Objective: The Medicaid Buy-In (Buy-In) program allows people with disabilities to "buy into" Medicaid when their earnings or assets would typically make them ineligible. This program may be advantageous to youth with psychiatric disabilities by providing continuous health care coverage while they are employed.
Methods: State-submitted participant-level Buy-In enrollment data were linked with Social Security Administration data to identify the receipt of federal disability benefits, the primary disability used to determine eligibility, and annual earnings. We assessed the differences in employment outcomes between young participants (ages 18 to 30) with psychiatric disabilities versus young participants with other disabilities, including the likelihood of being employed, average earnings, and changes in earnings around the time of Buy-In enrollment.
Results: Young Buy-In participants with psychiatric disabilities were just as likely to be employed as those with other disabling conditions, although their average earnings were slightly lower. Both groups were similarly likely to increase their earnings around the time of Buy-In enrollment, but among participants who had such increases, the amount of the increase was higher for those with psychiatric disabilities.
Conclusions and implications for practice: Young Buy-In participants with psychiatric disabilities achieve larger average increases in earnings around the time of enrollment in the program than those with other disabling conditions, though average earnings while employed are lower. This suggests that the coverage provided by Buy-In may be particularly beneficial for youth with psychiatric disabilities. Outreach to enroll these youth into the program may benefit this vulnerable group, who often lack other supports in the community.