Children with Special Health Care Needs: Coverage, Affordability, and HCBS Access

Issue Brief
  1. KFF analysis of 2019 National Survey of Children’s Health.

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  2. U.S. Department of Health & Human Services, Health Resources & Services Administration, Maternal & Child Health, Children with Special Health Care Needs (Date Last Reviewed: March 2019), https://mchb.hrsa.gov/maternal-child-health-topics/children-and-youth-special-health-needs#ref1.

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  3. Out of an estimated 2.0 million children with disabilities covered by Medicaid/CHIP, 21% are estimated to receive SSI. KFF estimates of the 2019 American Community Survey, 1-Year Estimates. Estimate includes non-institutionalized children ages 0-18. Disability classification incudes serious difficulty with hearing, vision, cognitive functioning, mobility, self-care, or independent living. This share is based on data from the American Community Survey which does not identify whether children are eligible for Medicaid in a poverty-related pathway vs. a disability-related pathway and may be a conservative estimate of the total number of children with SSI. The Social Security Administration reports about 1.1 million child SSI beneficiaries in 2019. Social Security Administration, SSI Annual Statistical Report, 2019, Table 7.A1 (released Feb. 2021), https://www.ssa.gov/policy/docs/statcomps/supplement/2020/7a.html. These two sources report differ numbers due to differences in underlying data collection methods, but the difference does not change the overall conclusion that most Medicaid children with special health care needs do not qualify based on their status as an SSI beneficiary.

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  4. For this analysis, children had an intellectual or developmental disability if they reported any of the following conditions: developmental delay, intellectual disability, speech/language disorder, learning disability, Down syndrome, or autism.

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