HI SB451

Requires the Department of Human Services to adopt the Medicaid buy-in program option under federal Social Security Act section 1902(a)(10)(A)(ii)(XIII), allowing workers with disabilities to maintain Medicaid eligibility while earning income above normal limits.

Establishes eligibility criteria including net countable income greater than 250% of federal poverty level, disability status under federal Social Security Act titles II or XVI, and net nonexempt resources not exceeding limits under title XVI.

Exempts disability income (federal, state, and private disability benefits) and retirement arrangements from income and resource calculations, with specific disregards under federal Social Security Act sections 1612 and 1613.

Establishes sliding-scale monthly premiums based on countable income ranging from a minimum of $20 to a maximum of $250, with annual adjustments by the department subject to legislative reporting at least 20 days before each regular session.

Takes effect December 31, 2050, and is contingent on federal financial participation being available under title XIX of the federal Social Security Act.