Many People With Disabilities Risk Losing Their Medicaid if They Work Too Much

PLEASANTVILLE, Iowa — Zach Mecham has heard politicians demand that Medicaid recipients work or lose their benefits. He also has run into a jumble of Medicaid rules that effectively prevent many people with disabilities from holding full-time jobs. “Which is it? Do you want us to work or not?” he said. Mecham, 31, relies on the public insurance program to pay for services that help him live on his own despite a disability caused by muscular dystrophy. He uses a wheelchair to get around and a portable ventilator to breathe. A paid assistant stays with Mecham at night. Then a home health aide comes in the morning to help him get out of bed, go to the bathroom, shower, and get dressed for work at his online marketing business. Without the assistance, he would have to shutter his company and move into a nursing home, he said. Private health insurance plans generally do not cover such support services, so he relies on Medicaid, which is jointly financed by federal and state governments and covers millions of Americans who have low incomes or disabilities. Like most other states, Iowa has a Medicaid “buy-in program,” which allows people with disabilities to join Medicaid even if their incomes are a bit higher than would typically be permitted. About two-thirds of such programs charge premiums, and most have caps on how much money participants can earn and save. Some states have raised or eliminated such financial caps for people with disabilities. Mecham has repeatedly traveled to the Iowa Capitol to lobby legislators to follow those states’ lead. The “Work Without Worry” bill would remove income and asset caps and instead require Iowans with disabilities to pay 6% of their incomes as premiums to remain in Medicaid. Those fees would be waived if participants pay premiums for employer-based health insurance, which would help cover standard medical care. Disability rights advocates say income and asset caps for Medicaid buy-in programs can

NASA Astronaut Tracy Dyson Speaks to Students

NASA astronaut Tracy Dyson points to the Expedition 71 patch on her flight suit as she answers a question from students, Wednesday, March 5, 2025, at Elsie Whitlow Stokes Community Freedom Public Charter School in Washington. Dyson and fellow crewmates Matthew Dominick, Michael Barratt, and Jeanette Epps served as part of Expedition 71 aboard the International Space Station.