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Many states, Nebraska included, have been actively developing programs to promote competitive employment for persons with disabilities. Buy-In programs (enabling persons with disabilities with increased earned income to continue to Medicaid eligibility) have become a keystone program in states’ efforts. States are implementing Buy-In programs (and related programs and supports) not as welfare programs, but as programs that help states make productive use of all of their human capital resources. Many policymakers support Buy-In programs as a means to increase workers with disabilities’ participation as productive citizens of states. That is, such programs are seen as a means to “enhance a state’s economic status; not simply as a means to enhance access to health care” (Jensen, Silverstein, Folkemer, and Straw, 2002, p. 5). This perspective may be particularly helpful as policymakers wrestle with the costs and benefits of such programs.