Medicaid provides health insurance for over 80 million Americans, including pregnant women, low-income parents, children, seniors, and people with disabilities, while Supplemental Security Income (SSI) is a monthly cash payment to help low-income people with disabilities pay for housing, food, and other basic needs. SSI does not include health insurance, but people who receive SSI generally automatically qualify for Medicaid. SSI enrollees are a subset of all Medicaid enrollees with disabilities. People who receive SSI cash assistance must meet stringent income, asset, and medical eligibility criteria. Many people with disabilities do not receive cash assistance from SSI but still qualify for health insurance from Medicaid through other eligibility pathways. Proponents of Medicaid work requirements often describe these policies as applying to "able-bodied" adults. Recent guidance from the Centers for Medicare and Medicaid Services (CMS), allowing states for the first time to condition Medicaid eligibility on meeting a work requirement, permits states to target only people who are "eligible on a basis other than disability." Kentucky's waiver, the first to include a work requirement (referred to as community engagement), applies to Medicaid expansion adults and traditional adults, including low-income parents. As of mid-January, 2018, nine other states have submitted waiver proposals to CMS seeking work requirements (AR, AZ, IN, KS, ME, MS, NH, UT, and WI). Although the CMS work guidance excludes people who are eligible for Medicaid based on a disability, many adults with disabilities will face Medicaid work requirements because they are eligible for Medicaid on another basis. While Medicaid work requirements could apply to all expansion adults and/or low-income parents, this issue brief focuses on the subset of those with disabilities because they may have difficulty meeting the work requirement or obtaining an exemption due to their health needs. We examine the implications of work requirements for nonelderly Medicaid adults with disabilities who do not receive SSI (referred to as non-SSI adults with disabilities) and compare their work status and functional limitations to those who do receive SSI. The Appendix contains 50-state data.
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