"I would essentially die without home health care," said Evans, who lives in New York's Hudson Valley.

With the support Medicaid provides, Evans could work more than he does. But, in a Catch-22, additional income would threaten his Medicaid eligibility.

“The financial situation for disabled people is dire,” Evans said. “A major reason is we have to choose between our job and the benefits we get.”

Even marrying his girlfriend could cause Evans to lose Medicaid, because state programs also monitor a spouse's resources. “There’s so much frustration,” he said.

Those are the dilemmas ABLE is meant to resolve. The first ABLE accounts are opening this summer in four states, with many more states on the way. While Florida’s program will be restricted to residents, the other three states – Ohio, Tennessee, and Nebraska – are also open to people who don't live there. 

The Social Security Administration says it has trained staff members on ABLE accounts. Still, Brasset, who was surprised to learn she is eligible, said she recently visited a Social Security office to renew her benefits and “that person had no idea what an ABLE account was.”

Brasset is leaning toward signing up for an account with Ohio. She’s hoping she'll be able to work more now and save the proceeds in her ABLE account. Relatives will be able to make contributions, too, helping to create a safety net for major expenses.

“It gives me peace of mind,” Brasset said. “Saving money should be a right to each and every American.”

Strings are attached. Total contributions, whether by an account holder, friends, or family, are capped at $14,000 a year. If an account exceeds $100,000, the holder can lose eligibility for cash benefits from Social Security's Supplemental Security Income program until the overage has been spent. When a Medicaid recipient dies, the health insurance program for the poor can take the contents of an ABLE account as compensation for the care that was provided.

ABLE accounts can be a valuable tool for parents of children with disabilities and for adults who get help from relatives. Families may be eager to make sure disabled children get the care they need after older relatives die. But parents and grandparents are often warned not to leave money to people with disabilities without hiring an attorney to set up a trust.