The Kansas Medicaid Buy-In: Factors influencing enrollment and health care utilization.
BACKGROUND
Medicaid Buy-Ins are optional programs states may implement to create work incentives for people with disabilities. These programs allow participants to increase earnings without losing Medicaid eligibility-potentially moving them out of poverty without risking loss of health care coverage. They also provide the opportunity for beneficiaries to offset some of their medical costs to the federal and state governments through premiums for coverage and increased taxes paid. State and federal policy makers and administrators have speculated about who might enroll, how they might use the benefits, and whether positive health outcomes for persons with disabilities would result.


OBJECTIVE
We compared characteristics and health care utilization of 184 enrollees and 158 eligible nonenrollees in Kansas' Medicaid Buy-In.


RESULTS
Enrollees were older and significantly more likely to have more than one disability, with mental illness being more prevalent than physical disabilities, and to have both higher Social Security and earned income. A majority of the sample was dually eligible for Medicare and Medicaid with Medicaid paying most costs. Home health service costs were the primary difference between enrollee and nonenrollee expenditures.


CONCLUSIONS
Increased Medicaid Buy-In enrollment could prevent long-term dependence on federal disability benefits.
Center for Research on Learning, University of Kansas, Lawrence, 66045-3101, USA. jhall@ku.edu
Jean P
JP
Hall
Michael H
MH
Fox
Emily
E
Fall
D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006078:Government Programs / Q000191:economics / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000706:statistics & numerical data; D007615:Kansas; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D014481:United States; D055815:Young Adult