B 26-0463 — Judith Heumann Memorial Workers with Disabilities Act of 2025

ENGROSSEDENROLLED ORIGINAL AAN BILLACT 3_______________________ 26-463 5 IN THE COUNCIL OF THE DISTRICT OF COLUMBIA 8 _______________________ To amend the District of Columbia Public Assistance Act of 1982 to establish the District Workers with Disabilities program to allow employed individuals with disabilities who meet eligibility requirements to enroll in Medicaid.

Official Code § 4-201.01 passim), is amended by adding a new Titletitle IV-IV-A A to read as follows:

ENGROSSED ORIGINAL “(3) “Disability” shall have the same meaning as in section 1614(a)(3)1614(a)(3)(A) of 48 the Social Security Act, approved October 30, 1972 (86 Stat.

or “(B) If self-employed, means the individual has engaged in paid work, subject to verification with applicable District and federal employment and tax requirements.”requirements. “(5) “Enrollee” means an individual who is enrolled in the program and provided coverage under Medicaid.

“(5) “Enrollee” means an individual who is enrolled in the program and provided coverage under Medicaid.

ENROLLED ORIGINAL “Sec.

“(a)(1) ThereNo isearlier than October 1, 2027, there shall be established the District Workers with Disabilities Program, to be administered by the Department of Health Care Finance, to provide eligible individuals with disabilities with Medicaid coverage, as authorized by section 1902 of the Social Security Act, approved July 30, 1965 (79 Stat.

ENGROSSED ORIGINAL “(b) An individual shall be eligible for the program if they:

“(2) Are a resident of the DistrictDistrict; of Columbia;

“(3) Are employed, which may be verified by providing evidence of one or more of the following:

or ENGROSSED ORIGINAL “(D) Enrolled in:

or ENROLLED ORIGINAL “(3) Are determined to be disabled by DHCF in accordance with this title and implementing regulations.

ENGROSSED ORIGINAL “(2) The coverage, scope, and related services under the program;

ENGROSSED ORIGINAL “(c)(1) An individual temporarily residing outside of the District but who intends to return to the District may apply by mail;

or ENROLLED ORIGINAL “(2) Not eligible for enrollment in the program, DHCF shall issue a written notice of its denial and include its findings and reason for denial, the applicable statutory or regulatory basis for the denial, and the applicant’s right to appeal.

“(2) Fail to submit a complete application or provide requested documentation within the required timeframes;timeframe;

or ENGROSSED ORIGINAL “(5) Fail to comply with any deadline established by DHCF;

or “(D) Fail to pay theirthe required premiums after receiving 30 days of notice of late payment.

and ENGROSSED ORIGINAL “(B) Provide written notice of termination and include its findings and reasons for denials, the applicable statutory or regulatory basis for the denial, and the enrollee’s right to appeal.

“(a)ENROLLED ORIGINAL “(a)(1) To determine countable net income, DHCF shall subtract from the enrollee’s total gross income:

“(1)“(A) The general income exclusions and disregards and the specific income exclusions and disregards for aged, blind, or disabled coverage groups as specified under section 405;

and “(2)“(B) Any documented cost-sharing for current employer-sponsored insurance coverage for the applicant.

“(3)“(2) DHCF shall include in the enrollee’s total gross income any annuity, pension, retirement, or disability benefits to which the enrollee is entitled, including:

ENGROSSED ORIGINAL “(B) Social Security Disability Insurance and other Social Security benefits;

“(2) For incomes above 139%138% to 200% of the federal poverty level, $25 per month;

ENGROSSED ORIGINAL “(d) DHCF may, through rulemaking, adjust annually the monthly premium amounts to account for changes to the Consumer Price Index.

ENROLLED ORIGINAL “(2) DHCF shall allow a grace period of up to 6 months within a 12-month period for enrollees who lose employment involuntarily or for medical reasons to remain in the program;

ENGROSSED ORIGINAL “(2) DHCF shall issue a recertification form to each enrollee at least 60 days prior to the end of the current certification period.

ENGROSSED ORIGINAL “(4) Provide timely notice to DHCF of any accident or incident giving rise to potential third-party liability, including the identities of parties involved, attorneys, and insurers;

ENROLLED ORIGINAL “(b) An enrollee’s failure to comply with subsection (a) of this section may result in termination of benefits under this title, the recovery of improperly paid benefits, and any other remedies available under District or federal law.

ENGROSSED ORIGINAL “(1) Benefits paid for any period during which the enrollee was not eligible for coverage;

“(e) DHCF may impose liensa lien and seek reimbursement against property or assets of a current or former enrollee to the extent permitted by federal and District law.

ENGROSSED ORIGINAL “(3) Not otherwise covered under employer-sponsored insurance or any other health insurance available to the enrollee;

“(1) EnrollmentEnroll in Medicaid managed care programs administered by the District;

“(2) EnrollmentEnroll in the Program of All-Inclusive Care for the Elderly;

or ENROLLED ORIGINAL “(3) Coverage of long-term care facility services exceeding 30 consecutive days.

ENGROSSED ORIGINAL “The Mayor, pursuant to Title I of the District of Columbia Administrative Procedure Act, approved October 21, 1968 (82 Stat.

“(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation.”.limitation.

“Sec.

421.