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THE WHITE HOUSE

Office of the Press Secretary

For Immediate Release November 18, 1999

                WORK INCENTIVES IMPROVEMENT ACT OF 1999
                           November 18, 1999

Today, the House of Representatives will vote on the Work Incentives Improvement Act of 1999. The President challenged Congress to pass this bill in his State of the Union address, and fully funded it in his 2000 budget. It gives people who want to work a chance to do so by removing the out-dated rules that end Medicaid and Medicare coverage when people with disabilities return to work. It modernizes the employment services system for people with disabilities. And, it affirms the basic principle manifested in the Americans with Disabilities Act: that all Americans should have the same opportunity to be productive citizens.

Improves Health care options for people with disabilities by:

Removing limits on the Medicaid buy-in option for workers with disabilities. This act creates two new options for states to offer the Medicaid buy-in, created by President Clinton in the Balanced Budget Act of 1997. First, removes the income limit of 250 percent of poverty (about $21,000), allowing states to set upper income, unearned income, and resource limits. This is important since it allows people to buy into Medicaid when their jobs pay more than low wages. Second, it allows coverage of people with a disability, such as rheumatoid arthritis, who can work only because of medical treatment. This act also provides $150 million over 5 years in health care infrastructure grants to those that do so.

Creating a new Medicaid buy-in demonstration to help people who are not yet too disabled to work. This act provides $250 million to states for a demonstration to assess the health and financial benefits of providing Medicaid coverage to people whose condition has not yet deteriorated enough to prevent work but who need health care to prevent that deterioration. 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. This demonstration would provide new information on the cost effectiveness of early health care intervention in keeping people with disabilities from becoming too disabled to work.

Extending Medicare coverage for people with disabilities who return to work. Although Medicare does not currently provide prescription drugs which are essential to people with disabilities, this act extends Medicare Part A premium coverage for people on disability insurance who return to work for another four and a half years. This means the difference between a monthly premium of nearly $350 and $45.50. This assistance will be available nationwide, even in states that do not take the Medicaid options.

Modernizes the employment services system by: Creating a "Ticket to Work Program." This new system will enable SSI or SSDI beneficiaries to go to any of a number of public or private providers for vocational rehabilitation. If the beneficiary goes to work and achieves substantial earnings, providers would be paid a portion of the benefits saved.

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