Whitney Holt, Dungarvin Minnesota Case Manager Assistant Department Supervisor
Finding meaningful employment is an important goal for many people with disabilities, and Dungarvin Employment Services around the country support individuals in doing so. For people with intellectual and/or developmental disabilities (I/DD), employment offers opportunities for personal growth, developing new skills and connecting with their communities.
But for the millions of Americans who receive health care and disability services through Medicaid, there can be a barrier to advancing in their employment: Medicaid eligibility income limits are quite low. For example, in Minnesota, the 2026 income limit for an adult without children is $21,226 annually.
Not being able to make very much money while retaining the services they need can cause individuals with disabilities to forgo promotions and raises, or even quit their jobs. For many, it becomes a delicate balance between keeping employment and the services they need.
“Income limits can have a significant impact on an individual’s long-term goals,” said Whitney Holt, Case Manager Assistant Department Supervisor at Dungarvin Minnesota. “To truly support independence, income thresholds need to reflect a realistic and livable wage. If we assume that someone working 32 hours per week at $15 per hour earns enough to comfortably meet all their needs, we risk creating barriers rather than opportunities.”
Erica Carter, an Iowa woman recently featured in a recent National Public Radio article, faced this type of situation. Erica is paralyzed from the chest down, but that has not stopped her from pursuing a successful accounting career. Over the years, she advanced and her income increased. In November 2023, she was informed by the Iowa Department of Health and Human Services that she would lose her Medicaid benefits unless her income dropped significantly.
When faced with the decision to either keep a job she loved or lose her benefits, she chose to keep her job. However, this is not a choice many people with disabilities have, because they would never be able to pay for services on their own.
“To truly support independence, income thresholds need to reflect a realistic and livable wage.”
For some people, state programs called “Medical Assistance for Employed Persons with Disabilities” (MA-EPD), commonly referred to as Medicaid buy-in programs, are helpful because they allow people to pay a percentage of their income to the state to maintain access to Medicaid benefits. Most states have income and asset limits on these programs as well, but they are still invaluable resources for many individuals with disabilities, Whitney said.
“Individuals who participate in MA-EPD, frequently express appreciation for the program because it allows them to pursue work, contribute to their communities and maintain a sense of purpose without constantly worrying that earning additional income will jeopardize their health care coverage. Programs like MA-EPD help remove barriers and create opportunities for individuals to achieve greater independence,” she said.
New Medicaid Eligibility Rules
New Medicaid eligibility rules are set to go into effect January 1, 2027, including work requirements for adult Medicaid beneficiaries. They will have to prove they are working, volunteering or going to school at least 80 hours per month to retain their benefits; there are exemptions for those who can prove they are “medically frail” or have “special medical needs,” including people with I/DD.
Whitney says there should be pathways that encourage and support employment for people with disabilities who are able and interested in employment. “However, broad requirements that apply to everyone are rarely the best solution. Disability is highly individualized; policies should reflect that reality.”
“I also believe there should be greater investment in employment opportunities for individuals with disabilities,” Whitney continued. “Too often, available jobs are limited to entry-level or task-oriented positions. Expanding access to competitive, meaningful employment that aligns with an individual’s skills, education and career aspirations would better support long-term success and independence.”
If you or someone you know is interested in learning how you can receive support from Dungarvin, please visit us at www.dungarvin.com to learn more.