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Improvements to Medicaid Buy-In for Workers with Disabilities Needed

Washington, DC – The Medicaid Buy-In (MBI) for Workers with Disabilities programs are vital to individuals with disabilities who want to live independently and work while retaining the unique services offered by Medicaid. To improve the programs’ availability across the country, the Bipartisan Policy Center’s Health Program released recommendations in a new report, Next Steps: Improving the Medicaid Buy-In for Workers with Disabilities. The recommendations build upon BPC’s research and recommendations from 2021, providing more specific actions that Congress, the administration, and states should take to improve access to coverage and remove barriers to work for the nearly 25 million adults with disabilities who were not in the labor force in 2021.

With support from the Robert Wood Johnson Foundation, BPC identified key challenges for states in adopting or optimizing their MBI for Workers with Disabilities programs and pinpointed federal reforms that will help states better provide needed benefits to individuals with disabilities across the United States. These reforms include clarifying existing options for states designing their MBI for Workers with Disabilities programs, and strengthening outreach, data, and interagency coordination.  

“Many individuals with disabilities rely on Medicaid’s services, such as home and community-based services, to live independently in the community and work,” said BPC Associate Director Lisa Harootunian. “BPC’s new recommendations will not only help more states adopt and optimize MBI for Workers with Disabilities programs but will also allow individuals with disabilities to improve their economic status and pursue gainful employment. In fact, one state found that program participants were four times more likely to be employed, compared with nonparticipants with disabilities, and worked 193 more hours on average.” 

Forty-six states currently cover the MBI for Workers with Disabilities eligibility groups—Work Incentives, Ticket to Work Basic, and Ticket to Work Medical Improvements—established under the Balanced Budget Act of 1997 and the Ticket to Work Act of 1999.

An event discussing the MBI for Workers with Disabilities programs and the report recommendations will take place later this afternoon. Watch online.

Read the report 

The 2021 report, Improving Opportunities for Working People with Disabilities, can be found here.