Medicaid

Medicaid – Vital to People with Disabilities for Their Health & Employment

Two women and a man in a wheelchair talk as they are walking down the street.

APSE is a strong and vocal proponent of Medicaid, and with good motivation:

  • Medicaid’s health and medical services are essential in helping individuals with disabilities remain at or achieve the needed level of sufficient health to be successfully employed.
  • The investment of Medicaid dollars in employment-related supports helps ensure that individuals with disabilities can maximize their incomes through work, fostering greater independence and better health and decreasing reliance on public benefits.

Medicaid increases access to preventive and primary health care and provides support for serious diseases, illnesses, and injuries. Medicaid has improved the health of millions of Americans (including individuals with disabilities).[i] Medicaid is important specifically for people with disabilities for several reasons:

  • Individuals with disabilities frequently have limited access to private insurance.
  • Medicaid covers a full scope of services that often individuals with disabilities need and that are not covered by private insurance or Medicare, even when private insurance or Medicare is available.
  • Private insurance and Medicare do not provide the same level of financial protection as Medicaid.
  • Many people with disabilities need long-term services and supports. Medicaid is the only source of funding for these long-term services.

Home and community-based services (HCBS) provide opportunities for Medicaid beneficiaries to receive services in their own home or community rather than institutions or other isolated settings. These programs serve a variety of targeted populations groups, such as people with intellectual or developmental disabilities, physical disabilities, and/or mental illnesses.

Medicaid Basics

What is Medicaid?

Medicaid is a government-funded insurance program that provides free or low-cost health coverage to millions of low-income people, families and children, pregnant women, the elderly, and people with disabilities. Many states have expanded their Medicaid programs to cover all people below certain income levels. Medicaid provides coverage to more individuals than to any other health insurance program: 20 percent[1] of the population of the United States (this varies widely from state to state). Medicaid represents $1 out of every $6 spent on health care in the U.S.[1]

Under federal rules, in most states, individuals receiving Supplemental Security Income (SSI) from Social Security are automatically eligible for Medicaid. However, several states use more restrictive criteria for Medicaid eligibility. There are also additional ways that individuals with disabilities may qualify for Medicaid.

What does Medicaid pay for?

As a health insurance program, Medicaid pays for a variety of traditional health care services (preventive care, emergency care, hospitalization, prescription drugs, medical equipment, etc.). In addition, Medicaid can also fund a variety of long-term services and supports, including employment-related supports for individuals with disabilities.

[i] Edwin Park, et. al., Frequently Asked Questions about Medicaid, Center on Budget and Policy Priorities, August 10, 2016 - http://www.cbpp.org/research/health/frequently-asked-questions-about-medicaid