Early Implementation of Pre-Existing Condition Insurance Plans: Providing an Interim Safety Net for the Uninsurable

Outlines enrollment trends and enrollee traits in a temporary program designed to provide affordable coverage to the uninsured with preexisting conditions, changes to structures and premiums, and estimated out-of-pocket costs by utilization and plan type

Working Healthy & Medicare Part D: Findings From Participant Surveys

In February and March 2006, KU researchers developed and administered a telephone survey to assess the actual experiences of Working Healthy enrollees with Part D transition. The survey addressed information and access issues and gave participants the opportunity to share positive and negative feedback about Part D. A random sample of 600 dually-eligible Working Healthy participants was contacted and 328 persons completed the survey, for a response rate of 55%. Demographically, the survey respondents were similar to he larger Working Healthy population. An analysis of claims data for these individuals showed that mental illnesses were the predominant disability type experienced by the grou

Will Medicaid Buy-In Participants Work and Earn More if Social Security Rules Change

Jensen and Silverstein (2005) reviewed federal actuarial estimates of potential increased earnings and program savings with a benefit offset and examined current employment and earnings trends among Social Security beneficiaries with disabilities. Preview federal studies projected that only 0.6% of SSDI beneficiaries would have earnings sufficient to reduce their cash benefits with a benefit offset program. Depending on various assumption, Jensen and Silverstein predicted that about 2-4% of current SSDI beneficiaries would increase their earnings to the point of reducing their federal cash benefits with the $1 for$2 federal demonstration model. We surveyed participants in the Kansas Working Healthy Medicaid Buy-In to assess how many people likely increase their employment and earnings under a gradual offset program and the characteristics of those who thought the would do so

Working Healthy: Getting the Job Done

When the Ticket to Work/Work Incentives Improvement Act (TW-WIIA) was passed in 1999, Congress acknowledges that the potential loss of Medicaid and/or Medicare coverage for people with disabilities who attained or increased employment was a serious disincentive to their meaningful participation in work. Medicaid Buy-In programs were offered as an option to states to extend Medicaid coverage to people with disabilities who wanted to work. Evaluation activities of the Kansas Medicaid Buy-In, Working Healthy, have demonstrated that Medicaid remains a crucial element in the ability of Kansans with disabilities to wor

Working Healthy: The First Step is Work

Working Healthy, the Kansas Medicaid Buy-In program, allows people with disabilities to enter or increase employment and keep their Medicaid coverage. One of the first requirements to quality for Working Healthy is to have a job. In a Satisfaction Survey mailed to participants in June 2003, we asked how each person found his or her more recent employment. By far the most common way respondents had found their jobs was by themselves, through such means as word of mouth

Dually-Eligible Working-Age Adults with Disabilities: Issues and Challenges as Health Reform is Implemented

This special section on working-age adults with disabilities dually eligible for Medicare and Medicaid is based on two panel presentations at the June 2012 meeting of the AcademyHealth Disability Research Interest Group. The papers included here consider the issues of health care access and outcomes as well as employment for this group of approximately four million individuals, many with complex health care needs and high costs.iThe Commonwealth Fund, AcademyHealth Disability Research Interest Group (DRIG

Narrowing the Breach: Can Disability Culture and Full Educational Inclusion Be Reconciled?

Because of the long history of exclusion of people with disabilities, total inclusion in the educational environment has many outspoken proponents. People and organizations favoring inclusion, however, are overlooking the value of the disability culture that is fostered when children with disabilities have the opportunity to associate with and learn alongside other individuals who share similar identities and life experiences.The history of the disability rights movement clearly illustrates that major changes do not occur unless people with disabilities band together to address shared injustices (e.g., Shapiro, 1993). The phenomenon of a disability culture has been convincingly demonstrated by many researchers and writers, and its importance to the development and self-esteem of students with disabilities is discussed. Although the current special education system has many negative aspects, changes to the existing system rather than a movement to full inclusion will be more effective in supporting disability culture and, ultimately, the needs of children with disabilities

Why a National High-Risk Insurance Pool Is Not a Workable Alternative to the Marketplace

The Pre-Existing Condition Insurance Plan (PCIP) was a national high-risk pool established under the Affordable Care Act (ACA) to provide coverage for individuals with preexisting conditions who had been uninsured for at least six months. It was intended to be a temporary program: PCIPs opened in 2010 and closed in April 2014. At that point, those with preexisting conditions could shop for health insurance in the marketplaces, where plans are prevented from using applicants' health status to deny coverage or charge more. This issue brief draws on the PCIP experience to outline why national high-risk pools, which continue to be proposed as policy alternatives to ACA coverage expansions, are expensive to enrollees as well as their administrators and ultimately unsustainable. The key lesson—and the principle on which the ACA is built—is that insurance works best when risk is evenly spread across a broad population.

Policy Issues for Working Healthy and Other States' Medicaid Buy-Ins: The Good, the Bad, and What Remains to be Seen

Medicaid Buy-In programs are a work incentive initiative under both the Balanced Budget Act of 1997 and the Ticket to Work/Work Incentives Improvement Act of 1999. They allow people with disabilities to work and get or maintain Medicaid coverage. The Kansas Buy-In, Working Healthy, has been very successful to date, with many positive stories from enrollees. The strengths of Working Healthy and Buy-Ins nationally, however, are offset by various policy issues that limit the degree to which Buy-In participants can gain true independence through work