TALLAHASSEE, Fla. – Amid talk during this year’s legislative session of making the Medicaid program more restrictive, lawmakers are poised to allow working adults with disabilities to earn more money and maintain their Medicaid benefits.
As part of a budget agreement, the House and Senate would allow adults with disabilities to earn $50,886 annually and not lose access to their Medicaid benefits.
The agreement also would allow working adults with disabilities to have up to $13,000 in cash in savings accounts without risking the loss of their Medicaid “home and community based” benefits, including services to help with activities of daily living.
“I was wondering if this day would ever come,” said Jim DeBeaugrine, a former director of the state Agency for Persons with Disabilities who now is a lobbyist.
Under current rules, a working adult with disabilities tapping into home- and community-based services cannot earn more than $27,000 a year or have more than $2,000 in cash savings.
Though they may be able to obtain traditional health-insurance benefits through employers, DeBeaugrine said many people cannot survive without the home- and community-based Medicaid services to assist with activities such as dressing and bathing.
As a result, DeBeaugrine said, many people will quit jobs or cut back on hours so they don’t lose Medicaid benefits.
Instrumental in helping to establish the program was 27-year old Sarah Goldman, who has cerebral palsy and works as an aide to Rep. Ben Diamond, D-St. Petersburg, in his district office.
In an interview with The News Service of Florida, Goldman recalled graduating from Florida State University with her master’s degree in 2015 when her Medicaid case manager first told her about the income restrictions.
The case manager’s advice to Goldman was to get a part-time job and apply for subsidized housing.
“I left that conversation and I was crying because I was just so frustrated,” she said. “How could I have come this far to basically be told, ‘Why would you work?’”
Irked, she began researching Medicaid income limits for people with disabilities who want to work in Florida and nationally. She quickly learned that Florida was one of four states that had not requested to increase the income limit for working adults. Such increases require federal approval.
Goldman in 2016 pitched her idea of expanding the income limits at an annual legislative meeting of the Florida Developmental Disabilities Council. She also applied for an unpaid internship at the Legislature.
Following the 2016 session, she interviewed with former Rep. Kathleen Peters, R-Treasure Island, for a full-time post.
“I told her we need to talk about salary because this is my cap and if I incur anything over this, then I am going to lose my services,” Goldman recalled telling Peters. “I could tell by (Peters’) facial expression, she was horrified. And she told me then if we worked together, she would help me fix this.”
Goldman’s full-time state job enables her to tap into the state employees’ health insurance plan. While it’s considered to be a generous health plan, Goldman noted it doesn’t cover personal-care services she requires, such as bathing and dressing.
“All I am authorized with under my insurance program is 30 shower visits a year. Can you imagine only showering like twice a month?” Goldman said.
But before the Legislature would consider a higher income threshold, it required an analysis to ensure that the move wouldn’t expand Medicaid rolls.
After an unsuccessful effort to pass the study language in 2017, money for the analysis was included in last year’s budget.
The move to allow adults with disabilities to earn more and maintain Medicaid benefits comes as lawmakers this year have considered other proposals to tighten restrictions on Medicaid enrollment and benefits.
The House, for example, passed a bill (HB 955) that would require an estimated 500,000 Medicaid beneficiaries to work or show they are trying to get jobs to keep their health-care benefits. The proposal would exclude seniors and would mostly impact young women with children. The Senate has not taken up the issue.
Valerie Breen, executive director of the Florida Developmental Disabilities Council said increasing the income threshold was one of her association’s top goals for the session.
The council is “extremely pleased that the Legislature adopted one of our top priorities to ensure that individuals receiving Medicaid paid supports can remain employed and not lose the care benefits that help them get to and sustain work on a daily basis,” Breen said in a statement to the News Service.
While the new budget hasn’t been finalized, the agreement opens opportunities for Goldman.
“It means I can move up in my career,” she said. “I one day want to work for a lobbyist or an agency that runs in the Legislature. And those jobs are much higher paying than what I was currently able to earn. So this gives me a peace of mind knowing I can reach the dreams I wanted to while still being able to get out of bed in the morning and get dressed and get ready to go to work. Before, it was basically asking somebody: ‘Do you want to get out of bed or do you want to go to work?’ I don’t think somebody should have to make that choice.”