By Ed Sealover Reporter, Denver Business Journal,
DENVER — Josh Winkler became paralyzed below the waist at age 17, but that didn’t stop him from getting a mechanical engineering degree in college and working for a NASCAR team until the Great Recession hit. He then launched his own company, Cripple Concepts, which makes a variety of aides for the wheelchair-bound, including joystick knobs for movement that don’t fall off and USB chargers that allow electric-wheelchair users to charge their phones without losing use of their mobility device.
Winkler also is one of about 10,000 Coloradans who are on a Medicaid buy-in program that allows them to get the benefits of the public insurance program for the poor and the disabled — including in-home care that is not covered by pretty much any private insurers — and to continue working and making money while they do so. Business owners or executives may not make up a huge portion of the program, but to them it is a lifeline that allows them to work as they want and contribute to society while getting vital health services they otherwise could not afford.
Though he is just 38 now, Winkler is thinking ahead and realizing that when he turns 65, he has just two options. He can either close his business, sell off all of his assets and continue on Medicaid as a destitute state resident or he could lose access to the twice-a-day in-home care he receives, which might leave him dead.
On Wednesday morning, however, the Colorado Senate Health and Human Services Committee will consider whether to give him and other disabled business owners and employees a third option — continuing to buy into Medicaid past age 65 until they choose to retire or sell their companies on their own terms. The change would be as simple as removing an age limit from the state’s 21-year-old Medicaid buy-in law, but it would also be so radical that the Centennial State could become the first in the country to make such a move that recognizes the desire of disabled workers to continue in their professions past what once was considered the age of retirement, said Julie Reiskin, executive director of the Colorado Cross-Disability Coalition.
“There are a lot of people who are a lot closer to 65 who are going to be in trouble. They’re going to be on Medicaid no matter what. It’s just a matter of whether they’re going to have to spend down their savings and become impoverished,” Winkler said. “I come down on the side that being in poverty is not good for anybody.”
There is a misconception that people like Winkler will be covered by Medicare once they get to retirement age, but Medicare pays for doctors’ visits, not in-home care. Medicaid is written so that those who receive it are supposed to have no other means of affording care, but the law did not predict when it was passed in 1965 that the disabled would be able to earn livings and to live to an older age while doing so.
Sponsoring Sen. Jack Tate, R-Centennial, said that when told about the problem confronting the working disabled, he immediately wanted to fix it. His House sponsor for Senate Bill 33 is a Democrat — Rep. Susan Lontine of Denver — and he hopes that fellow legislators can see the proposal as a bipartisan attempt to lift the human spirit.
“Anytime we have a provision in law which hurts people who have been taking the initiative to be entrepreneurs or save for the future, I want to take a look at it,” Tate said.
Kevin Smith agrees. Rendered a quadriplegic since 1983 after severing his spinal cord while diving into a pool, Smith rose up the ranks in the company Accent on Independence (AOI) Homecare, taking an equity stake when the firm converted to an employee-ownership model and then rose to become vice president after it was sold. He is 55 now and has no plans to retire at age 65, particularly after using the proceeds from the company sale to set up a trust for himself and a retirement account that would have to be liquidated if he were to stay on Medicaid past that age.
“There’s not a lot of folks that are on this program. But the ones that are and that ventured out long ago to make money should get credit for that,” Smith argued, recalling a time not long ago when it was rare to see any disabled person working. “If that went away, I don’t know what I would do.”