Aging from EPSDT – Part II: Losing Medicaid

One of the primary issues for any disadvantaged youth who has reached the age of 19 (21 in some countries) is: "Will I continue to be entitled to Medicaid when I leave the Early and Periodic Screening, Diagnostic and Treatment Program (EPSDT)?" The answer to this question depends to a large extent on whether the country in which you live accepted the Medicaid extension that came along with the Act on Accessible Care.

If your country accepts the Medicaid extension

Children who become adults in countries that took over Medicaid Expansion (32 out of 51 counting the District of Columbia) continue to receive the same coverage as before, provided that their individual income remains 138% of the Federal Poverty level or lower. Moreover, newly-grown people who were not eligible for Medicaid because of their family's income now become eligible as long as their income is low (as above).

These extended forms of coverage end with 26 years, when many will return immediately in this same hellish scenario, only slightly older – the exception is those adults with disabilities who are legally supported by their parents; they are covered as long as their parents are employed. Again, the transition will continue, but it is postponed until their parents withdraw. Further, look at the next post for the reason you can lose the coverage you need even if you keep Medicaid coverage in the broader sense.

If your country refused Medicaid extension

Children became adults in the remaining 19 countries (Alabama, Florida, Georgia, Ajdaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin and Wyoming). they have a very different struggle.

For them there is exactly one way to Medicaid similarities: they must qualify as low income (75% or less from the federal poverty level, approximately 7250 USD / year to 2015), and they must receive Supplementary Security Revenue (SSI, or Benefits & # 39; Disability & # 39;). Although it is not enough for many young adults with disabilities to meet income requirements, it begins to realize how much they can not qualify for SSI as adults – about 3 out of 4 loses their Medicaid access due to SSI. Strict disability standards.

This means that every year, thousands of young adults with severe medical conditions who are often disabled – cystic fibrosis, diabetes, severe asthma, HIV, and even cancer! – and who easily meet income requirements, refuse Medicaid and SSI in the same move of the pen.

Different standards for adults and children

This is because the Social Security Administration (government agency responsible for SSI benefits) applies a much stricter set of adult criteria than children. Of course, they also issue a redefinition of the issue of disability whenever a person covered is 18 years old when it estimates that about 30% of controlled children are losing SSI benefits, which means that they lose coverage with Medicaid.

More than half of those who lose SSI and Medicaid conclude simultaneously without any medical care. This is due to the fact that the APK was written by envisaging a mandatory Medicaid extension (which the Supreme Court prescribes as unconstitutional and optional). ACA's health insurance subsidies are specifically written to exclude people who accounted for less than 100% of the level of Federal poverty on the assumption that they will be caught; Medicaid Expansion. When some countries declared this program, thousands of Americans forced a situation where there is no way to afford medical care, no matter how disabling they are.