Medicaid called trap for disabled

BOISE – Medicaid is a trap to disabled people who want to work, encouraging them to stay at home so they don’t risk losing expensive benefits, advocates for the disabled argued Monday.

“We need to open the trap,” said Jim Baugh, who runs the Boise-based Comprehensive Advocacy Inc. “The federal government has given us the key, and all we have to do is take it.”

A host of disabled Idahoans told a Senate committee the answer is for the state to adopt a Medicaid buy-in program, as 28 other states have done.

Under the current system, Baugh and others said, disabled recipients risk losing funding for costly services if they work too many hours or make too much money. Most employer-provided health insurance doesn’t cover personal assistance or equipment for the severely disabled, so they are forced to work part-time and refuse raises and promotions to stay eligible for the Medicaid benefits.

“The state needs to help people with disabilities rise out of poverty,” said Kelly Buckland, the sponsor of SB 1143 and director of the State Independent Living Council. “We want them to take personal responsibility.”

Buckland’s bill would allow disabled, working Medicaid recipients whose incomes grow to keep getting benefits while paying for their premiums on a sliding scale.

Members of the Senate Health and Welfare Committee who heard testimony Monday delayed making a decision on the bill. The committee chairman, Sen. Dick Compton, R-Coeur d’Alene, was absent from the meeting after being unable to fly into Boise Monday morning because of fog.

Then-Gov. Phil Batt’s Medicaid reform advisory council recommended a buy-in program in 1996, and federal legislation gave states that option in 1999. Idaho was given a $2.1 million grant to analyze and design such a system in 2001, but an economic downturn put the issue on the back burner.

A similar measure fell one vote short last year of surviving the Joint Finance-Appropriations Committee.

The Department of Health and Welfare has estimated it would cost the state $430,000 to implement the program for the 2006 fiscal year.

Bobbi Ball, the executive director of the Idaho Task Force on the Americans with Disabilities Act, said she could make significantly more than the $23,000 a year she earns, but can’t afford to risk losing the Medicaid benefits.

“I’m sorry, but $430,000 just doesn’t sound like a lot of money to me,” she said, adding that she pays $1,200 a month for services.

“With this, I would just pay a premium,” she said.