28-03-2025
Disability advocates hoping for change to Medicaid program
A small program aimed at helping Hoosiers with disabilities keep their Medicaid benefits while working hasn't changed in more than 20 years — but advocates are hoping this year could be different.
Why it matters: MEDWorks is Indiana's Medicaid buy-in program, designed to make it easier for adults with disabilities to work and keep the health coverage they need.
Yes, but: Income and asset limitations haven't changed since it was implemented in 2002, discouraging some Hoosiers with disabilities from seeking employment.
How it works: To qualify for MEDWorks, individuals must be between the ages of 16 and 64, be determined to be disabled and make no more than 350% of the federal poverty level.
This year, that's $54,775 for an individual.
There's also a resource limit of $2,000. Your primary home, one car and a retirement account don't count toward that, but a savings account does.
What they're saying: "It really prevents someone from saving for emergencies," said Tom Crishon, chief legal officer with The Arc of Indiana.
MEDWorks has a work requirement built into the program and participants pay a premium, based on a sliding scale — two concepts that lawmakers want to incorporate into traditional Medicaid programs, Crishon said.
What they're asking: Advocates want lawmakers to increase the income limit to 500% of the federal poverty level, which would be $78,250, and to increase the asset limit to $20,000.
They also want to raise the maximum age for participation from 64 to 67, to match the full retirement age for Social Security benefits.
Context: The requests come from recommendations made by a subcommittee tasked with studying the MEDWorks program by legislation passed last year.
House Bill 1067 asked for recommendations to eliminate barriers to employment and independence for individuals with intellectual and developmental disabilities and to increase workforce participation for individuals participating in the program.
"The benefits extend far beyond people with disabilities," said Rep. Ed Clere, R-New Albany, who authored HB 1067. "This should be part of our conversation about workforce."
This year, he wrote House Bill 1106 to take the recommendations from the report and make them law, but it didn't get a hearing.
He views the bill as a way to get thousands of unemployed or underemployed Hoosiers working. As they would move up in the workforce, they would become more self-sufficient and pay more toward their Medicaid premiums.
Clere told Axios he's hoping to find a home for the ideas in legislation that's still moving this session.
When Clere's bill didn't move, advocates took the requests to the state's budget writers.
"A lot of people would work if the asset limit was higher than the $2,000 because they're afraid of losing their benefits," Shawn Fulton told the Senate Appropriations Committee last week. Fulton, the advocacy engagement and education manager with The Arc, does career counseling and referrals for individuals with disabilities.
Zoom in: Fulton is also a MEDWorks program participant.
Working enabled him to achieve his dream of owning a home, but when it needs a new roof in a few years, he's going to have to take out a loan to pay for it because the program prevents him from saving more than $2,000.
"I do really well at my job, and my job wants to give me a raise," Fulton told Axios, "but if I get another raise, I'm gonna lose all my benefits."
State of play: It's a tight budget year, so very few requests for new dollars are getting granted.
Advocates, though, say that the small program is unlikely to cost the state much and will have trickle-down benefits to the state economy as it encourages more Hoosiers with disabilities to work without fear of losing benefits.
In December, 2,700 people were enrolled in MEDWorks.
