Press Release

Most Medicaid Buy-In Participants Not Utilizing Work Incentive Programs
Offered by the Social Security Administration

New Brief from Mathematica^® Notes that Better Program
Design and Benefits Counseling Are Key to Improving Participation

Contact: Cheryl Pedersen, (609) 275-2258

WASHINGTON, D.C. (January 17, 2008)—Medicaid Buy-In participants who receive Social Security Disability Insurance (SSDI) benefits may not be taking full advantage of the available work incentive programs that can improve their prospects of finding employment and attaining economic self-sufficiency. The seventh policy brief in a new series on working with disability from Mathematica Policy Research, Inc., reveals that only 23 percent of Medicaid Buy-In participants who received SSDI benefits between 2000 and 2005 took part in a work incentive program. The brief summarizes Mathematica's study of participation rates for four specific SSDI work incentive programs: Trial Work Period, Extended Period of Eligibility, Impairment-Related Work Expenses, and Ticket to Work.

Many SSDI beneficiaries may avoid working or earning above the substantial gainful activity level for fear of losing their benefits. To encourage working-age adults with disabilities to seek employment or earn more income, the Social Security Administration offers work incentive programs that provide various benefits, from continuation of benefits while working to free employment services that include job training and placement.

As the brief explains, the Trial Work Period program was the most utilized among Buy-In participants who receive SSDI benefits, with approximately 16 percent of beneficiaries participating. The Extended Period of Eligibility program had the second highest participation rate, 7 percent, with Ticket to Work running a close third with 6 percent of beneficiaries participating. Less than one percent utilized the Impairment-Related Work Expenses incentive.

A state-by-state comparison of participation rates gives greater insight into how some state-designed programs can be more effective than others. Nebraska, for example, had the highest share of participants (58 percent) in any program. This trend may have been influenced by the design of the state's Buy-In program, which waives the unearned income limit for all SSDI beneficiaries who participate in the Trial Work Period or Extended Period of Eligibility programs. With the largest participation rate for the Ticket to Work program (25 percent), Vermont offers another example of an effective Buy-In design feature. The state provides centralized benefits counseling services and Buy-In outreach at state vocational rehabilitation agencies, thus educating beneficiaries about available incentive programs and increasing their likelihood of participation.

“We found higher participation rates in states whose Buy-In programs promote the use of work incentives through program policies or centralized benefits counseling and Buy-In outreach. Higher work incentive program participation rates are also associated with higher rates of economic self-sufficiency,” said Kristin Andrews, lead author and a research analyst at Mathematica. “These features may be a good model for educating beneficiaries about the work incentive programs and supporting them to attain self-sufficiency.”

“How do Medicaid Buy-In Participants Who Collect Social Security Disability Insurance Benefits Use SSA Work Incentive Programs?” by Andrews, Bob Weathers, and Su Liu, is available at www.mathematica-mpr.com/publications/redirect_pubsdb.asp?strSite=pdfs/WWDsocialsecurity.pdf. For more information on the study and access to previous briefs, go to www.mathematica-mpr.com/disability/medicaidbuy-in.asp.

Mathematica, a nonpartisan firm, conducts policy research and surveys for federal and state governments, foundations, and private-sector clients. The employee-owned company, with offices in Princeton, N.J., Washington, D.C., Cambridge, Mass., and Ann Arbor, Mich., has conducted some of the most important studies of disability, health care, early childhood policies, welfare, education, employment, and nutrition programs in the U.S. Mathematica strives to improve public well-being by bringing the highest standards of quality, objectivity, and excellence to bear on the provision of information collection and analysis to its clients.

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