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Congressional Research Service
Version 00 · Introduced in House · Feb 26, 2025
Ensuring Access to Medicaid Buy-in Programs Act
This bill removes certain age limitations for the Medicaid buy-in program for disabled, working individuals.
Current law allows disabled, working individuals ages 16 to 64 whose income exceeds applicable income limits to buy into Medicaid at the option of the state. The bill allows those age 65 or over to also buy into Medicaid.
People & committees
Rep. Ciscomani, Juan [R-AZ-6] · R–AZ
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
Referred to the House Committee on Energy and Commerce.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
Source last updated: Aug 18, 2025. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2025-02-26 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
This bill proposes removing the “less than 65” age restriction from two Medicaid provisions concerning working adults with disabilities. It addresses optional eligibility groups, rather than establishing coverage for everyone age 65 or older. States already providing the specified assistance when the bill becomes law would receive temporary protection from being treated as noncompliant with the cited requirements.
2. Removing certain age restrictions on Medicaid eligibility for working adults with disabilities (a) Modification of optional buy-In groups
(1) In general Section 1902(a)(10)(A)(ii)(XV) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XV)) is amended by striking , but less than 65,. (2) Definition modification Section 1905(v)(1)(A) of the Social Security Act (42 U.S.C. 1396d(v)(1)(A)) is amended by striking , but less than 65,.
(b) Application to certain States A State that, as of the date of the enactment of this Act, provides for making medical assistance available to individuals described in subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) shall not be regarded as failing to comply with the requirements of either such subclause (as amended by subsection (a)(1)) or with section 1905(v)(1)(A) of the Social Security Act (42 U.S.C. 1396d(v)(1)(A)) (as amended by subsection (a)(2)) before January 1, 2027.
Section 1 gives the proposal the short title “Ensuring Access to Medicaid Buy-in Programs Act.”
1. Short title This Act may be cited as the Ensuring Access to Medicaid Buy-in Programs Act.
Section 2(a) would delete the words “, but less than 65,” from section 1902(a)(10)(A)(ii)(XV) and the definition in section 1905(v)(1)(A) of the Social Security Act. These amendments remove that textual age restriction without reproducing or replacing the remaining eligibility requirements. The supplied text therefore does not establish the full eligibility rules after amendment.
(a) Modification of optional buy-In groups (1) In general Section 1902(a)(10)(A)(ii)(XV) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XV)) is amended by striking , but less than 65,. (2) Definition modification Section 1905(v)(1)(A) of the Social Security Act (42 U.S.C. 1396d(v)(1)(A)) is amended by striking , but less than 65,.
Section 2(b) would protect states that already provide assistance under either of the two specified eligibility groups on the enactment date from being treated as failing the cited requirements before January 1, 2027. This is a temporary compliance exception for qualifying states, not an express delay of the entire bill until that date.
(b) Application to certain States A State that, as of the date of the enactment of this Act, provides for making medical assistance available to individuals described in subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) shall not be regarded as failing to comply with the requirements of either such subclause (as amended by subsection (a)(1)) or with section 1905(v)(1)(A) of the Social Security Act (42 U.S.C. 1396d(v)(1)(A)) (as amended by subsection (a)(2)) before January 1, 2027.
The supplied official-actions snapshot, updated August 18, 2025, records introduction in the House and referral to the House Committee on Energy and Commerce on February 26, 2025.
Source snapshot updated 2025-08-18T21:18:45Z. 2025-02-26: Referred to the House Committee on Energy and Commerce. 2025-02-26: Introduced in House
A closer look
Reviewed version: Introduced in House · 2025-02-26. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy change attached to appropriations was identified after reviewing the complete supplied introduced text. This conclusion applies only to that version and does not establish absence in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified after reviewing the complete supplied introduced text. This conclusion applies only to that version; absent disclosures and accompanying materials prevent a broader determination of formal earmark status.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
Findings to examine
The supplied introduced text contains a limited compliance exception warranting scrutiny as a targeted benefit. This classification does not imply that the exception is unjustified.
Section 2(b) benefits states providing assistance under subclause (XV) or (XVI) on the enactment date by protecting them from being regarded as failing the cited requirements before January 1, 2027. The enactment-date condition limits this protection to an existing participating group of states. It is a transitional exception directly related to the bill’s eligibility amendments; its classification rests on the conditional compliance protection, not on the intended coverage population.
(b) Application to certain States A State that, as of the date of the enactment of this Act, provides for making medical assistance available to individuals described in subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) shall not be regarded as failing to comply with the requirements of either such subclause (as amended by subsection (a)(1)) or with section 1905(v)(1)(A) of the Social Security Act (42 U.S.C. 1396d(v)(1)(A)) (as amended by subsection (a)(2)) before January 1, 2027.
Full text preserved for this analysis. Legislative record snapshot: Aug 18, 2025. How PlainBill uses AI