Karen worked in higher ed administration. Deb assisted in the controller’s office at a tech company. Tina worked at a retail store. Each of them suffered a debilitating medical condition that left them unable to work full-time, and each sought help through a state-funded health insurance program called Medicaid for Employed Adults with Disabilities, or MEAD.
“I’m driven,” Karen said. “I want to get out and be engaged to the best of my ability. It’s not good for my mental or even my physical health to stay home and do nothing. It’s just that I can’t contribute on a fulltime basis.”
But despite being qualified for the MEAD program, they were each denied.
“They rejected me from a program I knew I didn’t qualify for and hadn’t applied for,” Karen said. “Then they determined I couldn’t be disabled, even though I was only working 10 hours a week, in a position that offered me lots of support.”
And meanwhile, the stress piled on for clients like Deb.
“I could only afford the co-payments. The rest was going onto my credit card debt, to collection agencies. It was awful. I was getting five, 10 bills a day,” she said.
The pattern stood out to NHLA Benefits Project Co-Director Megan Dillon.
“These are individuals who have been determined disabled by the Social Security Administration and in most cases, receiving disability for many years,” she said.
“Their complicated medical needs are often not fully covered by Medicare alone. The purpose of the MEAD program is to provide necessary medical coverage to working adults with disabilities. Despite meeting all criteria, they were being improperly denied, forcing them into medical debt they could not afford.”
Megan and other NHLA staff worked on each appeal. In the process, they saw that the state applied a far more restrictive definition for disability to determine MEAD eligibility than even the federal government.
The COVID-19 pandemic turned months into years. Dillon and other NHLA staff continued, on behalf of Karen, Deb, Tina and two other clients until the state proposed rules that make it easier for working disabled adults to access MEAD.
For the clients, it wasn’t just what NHLA did, but how.
“I felt like I had somebody who was on my side against the state, and I wasn’t made to feel like a charity case. I was treated with respect and with dignity,” said Karen.
“There were so many times I wanted to tell Megan forget it, to give up,” says Deb. “But she was so determined that we were going to win and fix things for everyone coming up. I stayed in it for all the future people.”
TJ is one of those people. TJ was denied MEAD benefits and called NHLA in January 2023 for help appealing. By June, their benefits were approved.
“Without MEAD, I can’t pay for the medications and services that enable me to work. MEAD will allow me to continue functioning in society,” TJ said. “Megan got the job done.”
Dillon continues to hear from people like TJ, improperly denied MEAD, meaning further policy change and advocacy may be required. She says will continue to fight for working adults with disabilities.
“These individuals, despite their significant medical impairments, are trying to remain in the work force,” she said. “They should have the critical medical coverage they require and are entitled to.”