Economic Evaluation of New Hampshire’s Medicaid for Employed Adults with Disabilities (MEAD) Program February 2002 – January 2003 Robin Clark, Ph.D. Center for Health Policy and Research University of Massachusetts Medical School Karin Swain, M.S. William Peacock, M.S. Dartmouth Medical School

Eligibility Age Must be employed Must meet disability standards Income less than 450% of poverty level Countable resources less than $20,560 (single) $30,840 (couple) Premium required if above 150% of poverty

Goals of Evaluation Measure State costs of MEAD Measure MEAD’s impact on participant’s earnings

MEAD Demographics Mean age 43 years 48% women 56% were “Medically Needy”

DiagnosisMEAD %Non-MEAD with Disabilities % Mental Retardation Schizophrenia/Psychoses Affective Disorders Central Nervous System Injuries/Poisonings Cardiovascular Immune/Nutrition/Blood Diseases Blind Musculoskeletal Selected Diagnostic Groups

Costs Measured Increased provider payments Costs of determining eligibility for new MEAD applicants Net premium payments (premiums minus administrative expenses) Comparisons are in 2002 dollars

Earnings increased by $1.4 million during the first year of MEAD Program expenditures were $.4 million

Income People with schizophrenia earned $60 less per month Those with prior Medicaid status earned $83 less per month Those with prior Medically Needy status earned $71 less per month Earnings decreased with age ($4/mo/yr) Prior earnings strongly predict future earnings