People With Disabilities Say Medicaid’s Limits on Income Stifle Career Advancement
Special Medicaid programs in many states allow disabled people to work while receiving benefits, and most limit how much participants can earn and the assets they can hold. Some Iowans are pushing lawmakers to remove those limits, which they say can dampen their career prospects.
Erica Carter, a 41-year-old finance manager and grant writer for the Omaha Nation school district in Nebraska, has been paralyzed from the chest down since a fall in her 20s. When her Medicaid coverage was threatened in November 2023 due to her income exceeding the program's limit, she faced a difficult decision. Iowa's Medicaid buy-in program for workers with disabilities caps income at $36,450 for a household of one, a level Carter found unrealistic given her $110,000 annual salary.
She could either accept a lower-paying job or lose her Medicaid coverage, which provided benefits she couldn't obtain through the school district's health plan. Carter chose to maintain her job and discontinue Medicaid participation, despite the increased out-of-pocket expenses for her disability-related needs. Disability rights advocates argue that income limits in Medicaid programs hinder disabled individuals from advancing in their careers and accumulating savings, while Congress originally aimed to incentivize work among people with disabilities.
Iowa, one of the first states to adopt a Medicaid buy-in program, currently allows 11,640 participants, but advocates suggest replacing strict income and asset caps with a more flexible 6% income contribution, a model implemented in Tennessee. However, progress in removing these caps has been slow, with recent legislative sessions failing to advance proposed bills.
Written by urgent.news from KFF Health News's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
