A discussion of the findings to date and future research plans concludes the article. The fourth section presents data on AB health benefit expenditures and the characteristics of beneficiaries who reached the $100,000 health benefit limit. The third section describes findings from the 6-month follow-up survey on AB service use and unmet medical needs. The second section describes the process used to identify, recruit, and enroll beneficiaries for the project, and presents findings from the enrollment process. The first section describes the core AB plan and the additional services available to some project participants. This article describes the AB demonstration and the early findings from the project. The project is called the Accelerated Benefits ( AB) demonstration because it provides beneficiaries with a health benefits package before the completion of the Medicare waiting period. In 2005, SSA awarded a contract to MDRC, a nonprofit social policy research organization, to conduct the demonstration project. Although the legislation did not alter the Medicare waiting period, it did authorize the Social Security Administration ( SSA) to conduct a demonstration project designed to produce credible data on the costs and benefits of altering the 24-month Medicare waiting period. Yet policymakers lack the data to quantify the extent of the problem and the potential benefits of eliminating the Medicare waiting period.Ĭongress recognized the importance of health insurance coverage for individuals with disabilities in the "purpose and findings" section of the Ticket to Work and Work Incentives Improvement Act of 1999. For example, the Consortium for Citizens with Disabilities has recommended eliminating the Medicare waiting period in order to help beneficiaries obtain the care required to stabilize their health condition and facilitate a transition to employment ( CCD 2008). Disability advocacy groups have stated that removing the Medicare waiting period may have the long-term benefit of increasing employment among beneficiaries. For example, one recent article uses the case of one beneficiary to infer a much larger problem, stating that many DI beneficiaries "have spent their savings on the care necessary to reach a diagnosis and now cannot get private insurance" (Saker 2010). The popular press has used stories about a handful of beneficiaries to conclude that many beneficiaries within the 24-month Medicare waiting period do not have health insurance and that many may go without the health care needed to address their disabling condition. As a result, DI beneficiaries may not have access to the health care they need to address their disabling condition during the waiting period. 2 Other beneficiaries may not have had health insurance before disability onset and may find it difficult to obtain affordable health insurance coverage because of a preexisting condition. Those who lose employer-provided health insurance may find it difficult to afford health insurance available through provisions of the Consolidated Omnibus Budget Reconciliation Act, commonly referred to as COBRA coverage. 1 Some beneficiaries within either of the waiting periods may lose employer-provided health insurance coverage because their disability prevents them from working. The 5-month waiting period begins with the first full calendar month after the onset of a disability. Most Social Security Disability Insurance ( DI) beneficiaries must complete a 5-month waiting period to qualify for cash benefits and an additional 24-month waiting period to qualify for Medicare. Consolidated Omnibus Budget Reconciliation Act
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