The Potential Employment Impact of Health Reform on Working-Age Adults With Disabilities

Abstract

Programs serving people with disabilities create employment disincentives in the form of public health insurance that ties eligibility to an inability to work. In 2009, insurance coverage decreased with employment for working-age people with disabilities. Health reform has the potential to ameliorate these employment disincentives by reforming the private health insurance system and by severing the link between eligibility for public health insurance and an inability to work. The authors predict the impact of the Affordable Care Act on working-age adults with disabilities using a simulation model based on 2009 American Community Survey data from Massachusetts, which enacted a similar reform in 2006. They estimate that more than 2 million adults with disabilities will gain coverage and that coverage rates will be higher among the employed. Although health reform may remove some existing employment disincentives, implementation issues are key determinants to insurance and employment outcomes.