Chairpersons and honorable members of the Committee. My name is Catherine E. Johnson. I am the Executive Director of Disability Rights Iowa. DRI is an independent, non-profit agency, which serves as the designated protection and advocacy system for people with disabilities in the state of Iowa, pursuant to federal mandates. The mission of the agency is to protect and advocate for the human and legal rights of Iowans with disabilities. I appear before you to share DRI’s opinion that that SF 368/HB 403 would have a positive impact on Iowans with disabilities ability to engaging in competitive integrated employment. SF 368/HB 403 would remove barriers that currently prevent Iowans with Disabilities from being able to engage in Competitive Integrated Employment.
Americans with Disabilities Act
Congress enacted the Americans with Disabilities Act over thirty-three years ago. Congress intended to create a world where individuals with disabilities have the opportunity for full inclusion, full access, equal opportunity, independence, and self-sufficiency. Engaging in competitive employment is key to achieving these goals set by Congress. More than three decades after the ADA, only 19.1 percent of the national workforce comprises people with disabilities.
According to the attached July 2022 Edition of Iowans with Disabilities: 2022, Only 90,597 of Iowans with disabilities between 18-64 were employed in 2021. 48.8 percent of this population worked only part-time. In 2021, Iowans with disabilities comprised only 5.9 percent of the labor force. The unemployment rate for Iowans with disabilities in 2021 was 8.9%. The unemployment rate for Iowans without disabilities in 2021 was 3.6%. SF 368/HB 405 would advance the goals set by Congress of independence and self-sufficiency for Iowans with disabilities, improving economic opportunities for Iowans with disabilities as well as the growing the economy in the State of Iowa.
Medicaid for Employed People with Disabilities (MEPD)
Iowans with disabilities want to participate in Competitive Integrated Employment (CIE). Medicaid for Employed People with Disabilities (MEPD) is a Medicaid coverage group that was designed to promote employment for people with disabilities. Medicaid provides access to resources (e.g., personal care attendants, adaptive equipment, community living supports, and waiver services) that are not covered by traditional insurance. However, it has restrictions like age, income, and asset limits which create barriers for individuals and families and disincentivizes employment.
SF 368 & HB 403 Increase Healthcare Access Based on Age
SF 368 & HB 403 increase healthcare access for older Iowans with disabilities. MEPD has an age limit of under 65-years-old, so individuals with disabilities who receive Medicaid coverage through MEPD become ineligible before they reach their full retirement age.
The proposed bills would create the Work Without Worry program for employed individuals with disabilities, which does not have an age cap. SF 368 & HB 403 enable individuals with disabilities to continue receiving Medicaid coverage and the supports they need for employment as long as they are working in wage or self-employment.
SF 368 & HB 403 Increase Healthcare Access Based on Income
SF 368 & HB 403 increase healthcare access for individuals with disabilities who fear losing Medicaid coverage by increasing their hours at work or accepting wage increases. MEPD has an income limit of 250% of the Federal Poverty Level and counts the income of the entire household. If an individual with a disability wants to apply for MEPD, an employed spouse and other employed members of the household count towards the income limit. Individuals with disabilities often are hesitant to or do not accept more working hours, wage increases, and bonuses from their employer due to the fear of losing their Medicaid coverage.
The proposed bills would increase the income limit to 450% of the Federal Poverty Level and only count the income of the individual with a disability. The proposed bills would encourage individuals with disabilities who want to work to accept additional hours and wage increases without the worry of losing the services they need for employment through Medicaid.
SF 368 & HB 403 Increase Healthcare Access Based on Assets
SF 368 & HB 403 increase healthcare access for individuals with disabilities who are ineligible for MEPD due to asset limits. People become disabled at all stages of life. Many individuals with disabilities become disabled after marrying, working for years, and saving for retirement. MEPD requires individuals with disabilities to have resources fewer than $12,000 for an individual and $13,000 for a couple. Besides penalizing married couples where one or both individuals are disabled, the asset limit prevents individuals who became disabled later in life from accessing Medicaid coverage.
