Working with Disability
Mathematica Policy Research:
How Much Are Medicaid Buy-In Participants Earning?
Authorized by the Balanced Budget Act of 1997 (BBA) and the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA), the Buy-In program allows states to expand Medicaid coverage to workers with disabilities whose income and assets would ordinarily make them ineligible for Medicaid.
To be eligible for the Buy-In program, an individual must have a disability (as defined by the Social Security Administration) and earned income, and must meet other financial eligibility requirements established by states.
Subsequent issues will profile participants' characteristics, health care use and expenditures, and involvement in other public programs for people with disabilities.
Given that sustained employment for people with disabilities is central to the Medicaid Buy-In program, policymakers will likely be interested in two questions: Are Buy-In participants working?
Annual earnings data for this analysis are based on information reported to the IRS on W-2 forms by all individuals ever enrolled in the Buy-In programs of 27 states in calendar year 2004.
As discussed below, results for both measures varied markedly across states, the differences being related to a number of factors including the context in which the program operates, the features of each state's program, and the individual characteristics of each program's participants.
Data Source: Buy-In enrollment information from 27 states linked with calendar year earnings data from the Social Security Administration's Master Earnings File.
For example, about 72 percent of Buy-In participants receive Social Security Disability Income (SSDI) payments (Liu and Ireys, 2006), and some may have income from dividends or investments.
