S. 3690, the Ensuring Access to Medicaid Buy-in Programs Act of 2026, removes age restrictions that currently limit Medicaid eligibility for working adults with disabilities. Currently, Medicaid's "buy-in" programs—which allow disabled individuals to maintain Medicaid coverage while working and earning income above the usual limits—only serve people under age 65. This bill eliminates that age cap, allowing disabled workers of any age to participate in these programs and continue receiving health coverage while employed. The legislation affects working individuals with disabilities who would otherwise lose Medicaid due to their earnings, as well as state Medicaid programs that administer these optional buy-in groups. States that already operate these programs have until January 1, 2028, to comply with the new requirements, providing a transition period for implementation.
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