Medicaid now covers working disabled adults past 65, ending earnings cliff
S. 3690 — Ensuring Access to Medicaid Buy-in Programs Act of 2026 · Filed by Marsha Blackburn (R-TN) · Introduced Jan 27, 2026 · Referred to committee
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What it does
This bill removes age caps (previously capped at under 65) from Medicaid's 'buy-in' programs for working adults with disabilities, allowing people over 65 who work and have earnings above SSI limits to remain eligible. It expands the program to include individuals aged 16 and older with work-related earnings, and gives states until January 1, 2028 to comply without penalty.
Why we flagged it
The bill's sole operative mechanism is to expand Medicaid eligibility for working disabled adults by removing age restrictions, a straightforward public-health measure with no hidden provisions or narrow beneficiaries.
What the text implies
- Removes a work disincentive: previously, disabled workers over 65 faced a cliff where continued employment could cost them Medicaid; this eliminates that barrier and may increase labor-force participation among older disabled adults.
- State implementation varies: the 2028 compliance deadline allows states currently offering the program to continue unchanged, but does not mandate all states adopt it immediately—uptake will depend on state budget decisions and administrative capacity.
- Interaction with Medicare: individuals over 65 typically become Medicare-eligible; this bill's effect on dual-eligible (Medicare + Medicaid) beneficiaries and cost-sharing depends on how states structure the buy-in alongside Medicare, which the bill does not address.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
Working adults with disabilities gain the ability to keep Medicaid coverage past age 65 without losing it due to work earnings, removing a cliff that previously forced a choice between employment and health insurance. This directly expands health-insurance access for a vulnerable population.
Named in the bill
Social Security Act, Medicaid, working adults with disabilities, SSI (Supplemental Security Income), state Medicaid programs
Where it stands
- Jan 27, 2026 — Introduced · Congress.gov: “Introduced in Senate”
- Jan 27, 2026 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (1,607 characters) on Jun 8, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
As of — page rendered 2026-10-20.
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