Iowans with disabilities are asking state lawmakers to loosen Medicaid income limits so they can advance their careers and get married without risking the loss of health care services they rely on.
Employed people with disabilities can’t have more than $12,000 of available resources or make more than 250% of the federal poverty level — $37,650 per year for one person — if they want to keep their government-funded health insurance. At a news conference at the Statehouse Wednesday held by Allies in Advocacy, six Iowans talked about how changing those limits would change their lives.
Some said they have turned down job promotions so that they don’t lose key services covered by Medicaid. They said private insurance does not pay for adaptive equipment or personal care attendants, who can help people with mobility restrictions get in and out of bed.
Zachary Mecham of Pleasantville said that is a huge deal for him.
“If I don’t have my benefits, I can’t get out of bed in the morning,” he said. “I can’t get my ventilator, which I rely on to breathe. So I literally, as a person with disabilities, have to choose between breathing and getting a full-time job.”
Mecham said the Medicaid income and asset limits are a barrier to being financially independent.
“The majority of Iowans with disabilities want to work, yet a disproportionate number of us are either unemployed or underemployed, and we’d like to change that,” he said.
Erica Carter-Hoffman said she lost Medicaid coverage after she got a promotion and a raise. She said she spent $34,000 on home health care services last year so that she could go to work each day.
“One-third of my wages goes to just getting in and out of bed every day, showering — all those daily activities that we take for granted — I face that every single day,” Carter-Hoffman said. “If they would increase the income limit or make it possible for me to be on Medicaid, I’d be able to replenish my savings. I’d be able to plan for my future. I’d be able to be a homeowner again.”
She said she also had to drain a retirement account to pay for wheelchair repairs that were not covered by private insurance.
The Medicaid asset limit has also been a concern for people with disabilities who want to get married. The cap on available resources for a single person is $12,000, and the cap for a married couple is $13,000.
Libby Schwers, a self-employed graphic designer who has a rare neuromuscular disease, said she recently got engaged.
“Becoming engaged to someone is normally a completely joyous time in anyone’s life, and it shouldn’t be a time to worry about potential marriage penalties from Medicaid,” she said. “It’s unjust that disabled Iowans like myself are having to choose between employment, marriage and health care when nondisabled folks are automatically granted all three options.”
A bill to raise the Medicaid income and asset limits advanced last year in the Iowa House, but it did not pass. It’s not clear if Republican state leaders are willing to loosen Medicaid limits for employed people with disabilities this year, as they seek to establish work requirements for other Medicaid recipients.
