The House passed first substitute HB 310, Disability Coverage Amendments, a bill intended to reduce a so-called Medicaid “benefit cliff” for working adults with disabilities by allowing private insurance to cover usual care while Medicaid continues to cover disability-specific in‑home supports on a sliding scale.

Sponsor Representative Daley Provost said the bill is not Medicaid expansion but a bridge for the relatively small population of adults with disabilities who rely on Medicaid for in‑home services (bathing, dressing and other supports) that private coverage typically does not provide. She described a case study of a college student who could not take opportunities to increase earnings because doing so would threaten eligibility for essential in‑home services. “This bill allows for people like John Welle to use his private health insurance for everything else that his private health insurance covers,” she said, and for Medicaid to pay a diminishing share of disability-related supports as income rises, up to 800% of the federal poverty level (which she said equates to $120,000 in the bill’s scale).

Representative Cutler asked what would happen “if CMS did not grant that waiver.” The sponsor replied that the policy depends on obtaining a federal waiver — without it the ramp cannot be executed as written. The sponsor and supporters noted the bill triggers a fiscal note because of interaction between private insurance premium credits and Medicaid credits; the floor discussion did not provide a full fiscal figure but acknowledged some increased state cost before the Medicaid share diminishes as earnings rise.

The House passed first substitute HB 310 by a 66-5 vote; the sponsor said the measure will be sent to the Senate for consideration.

Ending: The bill passed the House but explicitly requires a federal Centers for Medicare & Medicaid Services waiver before the proposed approach can be implemented, and floor discussion indicated a fiscal note and additional administrative steps will follow if the waiver is approved.