Is Medicaid Work Incentive for Florida?

11/30/07 Seán Kinane
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People who are medically eligible to obtain the government health insurance Medicaid might not receive it if they earn too much money to qualify for the need-based program.

A coalition of advocacy, government, and business groups are working to craft legislation that would allow Floridians with disabilities to work but still be able to opt-in to Medicaid insurance.

This morning at the public library in downtown Tampa, about 40 stakeholders learned about the proposed program, called Work Incentive Medicaid Coverage or Medicaid Buy-In.

Sharon Brent, director of training and technical assistance at the National Disability Institute, said that Work Incentive Medicaid Coverage would be a new way for people to qualify for medical insurance under Florida’s Medicaid program.

Brent told WMNF who would be eligible under Work Incentive Medicaid Coverage.

“People who are disabled, at this moment in time based on the Federal regulations, who are actually out there earning wages, who may not be able to keep health insurance because of the amount of wages that they’re earning or because they would not be eligible under other categories of Medicaid but they have a disability and they’re earning wages and they need access to health insurance and this would be a new door to that access.”

Under current Florida regulations, people who are working but on Medicaid would have no incentive to work more hours or earn more money because doing so would make them ineligible for Medicaid. Brent said that these people would be helped by the plan.

“It is encouraging folks with disabilities who are afraid to lose their Medicaid insurance under the current rules when you go to work, to increase their ability to earn wages and also to be able to save some money that they’re limited in doing at this point in time under current rules and regulations. So it’s a new door to enhance and encourage more wage earning and the ability to save more money in order for them to be more self-sufficient.”

In 1999 Congress passed the Ticket to Work and Work Incentives Improvement Act, which gave states the opportunity to opt-in to Work Incentive Medicaid Coverage.

“The option for states is available to all the states and the territories that belong to the United States. There are currently 39 states that have taken that option that was given through a piece of federal legislation that the Center for Medicare and Medicaid Services is implementing, and in order for Florida to take this option, is creating a piece of legislation and putting regulations together for it to be implemented in Florida.”

The tentative cost to the state to cover the estimated 1,000 additional Medicaid recipients who would benefit from Work Incentives Medicaid Coverage in its first year is projected to be $1.3 million, according to Brent.

“If someone is already eligible for Medicaid, it would not be an additional cost, if someone chooses to go from the current Medicaid door that they entered to this Medicaid door that they enter, there would be no additional cost to Florida. There will be an additional cost for those folks who don’t currently are eligible for Medicaid only in the fact that they may be earning too much money or have too much money saved.”

But Brent said that those costs could be offset by increased revenue coming to the state.

“It’s going to increase the money coming into the state federally, but there will be a cost. But the offset to that cost is that you have a workforce that is earning wages. You have those dollars going back into the economic area of the local jurisdictions plus the state. … There also may be an offset to the state in a premium cost to the person who enters into this program. So that would also be an offset to the expenditure that the state would make, so there’s a combination of things that could happen that would be a win-win for both.”

WMNF asked Brent what people could do to help Florida adopt Work Incentive Medicaid Coverage.

“I would tell them to stay tuned, get involved in their own organizations that they’re already connected to, whether it’s the mental health system, whether it’s the developmental disability system, whether it’s folks that are in the HIV system, because it’s going to belong to all disabilities, so if you’re connected already, stay tuned, get involved with that organization because each one of those kinds of organizations have what they call legislative agendas. Those agendas can be part of this particular subject matter so that they can start to advocate at the local level to their particular legislative representatives.”

Photo Credit: Seán Kinane/WMNF

Learn more:

National Disability Institute


Ticket to Work and Work Incentives Improvement Act

Ticket to Work on Social Security

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