Eligibility

This letter from several Congress members from the state of Ohio to the U.S. Department of Health & Human Services expresses concern for the January 10, 2014, rule from CMS that amends regulation of the type of settings in which states can use federal Medicaid funds to pay for home and community based services. The members detail concern that the rule could inhibit the availability of specific residential settings.

As low-income adults covered under Medicaid expansion become eligible for and transition into Medicare, these individuals will face higher cost-sharing requirements. This report describes programs and policy options that could help low-income Medicare beneficiaries.

This study focuses on understanding the rates and patterns of enrollment in Medicaid among individuals already enrolled in Medicare, the factors that predict this transition to dual coverage, and those that predict nursing home entry. This volume of this report is a descriptive examination of the number and characteristics of Medicare beneficiaries who transition to dual coverage in the coming year.

In this issue brief, the authors explore the provisions of the Affordable Care Act that may enable Americans with mental illness to obtain the mental health treatment and support services they need to continue working or get back to work.

This study focuses on understanding the rates and patterns of enrollment in Medicaid among individuals already enrolled in Medicare, the factors that predict this transition to dual coverage, and those that predict nursing home entry. This volume provides estimated econometric models that predict beneficiaries' enrollment in Medicaid, and their entry into long-term nursing home stays.

Shifting the balance in publicly-funded long-term care provision away from institutional care toward greater reliance on home and community-based services has been a federal goal for the past three decades -- a goal often referred to as "re-balancing" state LTC systems. This report explores inter-state variations in LTC expenditure and service use patterns, in terms of institutional and non-institutional services, and also by Medicaid LTC users' age and type of disability.

Access to affordable health insurance is essential to the ability of people with disabilities to seek and maintain employment. As their income fluctuates, people may migrate between Medicaid and Marketplace coverage, and they may face changes in their benefits and out-of-pocket responsibilities as a consequence. This issue brief uses hypothetical examples of working people with disabilities to illustrate the experiences they might have with Medicaid and Marketplace coverage in four states.

A new criticism of the variety in measures serving to identify the disabled population in the American Community Survey (ACS) has been raised by Burkhauser, Houtenville, and Tennant. This article provides another perspective on the relationship of the current ACS measure and a work limitation measure demonstrating the complications introduced by combining measures that represent two different metrics and introducing an unmeasured environmental element.

In this brief, the authors summarize key features of the Social Security Disability Insurance program and describe some of the salient issues policymakers will need to consider to address the projected depletion of the SSDI Trust Fund in 2016. They also discuss the eligibility criteria for the program, benefit levels, and beneficiaries' ability to work.

This report provides statistics and information about uninsured individuals in the Medicaid coverage gap. The Medicaid gap is a term used to describe uninsured individuals who do not have enough income to qualify for ACA subsidies and who live in a state that has elected not to expand their Medicaid program. According to the Kaiser report, approximately four million individuals are in the Medicaid gap across the country. Of the uninsured individuals, 17% are in the 55-64 age range.