Policy Frameworks for Designing Medicaid Buy-In Programs and Related State Work Incentive Initiatives

This report provides policy frameworks to assist stakeholders design and implement Medicaid Buy-In programs and related work incentive initiatives to enhance the level of economic self-sufficiency of persons with significant disabilities. Of particular focus are the design decisions affecting enrollment, costs, and a state's fiscal exposure. The policy frameworks describe the interrelationship between federal and state cash assistance programs (particularly SSI, SSDI, and state SSI supplementation programs) and health entitlements (particularly the Medicaid program). The policy frameworks are derived from the experience of the nine early implementation states--Alaska, Connecticut, Iowa, Maine, Minnesota, Nebraska, Oregon, Vermont and Wisconsin. [67 PDF pages]