Social Security Disability Insurance (SSDI) is the program for individuals with disabilities who previously worked and earned enough credits to reach insured status. SSDI beneficiaries must wait 2 years from the time they are approved and start receiving payments to become eligible for Medicare coverage. These individuals are often not eligible for healthcare coverage through MEPD due to the asset limit. As a result, SSDI beneficiaries often pay high COBRA premiums or go without insurance while they wait to receive Medicare.
The proposed bills would remove the asset limit for individuals with disabilities beyond one vehicle used by/for the individual and a primary residence valued less than $400,000. The proposed bills would encourage individuals with disabilities who want to work to pursue employment and be able to save for the future without fear of losing their healthcare coverage.
SF 368 & HB 403 Supports Access to Information on Employment Resources
Disability Rights Iowa (DRI) is one of 74 agencies across the country with a Work Incentives Planning and Assistance (WIPA) project. WIPA is a competitive grant-funded program from the Social Security Administration (SSA) that serves people who receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) due to a disability and are about to start work or already working. The program aims to improve employment outcomes and increase economic self-sufficiency for Social Security disability beneficiaries through their understanding of how employment can be an option for them. DRI’s WIPA project is staffed with Community Work Incentives Coordinators (CWICs). The CWICs are certified to provide benefits counseling to SSA disability beneficiaries in all 99 counties in Iowa and 34 counties in Northwest Illinois.
The lack of affordable and accessible healthcare are frequent barriers to individuals with disabilities seeking employment. The age, income, and asset limits with MEPD can prevent beneficiaries from fully exploring their options with employment due to fears of losing the medical coverage and supports they need to work. Unless a beneficiary has contacted DRI’s WIPA Team, there is a high likelihood that they were unaware of available resources. Many Social Security disability beneficiaries across Iowa remain unaware of the resources available to support them in pursuing employment and thus are not exploring opportunities for employment.
SF 368 & HB 403 increases awareness of the resources available for individuals with disabilities and employment. The proposed bills would implement a Work Without Worry public awareness campaign by the Department of Health and Human Services (HHS) to educate potential participants and the public about the program. Individuals with disabilities, along with their families, educators, and disability service providers, would have the knowledge they need to make educated decisions regarding employment. They can connect with resources sooner, including the DRI WIPA team for benefits planning support, to make their dreams for employment a reality. The proposed bills would support the DRI WIPA team in reaching more Social Security disability beneficiaries who want to start their employment journey towards financial independence.
SF 368 & HB 403 Supports the Principles of Employment First
SF 368 & HB 403 supports the Principles of Employment First for individuals with disabilities.
According to the Office of Disability Employment Policy at the U.S. Department of Labor, Employment First is:
a national systems-change framework centered on the premise that all individuals, including those individuals with the most significant disabilities, are capable of full participation in Competitive Integrated Employment (CIE) and community life. Under this approach, publicly-financed systems are urged to align policies, regulatory guidance, and reimbursement structures to commit to CIE as the priority option with respect to the use of publicly-financed day and employment services for youth and adults with significant disabilities. (Policy n.d.)
DRI respectfully requests that SF 368 and HB 403 be amended to include principles of Employment First, that serve as a catalyst to set the official policy of the State of Iowa that competitive and integrated employment is the first option when serving people with disabilities, to establish definitions of competitive and integrated employment and details how state agencies collaborate together to improve employment outcomes for Iowans with Disabilities.
DRI strongly supports this legislation. DRI urges this sub-committee to move this legislation forward. SF 368 and HB 403 will remove barriers related to Medicaid coverage and encourage employment for individuals with disabilities seeking employment. Work Without Worry will increase employment opportunities for Iowans with Disabilities, grow Iowa’s Labor Pool and move forward Congress’ ADA Goals of Independence and Self-Sufficiency.
DRI welcomes the opportunity to discuss this in more depth with any member of the Iowa Legislature. Thank you in advance for your thoughtful deliberation of our testimony in support of SF 368 and HB 403.
References
Policy, U.S. Department of Labor Office of Disability Employment. n.d. Employment First. Accessed January 25, 2024. https://www.dol.gov/agencies/odep/initiatives/employment-first.
