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Folkemer, D., Jensen, A., Silverstein, R., & Straw, T. (2002). Medicaid Buy-In Programs: Case studies of early implementer states. Washington, D.C.: U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and George Washington University.

Abstract

This study examines the experiences of nine states (Alaska, Connecticut, Iowa, Maine, Minnesota, Nebraska, Oregon, Vermont, and Wisconsin) that implemented the Medicaid Buy-In for working disabled persons. with the goal of expanding the provision of personal assistance services in order to help persons with disabilities obtain or enhance employment. This study is one component of a larger project that includes a summary of lessons learned by these nine "early implementer" states, a policy guide, and a summary of conclusions for use by federal agencies to enhance employment for persons with disabilities.

Through discussions with key stakeholders in each state, the researchers identify key design issues and themes in each state. Each case study presents program-specific information such as general eligibility criteria for the Buy-In, resource limits, premium levels, the number of participants, and the interaction of Medicaid with other sources of assistance, such as state SSI or employer-provided insurance. The case studies also describe state policy that governs the maximum number of hours and location for the provision of PAS.

In the findings, the case studies discuss each state’s pre-existing SSI and regular Medicaid eligibility categories, describe the Medicaid Buy-In and other work initiative programs, and show the effects of the Medicaid Buy-In on Medicaid eligibility. In addition, the case studies describe the formal roles played by the state legislature, the executive branch, and the disability community in developing the program. The case studies draw from available state-level surveys that examine perceived barriers to employment and individuals’ attitudes toward working.

Conclusions and major findings from these case studies have been reported in a follow-up study, entitled "The Medicaid Buy-In Program: Lessons Learned from Nine Early Implementer States," available at http://aspe.hhs.gov/daltcp/reports/

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This report was prepared under contract #HHS-100-00-0018 between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and George Washington University. For additional information about the study, you may visit the DALTCP home page at http://aspe.hhs.gov/daltcp/home.htm or contact the ASPE Project Officer, Andreas Frank, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201.: Andreas.Frank@hhs.gov

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