Employment-Related Health Insurance and Service Delivery Needs of Persons With Disabilities

Publisher: Journal of Disability Policy Studies (online ahead of print)
Aug 04, 2014
John Gettens and Alexis D. Henry
The health care reforms underway in the United States will benefit persons with disabilities; however, the reforms may not fully support the employment-related needs of persons with disabilities. Secondary health insurance to wrap around primary coverage may be a viable policy solution to meet the needs. This article identifies and examines the employment-related health insurance, health care, and service delivery needs of employed and potentially employed persons with disabilities. We conducted six focus groups with 54 working-age, insured, employed, and potentially employed persons with disabilities in Massachusetts. Participants reported unmet needs, high out-of-pocket costs, or a burden to manage their health care, disability, and employment. The needs included services currently limited by insurance plans, long-term services and supports, other disability services, care coordination, and cost protections. The data suggest that the combined needs are highest for persons working full-time or near full-time, and the unmet needs are lower for persons with Medicaid secondary coverage. The results suggest that full-time or near full-time workers are an important subgroup for wrap-around coverage; such coverage could potentially alleviate costs and increase work incentives among this subgroup. Additional research is needed to quantify the needs and to assess the design options for a wrap-around program.