This act changes the Ticket to Work Health Assurance Program in the following ways: (1) excludes retirement accounts from asset limit calculations; (2) modifies the income calculation from a net/gross calculation to a broader definition that would consider income for those disabled persons with incomes up to 250% FPL, with earned income of the disabled worker from 250 to 300% FPL disregarded, and retaining the requirement that persons with incomes over 100% FPL pay a premium; (3) removes all earned income of the disabled worker from the list of disregards in income determinations; (4) adds to the list of disregards the first $50,000 of earned income of a spouse; (5) if the Department elects to pay the person’s costs of employer-sponsored health insurance, MO HealthNet assistance shall be provided as a secondary or supplemental policy for only personal care assistance services and non-emergency medical transportation; (6) the Department shall provide an annual report to the General Assembly concerning the number of participants and outreach and education efforts; and (7) the expiration provision for the program of August 28, 2019, has been changed to August 28, 2022.