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When the final gavel fell on June 14th, the New York State Senate ended its regular legislative session for the year without taking action on the Medicaid Buy-in bill, also known as the "Work and Wellness Act of 2000." The bill recently passed the State Assembly.

Senate majority leader Joseph Bruno has indicated that the failure of his house to pass the Medicaid Buy-in bill may be a matter of timing. His comment has led to speculation that the Republican leadership will bring the Senate back to Albany closer to the November election, in order to more publicly link the passage of the Medicaid Buy-in bill to the U.S. Senate candidacy of Republican Congressman Rick Lazio. Lazio was a prime supporter of the federal Ticket to Work and Work Incentives Improvement Act of 1999 which expanded the Medicaid Buy-in options available to states.

The aim of the "Work and Wellness Act of 2000" is to permit persons with disabilities to become self-supporting or at least partially self-supporting without losing the Medicaid coverage they need to live independently, according to the bill's Assembly sponsor James Brennan of Brooklyn. Commercial insurance products generally do not cover the exceptional health care needs of individuals with severe disabilities as well as Medicaid.

The bill offers a sliding-scale proposal, under which individuals with net incomes below 150% of the federal poverty would pay nothing. Those with incomes between 150% and 400% of the federal poverty level would pay premiums from 2% to 12% of net available income.

The initial cost of the Medicaid Buy-in program to the state has been estimated at $14.2 million, with the federal government contributing another $45 million in the first year. The overall cost of the program would be defrayed by the premiums and income taxes paid by participants.

The Senate sponsor of the "Work and Wellness Act of 2000" is John Marchi of Staten Island.

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How Have Other States Acted
on the Medicaid Buy-in Option?
States that have adopted the program, received federal approval and are currently implementing the program: Alaska, Oregon, Massachusetts, Minnesota, South Carolina and Wisconsin.

States that have adopted and are awaiting federal HCFA approval: Maine, Mississippi and Nebraska.

States that have adopted the program and are in process of seeking federal approval: Arkansas, California, Illinois, Iowa, New Mexico and Vermont.

States where the Governor and legislature are in the process of approving the program: Connecticut, New Jersey, Rhode Island, Colorado, Florida, Georgia, Maryland, Michigan, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Utah and Virginia.

Source: The SSI Coalition, an Illinois-based organization whose mission is to work with low-income people of all ages who are disabled, have long-term illnesses or are elderly, to assure security and dignity.