Health Insurance Benefits Protection for Employees with Disabilities

Abstract

Workers experiencing serious health problems that temporarily make continuing work difficult face not only loss of earnings, but potentially loss of health insurance coverage. The Family and Medical Leave Act (FMLA), passed in 1993, helps to mitigate these losses by mandating employers provide temporary unpaid leave, continuation of health benefits during the leave, and the right to return to work in the same or similar job for eligible workers. This paper reviews earlier research with respect to how important a role health insurance continuation under the FMLA is for employees with disabilities.

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Introduction

Workers experiencing serious health problems that temporarily make continuing work difficult face not only loss of earnings, but potentially loss of health insurance coverage. The Family and Medical Leave Act (FMLA), passed in 1993, helps to mitigate these losses by mandating employers provide temporary unpaid leave, continuation of health benefits during the leave, and the right to return to work in the same or similar job for eligible workers.¹

The continuation of health insurance during a period of leave under FMLA can be particularly important for individuals with disabilities.² While not all persons with disabilities have serious health conditions (the two terms are not synonymous), on average, people with disabilities have greater medical expenditures than their non-disabled peers (Goodman et al 2007). While this does not mean workers with disabilities necessarily disproportionately need leave from work, some people with disabilities will experience times when they need health-related leave from work (in a block or intermittently) and continued access to their employer-sponsored health benefits. In addition, for any worker with health insurance who needs to take leave from work for health reasons, the continuation of health benefits while on leave (as provided for by FMLA) can provide access to necessary treatment that makes return to work possible.

This paper describes the provisions of FMLA and its limitations in coverage and eligibility. We review existing evidence that suggests the importance of the law for employees with disabilities, potential gaps in coverage for people with disabilities, and possible barriers to effectiveness of FMLA for those with coverage. We also discuss other programs and laws that extend some FMLA-like benefits and how they interact with FMLA.

Unfortunately, direct evidence on the use of FMLA by people with disabilities and the extent to which it is meeting the needs of people with disabilities is sparse. Two major studies of the FMLA commissioned by the Bureau of Labor Statistics (BLS) in 1995 and 2000 which contain information from both employers and employees on the use and effects of the FMLA do not include any separate information on workers with disabilities. No other surveys directly ask workers with disabilities about use of FMLA. Thus we do not have direct information on FMLA coverage for workers with disabilities or their use of FMLA. The final section of this paper discusses potential areas for additional research.

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