implement a Medicaid buy-in eligibility category as 18
permitted under P.L. 106-170, Ticket to Work and Work Incentives Improvement Act of 1999. 19
The Department shall establish rules, policies, and procedures to implement this act in 20
accordance with this section. 21
... 22
(c) Eligibility. – An Except as provided in subsection (c1) of this section, an individual 23
is eligible for HCWD if:if all of the following apply: 24
(1) The individual is at least 16 years of age and is less than 65 years of age;age. 25
(2) The individual either meets Social Security Disability criteria, criteria or the 26
individual has been enrolled in HCWD and then becomes medically improved 27
improved, as defined in Ticket to Work and as further specified by the 28
Department. An individual shall be determined to be eligible under this 29
section without regard to the individual's ability to engage in, or actual 30
engagement in, substantial gainful activity as defined in section 223 of the 31
Social Security Act (42 U.S.C. § 423(d)(4)). In conducting annual 32
redetermination of eligibility, the Department may not determine that an 33
individual participating in HCWD is no longer disabled based solely on the 34
individual's participation in employment or earned income;income. 35

General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 448-First Edition
(3) The individual's unearned income does not exceed one hundred fifty percent 1
(150%) of FPG, and countable resources for the individual do not exceed the 2
resource limit for the minimum community spouse resource standard under 3
42 U.S.C. § 1396r, and as further determined by the Department. In 4
determining an individual's countable income and resources, the Department 5
may not consider income or resources that are disregarded under the State 6
Medical Assistance Plan's financial methodology, including the 7
sixty-five-dollar ($65.00) disregard, impairment-related work expenses, 8
student earned-income exclusions, and other SSI program work incentive 9
income disregards; and 10
(4) The individual is engaged in a substantial and reasonable work effort 11
(employed) effort, as provided in this subdivision and subdivision, as further 12
defined by the Department Department, and as allowable under federal law. 13
For purposes of this subsection, "engaged in substantial and reasonable work 14
effort" means all of the following: 15
a. Working in a competitive, inclusive work setting, or self-employed. 16
b. Earning at least the applicable minimum wage. 17
c. Having monthly earnings above the SSI basic sixty-five-dollar 18
($65.00) earned-income disregard. 19
d. Being able to provide evidence of paying applicable Medicare, Social 20
Security, and State and federal income taxes. 21
(c1) Additional Earnings Requirements. – The Department may impose additional 22
earnings requirements in defining "engaged in substantial and reasonable work effort" for 23
individuals who are eligible for HCWD based on medical improvement. 24
(c2) Involuntary Unemployment. – Individuals who participate in HCWD but thereafter 25
become unemployed for involuntary reasons, including health reasons, shall have continued 26
eligibility in HCWD for up to 12 months from the time of involuntary unemployment, so long as 27
the individual (i) maintains a connection with the workforce, as determined by the Department, 28
(ii) meets all other eligibility criteria for HCWD during the period, and (iii) pays applicable fees, 29
premiums, and co-paymen