Clinton Touts Bill Giving Working Disabled Health Aid

An estimated 2 million disabled Americans sidelined from their jobs could opt to rejoin the work force without fear of losing federal health benefits under a bill hailed by President Clinton on Saturday.

Clinton, in his weekly radio address, called the legislation the most significant milestone for the disabled since the 1990 Americans With Disabilities Act.

“No citizen should have to choose between going to work and paying medical bills,” Clinton said. “. . . This will make a big difference to people with disabilities who want to be part of our nation’s growing economy.”

The Work Incentives Improvement Act was overshadowed by the conclusion of a lengthy, acrimonious debate on federal spending and the rush of Congress to adjourn for the year. But some say it may emerge as a sleeper--one of the most tangible achievements in an otherwise unremarkable legislative year.

The bill, which Congress sent to Clinton on Friday, is meant to solve a dilemma posed by advances in medicine and quirks in federal entitlement law.

More and more people with severe disabilities are getting treatment--subsidized by Medicaid or Medicare--that enables them to consider returning to work. Yet if they take a job, they risk losing the very health benefits that helped them recover their economic potential. What’s more, private insurance is often too expensive, too limited or unavailable.

The legislation attacks this Catch-22 through a combination of benefits, incentives and regulatory relief that would cost about $800 million over five years. Among the people most likely to take advantage of the new programs, administration officials say, are those with muscular dystrophy, Parkinson’s disease, diabetes and AIDS.

“This is a big deal” for 9 million working-age Americans receiving federal disability benefits, said Joe Karpinski, a spokesman for Republicans on the Senate Health, Education, Labor and Pensions Committee. “Not all of them are able or wanting to go back to work, but a good many will.”

Advocates for the disabled have said that as many as 2 million people could return to work under the legislation, which could also be a boon to employers who face a tight labor market.

More than many other acts of Congress, Sen. Edward M. Kennedy (D-Mass.) said Friday, this bill “has a human face.”

Similar legislation had been kicking around in Congress for at least three years. This year’s effort gained momentum when Bob Dole, the former Senate GOP leader and presidential candidate, endorsed it in testimony before the Senate Finance Committee. Dole, who lost the use of his right arm after a combat wound in World War II, said the bill is about “dignity and opportunity and all the things we talk about when we talk about being an American.”

Despite its overwhelming bipartisan appeal, the bill stalled while the Clinton administration and congressional leaders debated the budget. When the two sides reached a final spending accord last week, Clinton said, they included an extra $250 million for a six-year trial program that would allow certain people who are disabled--but who have kept their jobs and have not applied for disability benefits--to qualify for Medicaid coverage. The goal is to help workers stay on the job, through early health-care intervention, before their disabilities become too severe.

Three other key elements of the package are:

* An extension of Medicare benefits for disabled people who return to work, to allow them nearly eight years of eligibility. Under current law, the limit is 39 months.

* An option for states to expand Medicaid benefits available to certain workers with disabilities whose income would otherwise disqualify them.

* New rules specifying that disabled people who attempt unsuccessfully to go back to work will get rapid help with applications to renew their federal disability insurance.

The bill sped through the House on Thursday on a 418-to-2 vote and the Senate on Friday, 95 to 1. Backers say the program could well pay for itself because more disabled people would become gainfully employed taxpayers.