Special Article on Dually Eligible
Commentary
Dually-eligible working-age adults with disabilities: Issues and challenges as health reform is implemented

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Abstract

This special section on working-age adults with disabilities dually eligible for Medicare and Medicaid is based on two panel presentations at the June 2012 meeting of the AcademyHealth Disability Research Interest Group. The papers included here consider the issues of health care access and outcomes as well as employment for this group of approximately four million individuals, many with complex health care needs and high costs.

Section snippets

The papers

The 2012 DRIG meeting was held on June 23 in Orlando. The DRIG invited abstracts for presentations, with an emphasis on younger duals. The eight papers accepted for panel presentations fell naturally into two overarching categories: Employment and Health Outcomes. Papers based on five of these presentations are included in this issue. Even though papers were submitted independently, several common themes emerged across both the Employment and Outcomes panels. As might be expected, the

Employment panel

Dr. Jerry Riley of the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS) opened the Employment Panel by discussing his investigation of cash benefit and health care expenditure patterns for disabled adults under age 65 using linked federal datasets.2 This presentation reminded the audience that while health care expenditures account for a large portion of federal costs for adults with disabilities, cash supports through SSDI and SSI also play a

Health outcomes panel

Jenna Libersky, MPH from Mathematica Policy Research (this issue) used Medicaid administrative data to document enrollment rates of duals under age 65 into different types of state Medicaid managed care programs and compared their enrollment rates and costs with Medicaid-only enrollees.6 She found that enrollment for duals in any form of Medicaid managed care is one-third that of Medicaid-only beneficiaries with disabilities and that costs varied widely from state to state. Historically, states

Summary

More research will be needed as ACA implementation continues to assess the extent to which coverage expansions affect applications to and exits from federal disability programs. Because younger individuals dually eligible for Medicare and Medicaid are among the sickest and highest cost individuals in both programs, and because they have the potential to stay on the disability rolls for many years, their movement to employment and/or other health insurance coverage has the potential to result in

Acknowledgment

The content of this article is based on information presented at the AcademyHealth Disability Research Interest Group (DRIG) meeting held in Orlando, FL, June 23, 2012, with funding from The Commonwealth Fund. The author would like to thank René Jahiel for his lifetime contributions to the DRIG, Tracy Rausch McDowell for her work in making the meeting happen, and Allen Jensen and Craig Thornton for serving as discussants.

References (9)

  • A Data Book: Health Care Spending and the Medicare Program

    (June, 2012)
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    Expenditure patterns under the four major public cash benefit and health insurance programs for working-age adults with disabilities

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  • A. Levy et al.

    The potential employment impact of health reform on working-age adults with disabilities

    J Disabil Pol Stud

    (2012)
  • Hall J, Kurth N, Hunt S. Employment as a health determinant for working-age, dually-eligible people with disabilities....
There are more references available in the full text version of this article.

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