Editorial: Refreshing change by Congress

When the Americans with Disabilities Act became law in 1990 it ushered in landmark protections, among them a guarantee that people with disabilities couldn't be discriminated against when seeking a job. Almost a decade later those legal safeguards, coupled with a strong economy where employers practically are begging to get new employees, should be encouraging news for those who are disabled. Still, not everyone is benefiting from these fortunate times.

Americans with severe disabilities, who must rely on Medicaid funding to cover their health care costs, are faced with a dilemma that prevents them from entering the work force. If they get a job, most then will become ineligible for government assistance, which for some could result in a loss of tens of thousands of dollars in subsidized health care. Often their salaries alone couldn't possibly be enough to pay for at-home care. This can include renting costly medical equipment, such as respirators, and paying for nurses to help them with everyday tasks that most of us take for granted, such as getting dressed or even taking a bath.

So what has happened is a perverse incentive for the disabled to stay home and at least maintain the health care essential for their lives. It is an issue in this state with an estimated 18,000 disabled Nevadans receiving Medicaid assistance. A week ago the Sun's Kristen Peterson wrote a story about the struggles faced by one such Nevadan, Cricket Miller, a 37-year-old quadriplegic. Miller recently received a bachelor's degree in communications from UNLV, but if she took a job where she made more than $1,500 a month she would lose her Medicaid insurance. Paying for nursing care out of her own pocket would range between $1,500 to $2,000 a month, a scenario that effectively prevents her from entering the work force.

It now appears, however, that relief could be on the way. As part of the budget deal reached between Congress and the White House last week, an agreement was reached that will allow the disabled to keep their government health insurance benefits while at the same time holding a job. Some of the disabled would have to pay modest premiums to partly offset the costs of the program, which has a price tag of $800 million over five years. Clinton had fought hard to get the legislation passed and the White House's health policy coordinator, Chris Jennings, said the president saw this as one of the most important initiatives coming out of the budget negotiations.

The 106th Congress has rightly been maligned for failing to pass legislation on a number of health care issues, including a patient's bill of rights and coverage for the uninsured. Those failures won't be erased by the passage of this measure, but it should provide an example of how both parties -- if they're willing -- can put aside petty differences and make a difference to genuinely improve the state of health care in this nation.

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