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Livermore, G., Nowak, M., & Stapleton, D. (2001). The role of health insurance in successful labor force entry and employment retention. Falls Church, VA: The Lewin Group.
Abstract
This report is one of a series in a study that seeks to identify the roles of supports in enabling people with disabilities to be successfully employed and improving employment outcomes. Through a series of focus groups of working people whose disabilities began before the start of employment, the study identified key issues related to private and publicly-funded health insurance as an employment support.
The study found that access to health insurance is a primary need throughout the lives of people with disabilities, especially for those whose conditions require frequent medical attention and medication. Gaps in health coverage were common, especially restrictions on prescription drugs and eligibility, exclusions for pre-existing conditions, and caps. Participants also had difficulty transitioning from public to private coverage through employment. Finally, employment increased the complexity of health care management, requiring workers to limit earnings to keep Medicaid/Medicare and pay for uncovered medical costs out of pocket,
Implications for public policy include extending the period of Medicare eligibility for working SSDI recipients, as has been done under the Ticket to Work Act; designing Medicaid Buy-In programs with appropriate program design features; and developing more extensive outreach to educate consumers about work incentives.
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