Almost all of these programs are tiny, short on outreach, and thus far, grossly inadequate to the problems

MEDICAID BUY-IN OPTIONS: HELPING PERSONS WITH SEVERE DISABILITIES AND CHRONIC CONDITIONS TO WORK Eliot Fishman, Ph.D. and Barbara S. Cooper Institute for Medicare Practice Mount Sinai School of Medicine September, 2002 Prepared for “Partnership for Solutions …Better Lives for People With Chronic Conditions,” a program of the Johns Hopkins University, and by the Robert Wood Johnson Foundation EXECUTIVE SUMMARY “It is difficult to measure completely the impact that having a job makes in a person’s life. It gives people a sense of personal value and identity, and there is something very powerful about being able to support oneself.” --Rep. Nancy Johnson, (Connecticut), Statement before the Subcommittee on Social Security, Committee on Ways and Means, Hearing on Barriers Preventing Disability Beneficiaries From Returning to Work, March 11, 1999. INTRODUCTION For many Americans, a job and a paycheck are central to their sense of independence and self-worth. For people with severe disabilities and chronic conditions, the desire for independence and employment is perhaps even stronger. Yet because of their unusual health needs and their difficulties in getting the full-time jobs that offer comprehensive health benefits, even those people with severe disabilities and chronic conditions who want to and can work may depend on government health benefits—more specifically, Medicare and Medicaid. Medicare ...