1. 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

2. Eligibility Age 18-64 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

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

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

6. DiagnosisMEAD %Non-MEAD with Disabilities % Mental Retardation3.415.8 Schizophrenia/Psychoses38.612.7 Affective Disorders36.532.7 Central Nervous System4.715.0 Injuries/Poisonings8.419.7 Cardiovascular8.321.0 Immune/Nutrition/Blood Diseases8.315.2 Blind4.44.8 Musculoskeletal12.524.4 Selected Diagnostic Groups

9. 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

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

15. 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