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Goodman, N., & Livermore, G. (2004).The effectiveness of Medicaid Buy-In programs in promoting the employment of people with disabilities: Briefing paper prepared for the: Ticket to Work and Work Incentives Advisory Panel. Washington, DC: Cornell University Institute for Policy Research.
Abstract
This report is meant to provide the Advisory Panel with information about the features of states' Medicaid Buy-In programs and their potential to promote the employment of people with disabilities. At the time of the report, 29 states had implemented Buy-In programs; 15 of these had done so under the Ticket to Work and Work Improvement Incentives Act.
There was considerable variation across states in Buy-In eligibility criteria, premiums charged to participants, and enrollment rates. Most participants were covered by Medicaid prior to Buy-In enrollment, and tended to have low earnings. State policies tended to restrict access to their Buy-In programs to those with low SSDI benefits or low earnings. Buy-In programs appeared to provide significant supports for people with disabilities, notably through Medicaid coverage of prescription drugs and personal assistance services to SSDI beneficiaries who would not ordinarily qualify for Medicaid. However, many enrollees lacked clarity or knowledge about the benefits of the program.
The report concludes that while Buy-In programs appear to provide needed supports, they may not reduce work disincentives in the context of a complex system that defines disability in terms to inability to work.
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