Why Repealing Obamacare Would Worsen the Employment Problem for People with Disabilities

Eight years ago, I published an article that argued that our health insurance system posed the most important barrier to work for people with disabilities in the United States.  I therefore argued that enacting universal health care would be the most important step we could take to start reversing the problem of massive non-employment of people with disabilities.  (I didn't argue that universal health care would alone solve the problem, just that it was a necessary and central step toward solving the problem.)  I made the same argument in my book published three years ago.

Yesterday on the Nation's website, Ben Adler had this piece that, along similar lines, argues that repealing Obamacare would worsen the unemployment problem for people with disabilities.  An excerpt:

But one of Romney’s central campaign pledges—to repeal Obamacare—would undermine employment for those who are most likely to be unemployed: people with disabilities. The rate of unemployment among disabled adults has remained stubbornly high, even since the 1990 Americans with Disabilities Act banned workplace discrimination against them. In September, according to the Bureau of Labor Statistics, the labor force participation rate among people with disabilities was 21.9 percent, compared to 69.3 percent among people without disabilities. 

That is partly because our pre-Obamacare health insurance system makes it impossible for many people with disabilities to get a job. People with disabilities require comprehensive and continuous insurance coverage. If you are unemployed and impoverished, you qualify for Medicaid. If you get a job, your income will make you ineligible for Medicaid. But your job may not provide you with health insurance. Even if you get insurance, it may not cover services and medications you require. Or it may not cover pre-existing conditions. Or it may subject you to an annual or lifetime cap on coverage that you will exceed. Even if you have none of those problems, there may be an untenable three month waiting period for your insurance to kick in. “That’s a huge disincentive to working,” says James Weissman, general counsel of the United Spinal Association. “A person with disabilities on Medicaid doesn’t have any cap, lifetime or annual. A person on an employer’s plan, even if he’s covered right away and doesn’t have a waiting period, could still have an annual cap of $25,000.” 

Obamacare will correct all of those problems. It will eliminate annual and lifetime caps on coverage, make it illegal to deny coverage of pre-existing conditions and require large employers to provide immediate coverage to new employees. (It will also expand Medicaid coverage to include some 17 million low-wage workers.)