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How Might Older Nonelderly Medicaid Adults with Disabilities Be Affected By Work Requirements in Section 1115 Waivers?

Data Note
  1. People who receive SSI cash assistance (for those with low incomes and disabilities) are not subject to Medicaid work requirements according to Centers for Medicare and Medicaid Services (CMS) guidance.

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  2. Kaiser Family Foundation analysis of the 2016 American Community Survey, 1-Year Estimates.

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  3. Ibid.

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  4. The ACS questions used to classify an individual as having a disability include:  (1) Is this person deaf, or does he/she have serious difficulty hearing? (2) Is this person blind, or does he/she have serious difficulty seeing, even when wearing glasses? (3) Because of a physical, mental, or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions? (4) Does this person have serious difficulty walking or climbing stairs? (5) Does this person have difficulty dressing or bathing? (6) Because of a physical, mental, or emotional condition, does this person have difficulty doing errands alone, such as visiting a doctor’s office or shopping?  U.S. Census Bureau, How Disability Data are Collected from the American Community Survey, (Oct. 17, 2017). The ACS definition of disability is intended to capture whether a person has a functional limitation that results in a participation limitation and is similar to measures used in other federal surveys, such as the National Health Interview Survey.

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  5. People who meet the ACS definition of disability but do not receive SSI can be eligible for Medicaid as expansion adults or Section 1931 parents (based solely on their low income). They also may be eligible for Medicaid through an optional disability-related pathway (such as the state option to cover people with disabilities up to the federal poverty level or a home and community-based services waiver). People who qualify for Medicaid both as an expansion adult and based on a disability can choose the group through which they enroll in coverage; benefit packages may differ by coverage group.  42 C.F.R. § 435.911 (c) (2), (d).

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  6. These states include those with waiver approved by or pending with CMS.

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  7. For example, states may exempt people who are medically frail, in substance use disorder treatment, students, experiencing a “catastrophic event,” caregiving, or receiving unemployment compensation. Kaiser Family Foundation, Medicaid and Work Requirements:  New Guidance, State Waiver Details, and Key Issues (Jan. 2018).

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  8. Utah would exempt adults ages 60 and older from its work requirement. Data are for ages 50-64.

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  9. Arizona would exempt adults ages 55 and older from its work requirement. Data are for ages 50-64.

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  10. Indiana exempts ages 60 and older from its work requirement. Data are for ages 50-64.

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  11. Ibid.

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  12. Ibid.

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