Act 69 of 2021, a new law that expands the Medical Assistance for Workers with Disabilities (MAWD) Program, technically took effect on December 28, 2021. Pennsylvania’s Department of Human Services (DHS) is waiting until after the continuous eligibility protections connected to the public health emergency end before fully implementing the law; however, individuals who have been on MAWD for the last 12 months, without a break, can start earning more money now without fear of losing their Medicaid after the continuous eligibility protections end.
Workers with Job Success (WJS): A New MAWD Category
As we reported last year, Act 69 creates a new category of the Medical Assistance for Workers with Disabilities (MAWD) program called “Workers with Job Success” (WJS). Individuals who have been on MAWD for 12 consecutive months and then have an increase in their income that puts them over the limit to stay on MAWD can be moved to the new WJS category, instead of losing their benefits. Most people in the WJS category will pay a 7.5% premium (instead of the standard 5% MAWD premium), but some individuals will pay a higher premium based on their income. Any assets (resources) someone accumulates after moving into the WJS category will not count toward the MAWD or WJS asset limit. Click here for the 2022 income and resource limits for MAWD and other Medicaid programs.
Implementation After the PHE Ends
WJS will be available after the COVID-19 Public Health Emergency (PHE) ends. Under the continuous eligibility protections (in place as long as the PHE exists), people cannot be terminated from Medicaid, including MAWD, even if they no longer meet the eligibility criteria. Because of these protections, people stay on MAWD even if their income exceeds the MAWD income limit. The PHE is currently in place until at least mid-April 2022. Whether the PHE will be extended beyond April is not yet known. PHLP will keep readers apprised of any PHE extension(s).
DHS is working on a process to account for the fact that some people might have been moved to MAWD but were not because of the PHE protections mentioned earlier. This is important because Act 69 requires people to be covered by MAWD for 12 consecutive months before they quality to move into the Workers with Job Success category. DHS hopes to be able to identify people who would be in MAWD but for the PHE, and credit those months toward the 12-month MAWD coverage requirement needed to move to the Workers with Job success category.
Some details of implementation for the WJS category are still being finalized. DHS needs to start educating County Assistance Office caseworkers and drafting policies that explain the system and process changes related to the new WJS category. Advocates involved in the passage of Act 69 are working with DHS to finalize these details. At the end of 2021, DHS issued a Frequently Asked Questions (FAQs) document about WJS based on the information available as of that date.
People on Both MAWD and HCBS Waiver Program(s)
People who qualify for both MAWD and a Medicaid Home and Community Based Services (HCBS) Waiver program can continue to keep their Waiver if they move into the WJS category. This applies to any Waiver program available in Pennsylvania, and is not only limited to Waivers requiring someone to meet the Nursing Facility Clinically Eligible (NFCE) level of care as suggested by the DHS Frequently Asked Questions document.
Workers with Job Success (WJS) is an important move forward for Pennsylvania. The program will help people with disabilities who want to pursue new jobs or promotions, or make other important life decisions, without risking loss of the Medicaid and Waiver benefits that help them maintain independence and live healthy, self-determined lives.
We will continue to update readers about developments related to the implementation of Act 69 of 2021 and the WJS MAWD expansion.