Asset building: One way the ACA may improve health and employment outcomes for people with disabilities

Abstract

Working-age individuals with disabilities are often forced to live in poverty to maintain Medicaid coverage. This study explored the relationship between having assets in excess of usual Medicaid limits and health and quality of life in a sample of Medicaid Buy-In participants. Using self-reported survey data, we compared groups with US$2,000 or less in cash assets (the usual Medicaid limit) and those with more than US$2,000. Participants with higher assets had significantly better health status and quality of life. Males, younger respondents, and respondents with intellectual disabilities were most likely to have higher assets. Although many Buy-Ins allow assets greater than US$2,000, assets are still capped for most individuals. The Affordable Care Act’s Medicaid expansion does not limit assets in determining eligibility. Especially for younger individuals with disabilities, expansion coverage might allow greater asset accumulation and better health and quality of life, while avoiding lifelong dependence on disability programs.