208.146. Ticket-to-work health assurance program--eligibility--expiration date.
Ticket-to-work health assurance program--eligibility--expiration date.
208.146. 1. The program established under this section shall beknown as the "Ticket to Work Health Assurance Program". Subject toappropriations and in accordance with the federal Ticket to Work and WorkIncentives Improvement Act of 1999 (TWWIIA), Public Law 106-170, themedical assistance provided for in section 208.151 may be paid for a personwho is employed and who:
(1) Except for earnings, meets the definition of disabled under theSupplemental Security Income Program or meets the definition of an employedindividual with a medically improved disability under TWWIIA;
(2) Has earned income, as defined in subsection 2 of this section;
(3) Meets the asset limits in subsection 3 of this section;
(4) Has net income, as defined in subsection 3 of this section, thatdoes not exceed the limit for permanent and totally disabled individuals toreceive nonspenddown MO HealthNet under subdivision (24) of subsection 1 ofsection 208.151; and
(5) Has a gross income of two hundred fifty percent or less of thefederal poverty level, excluding any earned income of the worker with adisability between two hundred fifty and three hundred percent of thefederal poverty level. For purposes of this subdivision, "gross income"includes all income of the person and the person's spouse that would beconsidered in determining MO HealthNet eligibility for permanent andtotally disabled individuals under subdivision (24) of subsection 1 ofsection 208.151. Individuals with gross incomes in excess of one hundredpercent of the federal poverty level shall pay a premium for participationin accordance with subsection 4 of this section.
2. For income to be considered earned income for purposes of thissection, the department of social services shall document that Medicare andSocial Security taxes are withheld from such income. Self-employed personsshall provide proof of payment of Medicare and Social Security taxes forincome to be considered earned.
3. (1) For purposes of determining eligibility under this section,the available asset limit and the definition of available assets shall bethe same as those used to determine MO HealthNet eligibility for permanentand totally disabled individuals under subdivision (24) of subsection 1 ofsection 208.151 except for:
(a) Medical savings accounts limited to deposits of earned income andearnings on such income while a participant in the program created underthis section with a value not to exceed five thousand dollars per year; and
(b) Independent living accounts limited to deposits of earned incomeand earnings on such income while a participant in the program createdunder this section with a value not to exceed five thousand dollars peryear. For purposes of this section, an "independent living account" meansan account established and maintained to provide savings fortransportation, housing, home modification, and personal care services andassistive devices associated with such person's disability.
(2) To determine net income, the following shall be disregarded:
(a) All earned income of the disabled worker;
(b) The first sixty-five dollars and one-half of the remaining earnedincome of a nondisabled spouse's earned income;
(c) A twenty dollar standard deduction;
(d) Health insurance premiums;
(e) A seventy-five dollar a month standard deduction for the disabledworker's dental and optical insurance when the total dental and opticalinsurance premiums are less than seventy-five dollars;
(f) All Supplemental Security Income payments, and the first fiftydollars of SSDI payments;
(g) A standard deduction for impairment-related employment expensesequal to one-half of the disabled worker's earned income.
4. Any person whose gross income exceeds one hundred percent of thefederal poverty level shall pay a premium for participation in the medicalassistance provided in this section. Such premium shall be:
(1) For a person whose gross income is more than one hundred percentbut less than one hundred fifty percent of the federal poverty level, fourpercent of income at one hundred percent of the federal poverty level;
(2) For a person whose gross income equals or exceeds one hundredfifty percent but is less than two hundred percent of the federal povertylevel, four percent of income at one hundred fifty percent of the federalpoverty level;
(3) For a person whose gross income equals or exceeds two hundredpercent but less than two hundred fifty percent of the federal povertylevel, five percent of income at two hundred percent of the federal povertylevel;
(4) For a person whose gross income equals or exceeds two hundredfifty percent up to and including three hundred percent of the federalpoverty level, six percent of income at two hundred fifty percent of thefederal poverty level.
5. Recipients of services through this program shall report anychange in income or household size within ten days of the occurrence ofsuch change. An increase in premiums resulting from a reported change inincome or household size shall be effective with the next premium invoicethat is mailed to a person after due process requirements have been met. Adecrease in premiums shall be effective the first day of the monthimmediately following the month in which the change is reported.
6. If an eligible person's employer offers employer-sponsored healthinsurance and the department of social services determines that it is morecost effective, such person shall participate in the employer-sponsoredinsurance. The department shall pay such person's portion of the premiums,co-payments, and any other costs associated with participation in theemployer-sponsored health insurance.
7. The provisions of this section shall expire six years after August28, 2007.
(L. 2001 S.B. 236, Repealed L. 2005 S.B. 539 § A, L. 2007 S.B. 577)Expires 8-28-13