DC Medicaid Buy-In: The Judith Heumann Workers with Disabilities Act
The Problem This Law Solves
For years, adults with disabilities in DC faced an impossible choice: earn a meaningful income, or keep Medicaid. The ABD Medicaid income cap sits at roughly $1,330 per month in 2026. Cross that line through even modest part-time work, and you risk losing the health coverage that pays for personal care assistance, therapies, and supports that private insurance typically doesn't cover.
Section 1619(b) protects some workers who previously received SSI, and the medically needy spend-down program catches people with high medical costs. But neither fully solves the problem for someone who wants to build a career, save money, and still access Medicaid's disability-specific services.
The Judith Heumann Memorial Workers with Disabilities Act of 2025 (Bill B26-0463) is DC's answer. Named after Judith Heumann — the DC-born disability rights activist who helped shape the ADA — the law creates a Medicaid Buy-In program that lets employed adults with disabilities purchase Medicaid coverage regardless of how much they earn or save.
How the Buy-In Works
The program, administered by the DC Department of Health Care Finance (DHCF), is structured around three core principles:
No income limit. Unlike standard ABD Medicaid ($1,330/month cap) or the Special Income Standard ($2,982/month for waiver participants), the buy-in has no income ceiling. You pay a premium scaled to what you earn.
No asset limit. This is the transformative piece. Standard ABD Medicaid enforces a $4,000 resource limit. The buy-in eliminates it entirely, allowing participants to build savings, contribute to retirement accounts, and accumulate assets like any other working person.
Disability-based eligibility. You qualify if SSA or DHCF has determined that you have a disability, and you're employed. The program covers individuals aged 16 to 64.
The Premium Structure
Monthly premiums are income-based and deliberately affordable:
| Monthly Income | Monthly Premium |
|---|---|
| Below 150% FPL | $0 |
| 150%–250% FPL (~$1,995–$3,325/month) | $20 |
| 250%–400% FPL (~$3,325–$5,320/month) | $40 |
| Above 400% FPL | 5% of net monthly income |
For context, an adult with a disability earning $2,500 per month through supported employment would pay $20 per month for full Medicaid coverage — including personal care assistance and home and community-based services that a private plan wouldn't touch.
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Job Loss Protection
The law includes a safety net for involuntary job loss. If you lose your job through no fault of your own — or for medical reasons — you get a 6-month grace period within any 12-month span. During that period, your Medicaid buy-in coverage continues as long as you keep paying your premium. This prevents the devastating cycle where losing a job also means losing healthcare at the exact moment you need it most.
Implementation Timeline
The DC Council passed the Judith Heumann Act with a projected congressional law date of September 18, 2026. The law has been partially funded for initial administrative updates to the DC Access System (DCAS), but full implementation requires additional funding starting in FY2027.
What this means practically: the framework is law, the premium structure is defined, but enrollment may not open immediately. Families should track DHCF announcements for the program launch date.
How This Fits with Other DC Programs
The Medicaid buy-in doesn't replace existing pathways — it adds a new one for people whose employment disqualifies them from traditional options.
If your adult child receives SSI and works part-time, Section 1619(b) already protects their Medicaid. The buy-in becomes relevant if their earnings grow to the point where 1619(b) thresholds are exceeded.
If they're on the DDA waiver, their Medicaid runs through the Special Income Standard ($2,982/month). The buy-in could serve as backup coverage if waiver enrollment is interrupted or if income exceeds even the SIS cap.
If they earn too much for ABD Medicaid but don't have high enough medical costs for the medically needy spend-down, the buy-in fills the gap without requiring documented medical expenses.
The most powerful combination for working adults may be the buy-in plus a DC ABLE account. With no asset limit on the buy-in side and tax-free savings growth on the ABLE side (up to $19,000 annual contributions, $500,000 lifetime cap), an employed adult with a disability can build genuine financial independence while maintaining full healthcare coverage.
Why This Matters for Transition Planning
Families navigating the age-18 transition should factor the Judith Heumann Act into their long-term planning. The traditional fear — that work leads to benefit loss — is becoming less accurate in DC. Between Section 1619(b), ABLE accounts, the PASS program, and now the Medicaid buy-in, there's a real path to employment that doesn't sacrifice healthcare.
The challenge is knowing which programs apply at which income levels, and how they interact. For a structured walkthrough of all these pathways and how they fit together, the DC SSI at 18 & Adult Disability Benefits Guide covers each option with eligibility criteria, application steps, and timeline milestones.
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