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Vocational Rehabilitation, the Affordable Care Act, and New Opportunities: Where Will Health Care Reform Take Us?

In a recently published piece on health care reform, Linda Rosenberg describes health care reform as a revolution and outlines many ways in which we must take advantage of the opportunities it presents (Rosenberg, 2012; Merrens & Drake, 2013). The passage of the Affordable Care Act (ACA) and subsequent ruling by the Supreme Court upholding all but the provisions mandating Medicaid expansion, may open the possibilities for medically related vocational rehabilitation services and supports as well. In a report prepared for the Rehabilitation Research and Training Center on Vocational Rehabilitation, Institute for Community Inclusion, University of Massachusetts Boston, Mr. Robert “Bobby” Silverstein states, “under the ACA essential health benefits, including rehabilitative and habilitative services and devices, will be more readily available to an expanded population of persons through the private insurance market. Also, under the ACA an expanded number of persons may, at a State’s discretion, receive health care services under the Medicaid program” (Silverstein, 2012, p. 1). Title 1 of the Rehabilitation Act regulates the public vocational rehabilitation program. The act permits for the provision of physical and mental restorative services when required to achieve a vocational outcome. Although each state vocational rehabilitation agency may have additional state-imposed rules mandating processes, all must comply with the provision of the act that requires the state to determine the availability of comparable services and benefits before committing vocational rehabilitation resources. The benefits outlined in the Affordable Care Act through private health providers and other federal, state, and local programs such as Medicaid would be considered as comparable services and benefits. The extent of physical and mental restorative services varies from state to state, however the addition of the Affordable Care Act provisions should open up the chances for vocational rehabilitation agencies to access those resources for consumers in need. Too frequently, vocational rehabilitation consumers are derailed from their vocational pursuits due to poorly managed