Abstract
Working-age adults with severe disabilities face many barriers to reaching their employment potential. One important barrier is the concern that working will result in the loss of Medicaid benefits, which cover many needed healthcare services for people with disabilities at little or no cost. Now offered by over 30 states, Medicaid buy-in programs address this concern by allowing people with disabilities to retain Medicaid while they work and increase earnings. Prior reports of buy-in programs have not examined whether work outcomes vary with characteristics of buy-in enrollees. Using data from a statewide survey of Massachusetts buy-in program members, we found type of disabling condition to predict three work outcomes: current work status of all members; annual earnings over $10,000 among currently working members; and future work intentions of currently non-working members. Members with developmental or psychiatric disabilities were generally more likely to work but had lower earnings than other members. Members with a physical disability were generally less likely to work than other members, but when working tended to have higher earnings. Those with co-occurring psychiatric and physical disabilities had the poorest work outcomes. Across all conditions, few members had earnings at levels consistent with economic self-sufficiency. Policy and practice implications are discussed.
Published Version
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