The House gave overwhelming approval yesterday to a bill designed to let disabled people keep their government health benefits when they go to work, reducing what critics of the current system call a "perverse incentive" that keeps many disabled people unemployed.
The House's 412 to 9 vote was an important advance for the Work Incentives Improvement Act, a version of which has already passed the Senate on a 99 to 0 vote. But the legislation still faces considerable hurdles before enactment, most of them over how to pay for the measure.
President Clinton, in a statement, hailed what he called an "impressive vote" for the legislation, which he said "sends a strong signal that all Americans, including people with disabilities, should have the opportunity to work." But he warned that the House bill had "inadequate and problematic financing provisions," including one that the White House warned would hurt funding for student loans.
The Senate's measure, moreover, did not include funding provisions at all. The financing problem means the fate of the bill will depend heavily on the work of House and Senate negotiators in a conference committee. Leaders in both parties say they want the disabilities measure to transcend the heavy partisan acrimony that has affected so much other legislation, and have expressed optimism that an acceptable compromise will be found.
Some 75 percent of disabled adults are unemployed, according to administration backers of the bill. The House bill would allow disabled people who receive Social Security Disability Insurance and return to work to receive Medicare health coverage for up to 10 years, as opposed to four years under current law. The bill also allows states to let disabled people who return to work buy into the Medicaid program.
It also gives new help to disabled people to buy rehabilitation services needed to enter the work force. Backers estimate that if fully implemented, the bill would allow the number of disabled people receiving rehabilitation and training services to more than quadruple, to 550,000, according to an Associated Press account.
The legislation originated in the Senate, where its sponsors were Sens. Edward M. Kennedy (D-Mass.) and James M. Jeffords (R-Vt.). The two had proposed paying for the estimated $800 million five-year cost of the measure by eliminating a tax break for some overseas corporate operations. Sen. Phil Gramm (R-Tex.) opposed ending the tax break and the bill won passage only when the provision was dropped. No alternate funding mechanism was proposed.
Clinton included funding for the measure in his budget proposal earlier this year, but that spending plan was a dead-letter on Capitol Hill.
The House has found funding sources for about $300 million of the projected five-year cost.
"This is the most dramatic breakthrough for Americans with disabilities since the Americans With Disabilities Act," said Rep. Rick Lazio (R-N.Y.), sponsor of the House version.
Lazio has complained that the White House has not done enough to find funding sources for the measure, but White House officials said they have worked with Democrats in the House, and senators in both parties.
The White House's top health policy official, Chris Jennings, expressed optimism that an acceptable proposal would emerge this fall. "It's not perfect yet. It's not adequately financed yet," he said, "but it's easily worth proceeding into the conference."