July 28, 1999

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July 28, 1999

TALKING IT OVER

HILLARY RODHAM CLINTON

July 28, 1999

No one should be forced to choose between health care and a job, but that is exactly what happens to millions of people with disabilities in this country every day.

Joann Elliot worked as a food-service worker at St. Elizabeth's Hospital here in Washington for 20 years. She loved her job, but in 1991, a massive stroke left her paralyzed on her left side. Now, she needs a wheelchair to get around and help with bathing, dressing and completing other day-to-day activities.

Because she had to give up her job, Joann receives Social Security Disability Insurance, Medicare and Medicaid to cover her personal-care assistant, prescriptions, special equipment, therapy and some transportation. But she wants to go back to work. "I don't like staying at home," she explains. "I want to get out and be productive."

Here's the problem: If Joann finds a job -- even a low-paying one -- she'll lose her Medicaid benefits -- the very health care coverage that she needs to be able to go to work. Karen Moore, who is a wheelchair user, was thrilled when she found a job as a dispatcher for the River Cities, S.D., Transit System. When she began working full-time, Karen found that she needed less medical care, made new friends and was able to reduce her SSDI benefits.

But like Joann, she also found herself in a Catch-22. She depends on an attendant to get ready for work every day, but lost coverage for that care once she went to work. "I believe in contributing for these services," she says, "but the current arrangement makes it impossible for me to continue working."

After David Robar sustained a spinal-cord injury in 1990, he learned the same unfortunate lesson. Determined to return to work, he managed to finish his degree in business administration, but when he began looking for a job, he found that he would have to give up his health care benefits. "If I were to pay for my personal attendant services out of pocket," he says, "it would cost me more than I would make working full-time."

Today, millions of Americans live with disabilities and can bring enormous energy and creativity to our workforce. Studies show that the vast majority wants to work, yet 75 percent of them are unemployed. Too often, they find themselves in the same boat as David, Karen and Joann: If they find a job, they stand to lose the very benefits that allow them to go to work in the first place.

Nine years ago this week, the Americans with Disabilities Act became law, opening doors in the same way that the Civil Rights Act did three decades ago. Whereas, at one time, we presumed that a disability meant a lifetime of dependence, now, we know that those with disabilities want to -- and can -- lead independent lives and contribute to our nation's prosperity.

I am proud of the steps this Administration has taken to integrate people with disabilities into the workplace. Last year, my husband created a National Task Force on Employment of Adults with Disabilities. He has implemented new regulations that increase the amount of income that those with disabilities can earn while still receiving critical benefits; taken steps to remove federal hiring barriers for people with mental illness; and ordered the development of a plan for the federal government to hire more people with disabilities.

But while these actions have been a source of hope to Americans with disabilities, a major obstacle to employment remains: Most Medicare and Medicaid benefits are limited to those too disabled to work. That is why, this week, as we celebrate the anniversary of the ADA, my husband has urged Congress to pass legislation that would provide new health care options and employment assistance so that people with disabilities can work.

Last year, when we celebrated the anniversary of the ADA, the President promised to work with Senators Jeffords and Kennedy to achieve this goal. In his State of the Union Address in January, he urged Congress to make this legislation a top priority, and he included full funding for it in the budget he sent to Congress. In June, by an overwhelming bipartisan vote of 99-0, the Senate passed a bill. But the full House has yet to act.

In many ways, work helps build our self-respect as well as our nation's economy. But although our nation is enjoying its lowest unemployment in a generation, too many Americans with disabilities cannot participate because of the barriers that still stand.

Ignoring the potential of these citizens is not only a missed opportunity for them, it is a missed opportunity for the entire country. Let's celebrate the anniversary of the ADA by opening the doors of opportunity for millions of Americans even wider, so that no American has to choose between going to work and paying medical bills ever again.

To find out more about Hillary Rodham Clinton and read her past columns, visit the Creators Syndicate web page at www.creators.com.

Talking It Over: 1999