#Medicaid #DisabilityRights #HealthcarePolicy #WorkWithoutWorry
Balancing Work and Medicaid Eligibility
Zach Mecham, a 31-year-old entrepreneur with muscular dystrophy, faces a frustrating contradiction in Medicaid policies. While politicians push for Medicaid recipients to work, existing rules limit how much people with disabilities can earn before losing critical benefits.
Mecham relies on Medicaid to cover essential services, including a nighttime assistant and a morning home health aide who helps him prepare for work. Without these supports, he would be forced to close his online marketing business and move into a nursing home.
Medicaid Buy-In Programs and Financial Restrictions
Medicaid, funded by both federal and state governments, provides healthcare for low-income individuals and those with disabilities. Many states, including Iowa, offer Medicaid buy-in programs that allow individuals with disabilities to qualify even if they exceed income limits. However, most of these programs include premiums, income caps, and savings limits that can discourage full-time employment.
Some states have already removed these financial restrictions, allowing people with disabilities to work without fear of losing their benefits.
Advocating for Policy Change
Mecham has repeatedly lobbied at the Iowa Capitol in support of the “Work Without Worry” bill, which proposes removing income and asset limits. Instead, it would require Medicaid recipients with disabilities to pay 6% of their income as premiums to maintain coverage. These premiums would be waived if they also contribute to employer-based health insurance.
Disability rights advocates argue that the current system traps people in poverty by discouraging career advancement. “It’s a trap — a poverty trap,” said Stephen Lieberman from the United Spinal Association, emphasizing the need for reforms to allow people with disabilities to work without risking their healthcare.
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