Medicaid Buy-In Legislation Progress Report
Goals
In 2002, the Medicaid Buy-In Work Group Final report described the Workgroup's goals:
1. To develop and get enacted into law a Medicaid Buy-In for people with disabilities that will de-link Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) payments from health benefits in order that individuals will be able to return to competitive employment and at the same time be covered with affordable health insurance.
2. A second goal is to develop a program that will prevent and /or delay both employed individuals who become disabled and disabled youth in transition from having to go onto the public programs in the first place.
Background
The main purpose for developing a Medicaid Buy-In is to enable people with disabilities to live a productive life of dignity. The key element for any person to live a productive independent life is being able to work in good paying jobs that provide health benefits.
For many people with disabilities, returning to work could mean a substantial loss of health insurance, personal care assistants, housing, transportation services, food stamps, mental health and other critical life support services. The greatest fear for these individuals is the loss of health and support services they receive from the Medicaid program: being on Medicaid has become a life necessity with recovery and return to full employment being thwarted by the fear of losing benefits (e.g., prescription drugs and personal care assistants)
2002 Recommendations
The passage of the Medicaid Buy-In will take a targeted effort over the next six months. A consultant will be retained to educate key members of the House and Senate on the issues surrounding a Medicaid Buy-In in Rhode Island. The Governor's Commission on Disabilities should become actively involved in getting legislative support for this initiative. In addition, a budget article template should be developed with technical assistance by the Department of Human Services to address the cost of this program in the short run. Over a five-year period the expectation is to help .5% of the current number of people on SSDI get back to competitive employment. This estimate is approximately 120 people.
2003 Accomplishments and Progress
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The Medicaid Buy-In Legislative Strategy Workgroup worked toward developing and submitting MBI legislation. From January – June 2003, the Legislative Strategy Workgroup met twice a month to develop MBI legislation and strategy toward gathering support for the Medicaid Buy-In in the House and Senate and among key leadership individuals.
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A consultant was hired to educate House and Senate members on the
issues surrounding a Rhode Island Medicaid Buy-In.
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While legislative cultivation was on the whole successful, the budget crisis, the Governor's no new program mandate and concern in DHS regarding the administrative cost of a MBI created an insurmountable barrier for this legislative session.
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With the failure of MBI legislation to pass in June 2003, the MBI Workgroup ceased to meet.
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A Steering Committee MBI legislation subcommittee was formed in October '03. Meetings were held in November and December with the Governor's staff to provide clear information on the economic benefits of the Medicaid Buy-In for the state. In addition, Steering Committee representatives met with officials of the Economic Development Council.
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It was decided that the MBI is be promoted as an economic / workforce issue as opposed to a health services initiative; thus pressure to pass the bill would come from multiple economic development entities.
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Rhodes to Independence Steering Committee members met with the Governor's staff and key workforce development representatives in November and December to garner support for passage of a MBI in 2004.
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A meeting was being planned for early 2004 at which a nationally recognized expert on Medicaid Buy-Ins (Allen Jensen – who has crafted MBIs for other states) would give a presentation concerning possible methodologies for fashioning a modest incremental MBI. Agency representatives, key legislators, the State Economic for the Budget Office and others would be invited to participate.
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DHS was requested to put together a fiscal analysis of the RI MBI.
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Key legislator Representative Eileen Naughton and other legislators expressed support for the MBI legislation.
At the end of 2003, with growing support from legislators, workforce and economic resource entities, and increasing numbers of advocates and stakeholders speaking out concerning the need for MBI among consumers, passage of Medicaid Buy-In legislation seems favorable for the 2004 legislative session.
