Exploratory Study of Health Care Coverage and Employment of People with Disabilities: Final Report

Most policymakers agree that the current structure of the Social Security Administration's disability programs creates substantial work disincentives for people with disabilities. One set of policy options concerns changing the links both between Medicare and the Social Security Disability Insurance (SSDI) program, and between Medicaid and the Supplemental Security Income (SSI) program. More generally, reforms that expand access to health insurance for people with disabilities who are not SSDI or SSI recipients could have an impact on both employment and program participation. The purpose of this study was to examine empirical evidence on the relationship among health insurance, employment, and program participation of people with disabilities. Specifically, we present the findings of an analysis of expansions in the income threshold for the SSI work incentive program established by Section 1619 of the Social Security Act; these expansions have allowed many working SSI recipients to maintain Medicaid eligibility even after their incomes rise above the level that makes them ineligible for SSI payments. This report also presents findings from an analysis of the employment, insurance and program participation status of people with disabilities using the 1993 Survey of Income and Program Participation and the 1994 National Health Interview Survey. This analysis focuses on groups of people with disabilities who would most likely be affected by expansions in public health insurance. [85 PDF pages]