[Congressional Record (Bound Edition), Volume 145 (1999), Part 2]
[Senate]
[Pages 1746-1747]
[From the U.S. Government Publishing Office, www.gpo.gov]




                WORK INCENTIVES IMPROVEMENT ACT OF 1999

 Mr. ROTH. Mr. President, the great Leo Tolstoy once confided 
in his diary that he would be the unhappiest of men if he could not 
find a purpose for his life. As we all know, Tolstoy did, indeed, find 
purpose. As a novelist, philosopher, and social reformer, he brought 
entertainment, meaning, and direction into the lives of millions--his 
influence continuing even into our day and age.
  The need to bring meaning and success into our lives--the need to 
have a purpose, to be anxiously engaged in a good cause--is, as Tolstoy 
pointed out, one of the most basic in our nature. With this in mind, it 
is my pleasure to join Senators Moynihan, Jeffords, and Kennedy to 
introduce legislation that while simple in purpose will be infinite in 
application and influence. Our objective? To help people with 
disabilities go to work.
  In 1990, Congress passed the Americans with Disabilities Act. That 
law made an important statement about this nation's commitment to 
independence and opportunity for people with disabilities. Since then, 
barriers that had made some of even the simplest daily tasks difficult 
or even impossible have been lifted. Millions of Americans have gone 
back to work or found their daily chores to be more accessible--easier 
to address and accomplish.
  Despite these successes and the progress that has been made in the 
ensuing eight years, there are still serious obstacles for too many 
people with disabilities--obstacles that stand in the way of their 
realizing the most basic and important opportunity of getting a job.
  With this legislation, we begin to address some of the remaining 
impediments to employment for people with disabilities. These include 
the lack of access to health insurance and fundamental job assistance.
  At a hearing held by the Finance Committee last July, witness after 
witness testified about the importance of health insurance for people 
with disabilities trying to enter the workforce. Jeff Bangsberg of the 
Minnesota Consortium for Citizens with Disabilities put it best when he 
said that ``having appropriate, affordable health care is a critical 
factor in decisions people with disabilities make about working. Many 
individuals are afraid to work because they can't afford to lose access 
to continued Medicaid coverage.''
  The simple fact, Mr. President, is that people with disabilities are 
often presented with a Catch-22 between working and losing their 
Medicaid or Medicare. This is a choice they should not have to make. 
But even modest earnings can result in a loss of eligibility for 
Medicaid or Medicare. Without health insurance, medical treatment often 
becomes prohibitively expensive for individuals with disabilities, and 
without medical treatment it becomes impossible for many to work.
  My constituents in Delaware have made it clear that lack of access to 
health insurance is a real and seemingly insurmountable barrier to 
employment. Larry Henderson, Chair of

[[Page 1747]]

Delaware's Developmental Disabilities Planning Council, supports our 
bill ``because it does not penalize persons with disabilities for 
working in that it allows for continued access to health care.''
  Our bill is designed to empower States to break this cycle of 
uncertainty by making it possible for people with disabilities who 
choose to work to do so without jeopardizing health insurance access.
  We do this by creating two new Medicaid options. The first option 
builds on a change enacted in the Balanced Budget Act of 1997 (BBA). 
That law allows States to permit people with disabilities to buy-in to 
Medicaid who would otherwise be eligible except that they earned too 
much. The new change would eliminate the income cap on this buy-in 
option.
  The second Medicaid change would make it possible for States to 
permit a similar Medicaid buy-in option for individuals with a severe, 
medically determinable impairment who would otherwise lose eligibility 
because of medical improvement.
  Let me also note that both Medicaid expansions would be voluntary on 
the part of each State.
  Under both options, States would be able to set their own cost-
sharing requirements for people with disabilities who enroll. States 
could require individuals buying into the program to pay 100 percent of 
premium costs in order to participate. The bill also extends Medicare 
Part A coverage for a ten-year trial period for individuals on SSDI who 
return to work.
  In addition to these health coverage innovations, the bill also 
provides a user-friendly, public-private approach to job placement. 
Because of a new, innovative payment system, vocational rehabilitation 
agencies will be rewarded for helping people remain on the job, not 
just getting a job.
  Mr. President, this combination of health care and job assistance 
will help disabled Americans succeed in the work place. And our society 
will be enriched by unleashing the creativity and industry of people 
with disabilities eager to go to work.
  I encourage my colleagues to cosponsor this legislation. And it is my 
intention to hold a hearing on the bill in the Finance Committee next 
week and mark it up later this spring.

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