Some disabled people want to advance their careers. They say Medicaid rules stop them

Erica Carter is passionate about her job, and she has 7 acres of flowers and vegetables to show for it.Carter's specialty is reeling in grants to support students in the Omaha Nation school district, where she is a finance manager.One paid for the garden that sits next to the district's campus.

Another allowed the school system, in one of Nebraska's lowest-income counties, to pay students to maintain it.This story was produced in partnership with KFF Health News."They're out in the sun.They're watering plants," she said.

"It's the first time they get a paycheck in their life."Carter, 41, is paralyzed from the chest down, an injury she's lived with since a fall in her early 20s.It didn't slow her down as she built her accounting career and got a master's degree in human resource management.But in November 2023, Carter — who lives in Sioux City, Iowa — got a letter from Iowa's Department of Health and Human Services.

It said that her income was too high for her to stay on Medicaid and that she might lose her benefits in two weeks if she didn't take action.States are scrambling to get ready for a new federal requirement to double-check that many people on Medicaid qualify for the benefit, by showing they are working, volunteering, or studying at least 80 hours per month.Politicians' focus on requiring work has angered many people with disabilities who have Medicaid and say current policies that apply to them have the opposite effect — making them choose between working or receiving benefits.When Carter got the letter, she was making $110,000 a year, well above Iowa's 2023 income limit for working people with disabilities: $36,450 for a household of one."I had no time at all to prepare," she said.

"I had a decision to make."At the time, Carter got her health coverage through Iowa's Medicaid for Employed People With Disabilities, a "buy in" program that allows working disabled Iowans to pay a part of their income to the state to maintain access to Medicaid ben...

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Publisher: NPR News

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