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Mobility Limitations Negatively Impact Work Outcomes among Medicaid Enrollees with Disabilities

Journal of Occupational Rehabilitation volume 17, pages 355–369 (2007)Cite this article

Abstract

Introduction

Fear of losing health insurance is believed to be a significant work barrier for people with disabilities in the US. We examined the relationship of different types of daily activity limitations to work outcomes among adults with a variety of disabling conditions for whom the risk of losing health insurance has been removed by enrolling in a Medicaid buy-in (MBI) program.

Methods

1093 working-age adults with disabilities in the Massachusetts MBI program responded to the MassHealth Employment and Disability Survey, which provided data on the types of disabling conditions and activity limitations members experienced as well as three work outcomes––work status of members; annual earnings above substantial gainful activity of working members; and plans to work in the future of non-working members.

Results

Among different types of activity limitations, mobility limitations were generally associated with poorer work outcomes, regardless of disabling condition. Across members in three disability groups––psychiatric; physical; and co-occurring psychiatric and physical––those reporting mobility limitations were significantly less likely to be working or, if non-working, to be planning work than those reporting no or other types of limitations. There was an exception to this pattern with respect earnings among working members. Overall, work outcomes among members with co-occurring psychiatric and physical disabilities were most consistently negatively impacted by mobility limitations.

Conclusions

Rehabilitation providers aiming to promote entry into the workforce need to be aware of the varied ways in which mobility limitations may create barriers for people with all types of disabilities.

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Notes

  1. As defined by the US Social Security Administration, people with disabilities are generally considered to be engaging in SGA when their countable monthly earnings from work exceed $900 (2007 level). SGA is higher for those who are blind. At the time of the current study (2003), SGA was $800 for non-blind individuals. http://www.ssa.gov/OACT/COLA/SGA.html

  2. Using MassHealth administrative data, we found that respondents were significantly more likely to be female, older, have higher family income and have higher Medicaid expenditures than non-respondents. Respondents and non-respondents did not differ in CommonHealth eligibility category or in Medicare enrollment.

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Acknowledgements

This article was supported by the Massachusetts Medicaid Infrastructure Grant (Grant # DHHS/11-P-91918), and the Massachusetts Medicaid Infrastructure and Comprehensive Employment Opportunities Grant (CFDA # 93.768, HCFA/11–91234). Funding for both grants was provided by the Centers for Medicare and Medicaid Services. The authors thank Abigail Averbach, John Butterworth, Marsha Langer Ellison, Patricia Gallagher, Raymond Glazier, Fred Hooven, Zofia Kumas-Tan, Leslie Olin, Annette Shea, and Vickie Stringfellow for their contributions to the paper.

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  1. Center for Health Policy and Research, University of Massachusetts Medical School, 222 Maple Avenue, Shrewsbury, MA, 01545, USA

    Alexis D. Henry, Steven Banks, Robin Clark & Jay Himmelstein

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  1. Alexis D. Henry
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Correspondence to Alexis D. Henry.

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Henry, A.D., Banks, S., Clark, R. et al. Mobility Limitations Negatively Impact Work Outcomes among Medicaid Enrollees with Disabilities. J Occup Rehabil 17, 355–369 (2007). https://doi.org/10.1007/s10926-007-9088-x

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  • DOI: https://doi.org/10.1007/s10926-007-9088-x

Keywords

  • Adults with disabilities
  • Employment
  • Activity limitations
  • Rehabilitation
  • Medicaid