Disability, Health Insurance, and Access to Care

Session Submission Type: Panel

Abstract

People with disabilities face unique and compounding challenges in accessing health care and maintaining financial security. This panel brings together four papers that examine the role of health insurance coverage, policy design, prescription drug use, and field office closures in shaping the health and economic outcomes of individuals with disabilities across the life course.

The paper by Naher, Mroz, and Molton focuses on individuals with long-term physical disabilities and the barriers they face in accessing essential medications. Drawing on longitudinal survey data, the authors demonstrate that lack of health insurance is a strong predictor of cost-related medication nonadherence, such as skipping doses or delaying prescription fills. The study underscores the protective role of health insurance in reducing financial barriers to medication access and supporting health management for this population.

The paper by Armour examines the long-term consequences of prescription opioid use among older Americans, using panel data from the Health and Retirement Study. The analysis reveals substantial effects on health, mortality, work disability, and participation in disability programs, with opioid users significantly more likely to apply for or receive Social Security disability benefits. The findings raise important questions about how opioid use intersects with aging, labor force detachment, and the social safety net.

The paper by Coe and Rennane investigates the impact of state-level automatic enrollment policies linking Supplemental Security Income (SSI) to Medicaid eligibility. Using nationally representative data and a difference-in-differences framework, the study finds that automatic enrollment significantly increases Medicaid coverage among adult SSI recipients, especially for those with limited alternative pathways to insurance. These findings highlight the importance of streamlined policy coordination in reducing administrative burdens and improving access to care.

The paper by Welter estimates the impact of COVID-19-induced SSA field office closures on disability benefit applications using a ZIP-code-level panel of SSA beneficiaries. Closures led to a significant and persistent decline, especially in non-metro and rural areas, implying remote options did not substitute for in-person help. The results underscore the importance of local administrative presence for program participation, particularly for populations with limited internet access or digital literacy, and offer guidance for building more inclusive, resilient service delivery.

Together, these papers provide new evidence on how health insurance policies, healthcare access, and public service accessibility affect well-being and participation in disability programs among people with disabilities, with direct implications for Medicaid design, prescription drug policy, and disability insurance systems.

Policy Area

• Health Policy

Chair

• Kelly Nye-Lengerman, University of Maryland, College Park

Discussants

• Na Yin, Baruch College (City University of New York)

• Jody Schimmel Hyde, Mathematica

Organizer

• Callie Freitag, University of Wisconsin-Madison

Individual Presentations

• The Impact of Health Insurance Coverage on Medication Access in Persons with Long-Term Physical Disabilities - Presenting Author: Samsun Naher, University of Washington

• The Causes and Consequences of Opioid Use among Older Americans: A Panel Survey Approach - Presenting Author: Philip Armour, RAND School of Public Policy

• The impact of SSI-Medicaid autoenrollment policies on health insurance coverage - Presenting Author: Jessie Coe, RAND Corporation; Non-Presenting Co-Author: Stephanie Rennane, RAND Corporation

• Impact of COVID-19-induced SSA Field Office Closures on Disability Benefit Applications - Presenting Author: Caroline Welter, West Virginia University