Vol. 8, No. 1 Winter 2000	Previous Issues Subscribe to AT Messenger Download PDF Viewer
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Work Incentives Improvement Act Becomes Public Law

On December 17, President Clinton signed the Ticket to Work and Work Incentives Improvement Act of 1999 (WIIA), landmark legislation that will enable millions of Americans with disabilities to join the workforce without fear of losing their Medicaid and Medicare coverage. The legislation will also modernize the employment services system for people with disabilities.

Though the U.S. unemployment rate is at a 29-year low, the unemployment rate among working-age adults with severe disabilities is nearly 75%.

Local Efforts

This signing was the culmination of much work, some of it based right here in Delaware. Senator Bill Roth (R-DE), chair of the Senate Finance Committee, helped to forge the bipartisan effort to develop this legislation. Roth's efforts were featured in the April/May/June 1999 issue of The AT Messenger. Since that article, the Work Incentives Improvement Act passed the House of Representatives on November 18, and has now been signed into law by the President. At a November 22 press conference in Wilmington, Roth said, "No one should have to choose health care over employment."

Highlights of the Legislation

Under current law, people with disabilities can become ineligible for Medicaid or Medicare if they work. The WIIA will break down the barriers for millions of Americans who are disabled by:

• creating new options and incentives for states to offer a Medicaid buy-in for workers with disabilities;
• extending Medicare coverage for an additional four years for people on disability insurance who return to work
• creating a $250 million Medicaid buy-in demonstration to help people whose disabilities are not yet so severe that they cannot work; and
• enhancing employment-related services for people with disabilities through the new "Ticket to Work" Program.

Medicaid and Medicare Options Available to States

The act creates two new options: first, it lets states remove the income limit of 250 percent of poverty (about $21,000), allowing them to set higher income, unearned income, and resource limits. This means that people can buy into Medicaid when they don't have access to private health insurance. Second, it creates the option to allow people with disabilities to retain Medicaid coverage even though their medical condition has improved as a result of medical coverage.

The act also creates a new Medicaid by-in demonstration to help people who are not yet too disabled to work. For example a person with muscular dystrophy, Parkinson's Disease, or diabetes may be able to function and continue to work with appropriate health care, but such health care may only be available once their conditions have become severe enough to qualify them for SSI or SSDI and thus Medicaid or Medicare. For people with disabilities who are returning to work, the act extends Medicare Part A premium coverage-for another four years-for people on Social Security Disability Insurance who return to work. This means the difference between a monthly premium of nearly $350 (roughly the cost of purchasing Part A and B coverage) and $45.50.

Ticket to Work

The Act creates a "Ticket to Work Program." This new system will enable SSI or SSDI beneficiaries to obtain vocational rehabilitation and employment services from their choice of participating public or private providers. If the beneficiary goes to work and achieves substantial earnings, providers would be paid a portion of the benefits saved.

More information will follow as the legislation is implemented.

Nathan Hill, President of Greenwood Trust Company and Vice President for Discover Financial Services, Inc., Senator Bill Roth, and Larry Henderson, Independent Resources, Inc. talk about the Work Incentives bill at a November press conference in Wilmington.