Iowa considers bill to support disabled workers' Medicaid

Many people with disabilities face challenges with Medicaid if they work too much. Disability rights advocates warn that income and asset limits in Medicaid programs can create a "poverty trap" for millions of Americans. Zach Mecham, 31, is one of those affected. He has muscular dystrophy and relies on Medicaid for help. Without support services funded by Medicaid, he could not run his online marketing business and might have to live in a nursing home. Iowa has a Medicaid "buy-in" program that allows individuals with disabilities to work while still receiving Medicaid, but there are income limits that can make it risky to earn more. Proposed changes in Iowa aim to remove these income and asset caps. The "Work Without Worry" bill would require people with disabilities to pay a percentage of their income as premiums instead. Advocates believe this will help remove barriers that stop individuals from working full-time or advancing in their jobs. Several states are considering similar changes. In Iowa, the proposed bill has gained bipartisan support and has already passed a key committee vote. Supporters argue that these changes could help solve worker shortages in many areas. Issues with Medicaid can extend to couples as spouses' incomes count against eligibility limits. This financial pressure can discourage marriage or lead couples to separate. Advocates argue that lifting these caps would allow people with disabilities to earn more while still accessing necessary medical support. Despite these efforts, enrollment in Medicaid buy-in programs remains low, and many people are not aware of their options. Some states have had success in removing income limits, which has encouraged more individuals to apply. Mecham hopes that the Iowa bill will help him grow his business and work more hours. However, navigating the complex Medicaid system is daunting for many. Those who fear making a mistake may choose not to apply for support, jeopardizing their healthcare and independence.