1. Developing Fiscal Estimates for a Medicaid Buy-In Program: Using Data from Early Implementer States (2002)
   - Prepared by Allen Jensen and Donna Folkemer
   · Word version
   
   
2. Case Studies and Technical Assistance for Medicaid Buy-Ins for People with Disabilities
   - http://aspe.hhs.gov/daltcp/projects.htm#GWU5
   - prepared by Allen Jensen, Center for Health Services Research and Policy at The George Washington University Medical Center, Robert Silverstein, Center for the Studey and Advancement of Disability Policy, and Donna Folkemer, National Conference of State Legislatures.

   Purpose: In an effort to encourage more states to provide Medicaid to working individuals with disabilities, and to give states addition options for providing Medicaid to those individuals, Congress permitted states to expand their Medicaid programs (through a Medicaid "buy-in") and allow people with disabilities to continue to receive Medicaid services even if they return to work. The goal of this project is to: (1) examine the early implementation experiences of states that have opted for a Medicaid buy-in for people with disabilities, and (2) offer technical assistance to states on developing cost models, design features of a buy-in, as well as implementation and administration considerations for a buy-in. The project represents a unique opportunity to compare the design and implementation experiences of different states, and use the information gathered to inform both state and federal policy makers about strategies for improving systems that support the employment of people with disabilities.

   Contact person at ASPE: Andreas Frank (afrank@osaspe.dhhs.gov)

   
   
3. Policy Frameworks For Designing Medicaid Buy-In Programs and Related State Work Incentive Initiatives (2002)
   - Prepared by Allen Jensen, Robert Silverstein, Donna Folkemer, Tara Straw
   · Executive Summary - http://aspe.hhs.gov/daltcp/reports/polfrmes.htm
   · Full Report - http://aspe.hhs.gov/daltcp/reports/polframe.htm

   This report provides policy frameworks to assist stakeholders design and implement Medicaid Buy-In programs and related work incentive initiatives to enhance the level of economic self-sufficiency of persons with significant disabilities. Of particular focus are the design decisions affecting enrollment, costs, and a state's fiscal exposure. The policy frameworks describe the interrelationship between federal and state cash assistance programs (particularly SSI, SSDI, and state SSI supplementation programs) and health entitlements (particularly the Medicaid program). The policy frameworks are derived from the experience of the nine early implementation states--Alaska, Connecticut, Iowa, Maine, Minnesota, Nebraska, Oregon, Vermont and Wisconsin.

   
   
4. The Medicaid Buy-In Program: Lessons Learned from Nine Early Implementer States (2002)
   - Prepared by Donna Folkemer, Allen Jensen, Robert Silverstein, Tara Straw
   · Executive Summary: http://aspe.hhs.gov/daltcp/reports/EIlesses.htm
   · Full Report: http://aspe.hhs.gov/daltcp/reports/EIlesson.htm

   This report discusses findings from case studies of nine states--Alaska, Connecticut, Iowa, Maine, Minnesota, Nebraska, Oregon, Vermont and Wisconsin--operating Medicaid Buy-In programs for working persons with disabilities. At the time of this study, approximately 13,000 persons were enrolled in the programs in these nine states. The paper gives particular attention to the decisions made by states concerning program eligibility, their approaches to estimating program enrollment and costs, and the patterns of program enrollment to date.

   
   
5. The Medicaid Buy-In Program: Case Studies of Early Implementer States (2002)
   - Prepared by Donna Folkemer, Allen Jensen, Robert Silverstein, Tara Straw
   · Report: http://aspe.hhs.gov/daltcp/reports/EIcasest.htm

   This paper describes the findings from nine Case Study states. These case studies were conducted: (1) To examine early implementation experience among the states in order to gain an understanding of the programmatic, fiscal, and political context in which design decisions were made. (2) To gather quantitative and qualitative descriptive information for use in providing technical assistance to other states regarding the range and scope of state approaches to enable state policy makers to make informed decisions. (3) To inform federal policy makers and other stakeholders about issues associated with Medicaid Buy-In programs.

   Individual State Case Studies are also available on the following website:
   http://www.uiowa.edu/~lhpdc/work/index.html.
   Click on individual states on US Map

   
   
6. A Summary Description of the Federal Income Maintenance and Health Care Programs for Disabled Persons Who are Working or Want to Work (2002)
   An Appendix to State Case Studies, Analysis and Policy Papers on State Medicaid Buy-In Programs and Related State Work Incentive Initiatives for People with Disabilities
   - Prepared by Allen Jensen, Robert Silverstein, Donna Folkemer
   · Word version

At a Glance