New Public Act 096-0181

Health Benefits for Workers with Disabilities
Assuring All Workers with Disabilities Continue to Have Access to Affordable Health Care

Health Benefits for Workers with Disabilities (HBWD) is a program that allows individuals with disabilities who work topurchase Medicaid coverage. This Program is mostly utilized by individuals who receive or received Social Security Disability Insurance and return to work. It allows them to afford Medicaid without a large spend-down and receive “extra help” in paying for Medicare Part D prescription drugs.

By law, enrollees in this Program are subjected to Continuing Disability Reviews. While very rare, some individuals are found to be medically improved through these reviews. When this happens, the individual loses eligibility for cash benefits for Social Security, Medicare, Medicaid and Health Benefits for Workers with Disabilities (HBWD), if applicable. However, federal law does allow Medicaid Buy-In Programs such as HBWD to continue to cover these individuals under
a category called “medical improvement.”

When an enrollee is found to be medically improved, the resulting loss of medical benefit is devastating. These individuals have successfully made the transition back into the workforce and are using HBWD to obtain needed medications and healthcare to maintain that job. Then, after this Review and an unfavorable decision, they lose access to the very healthcare that made the work transition possible. This can easily lead to lose of the job and a worsening of their medical condition just at a time when they are transitioning back to being active members of their community.

Public Act 096-0181 assures that all individuals with disabilities who have successfully transitioned to employment can maintain eligibility to HBWD and its needed healthcare. Adding this category of coverage to Medicaid costs very little as only a small number of working individuals are ever found medically improved each year. Providing these individuals with continuing access to healthcare does allow them to continue working, paying taxes to the state, and feeling empowered and productive.