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President Clinton Announces New Action to Expand Medicaid Coverage for People with Disabilties

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October 27, 2000

President Clinton Announces New Action to Expand Medicaid Coverage for People with Disabilties

Today, in a meeting with national disability groups, the President will announce a major new administrative action to expand Medicaid eligibility for people with disabilities and promote the use of home and community-based services and supports. He will also call on the Congress to refocus their priorities from excessive and unaccountable HMO payment increases and towards investments in coverage expansions for workers and children with disabilities, as well as new grants to help states expand alternatives to institutionalization. The proposed regulation invests $960 million over five years in a new option for states to expand Medicaid coverage for tens of thousands of people with disabilities, preventing them from having to become impoverished and allowing them to move from institutions into community based care settings.


  • State options for Medicaid coverage for people with disabilities are limited. Thousands of people with disabilities and senior citizens only qualify for Medicaid if they have very high medical expenses that force their incomes below the poverty level. Since Medicaid is the only available source of health care and essential personal assistance services for many people, they are forced to keep their incomes low in order to qualify. As a result, they must choose between paying for essentials such as food or shelter and critical health expenses in order to lower their income to the "medically needy" income levels currently required.
  • Families of disabled children are forced into poverty in order to retain Medicaid eligibility for their children. Current data indicates that over 60 percent of the thousands of families with special needs children are turning down jobs, raises, and overtime in order to ensure that they stay in the income bracket that qualifies their child for Medicaid.
  • There are insufficient home and community-based services and supports for people with disabilities. For decades people with disabilities who need long-term care services, both old and young, have advocated for "real choice" about where to receive those services and asked for alternatives to nursing homes and other institutions where they receive long-term care services. Every state Medicaid program must provide nursing home services, but community-based services are optional. In part, this is because the institutional bias in Medicaid precludes the development of community based services and supports.

PRESIDENT CLINTON TAKES STRONG NEW ACTION TO EXPAND MEDICAID ELIGIBILITY FOR PEOPLE WITH DISABILITIES. Today, President Clinton will announce new action to expand Medicaid eligibility for people with disabilities. The proposed regulation, which costs $960 million over 5 years, allows states to further "disregard" portions of an individual's income when determining their eligibility, such as the amount spent on food or shelter. States can use these broader rules to provide Medicaid coverage to people who would not otherwise be eligible, and move people from institutions into the community by allowing them to retain additional income to pay for food, clothing, and shelter. In addition, the broader rules can be used to encourage people to return to work or continue to work by ensuring that they will not lose their health insurance coverage if their income increases slightly.

URGES THE CONGRESS TO ACT NOW TO ADDRESS HEALTH CARE PRIORITIES FOR PEOPLE WITH DISABILITIES. Today, the President will call on the Congress to refocus their priorities from excessive and unaccountable HMO payment increases and towards investments in coverage expansions for workers and children with disabilities, as well as new grants to help states expand home and community based services and supports. As part of this effort, he will urge the Congress to act now to address critical health care priorities for the disability community, including:

  • Increasing access to Medicaid for working families with disabled children. Today, the President will urge the Congress to pass the bipartisan Grassley-Kennedy-Sessions-Waxman Family Opportunity Act of 2000 (S. 2274 and HR 4825), which was sponsored by a bipartisan majority in the Senate and a growing coalition in the House. This bill, which is the next logical step beyond the Jeffords-Kennedy Work Incentives Improvement Act, invests $2.1 billion over five years to establish a new Medicaid buy-in option for thousands of children with disabilities who lose their Medicaid coverage because of increased family income due to employment and a time-limited demonstration that extends Medicaid coverage to children who have a disabling condition that, without health care coverage, would cause them to become so severely disabled as to be eligible for SSI.
  • Enhancing state capacity to provide home and community-based alternatives to institutionalization. The President will join Senator Harkin in urging the Congress to fund $50 million in new grants to conduct intensive outreach efforts to educate people with disabilities about the home and community based options currently available to them; create new one-stop-shopping centers that streamline application and eligibility processes for home and community-based services and supports; and identify, develop, and implement strategies to modify state policy that results in the unnecessary institutionalization of people with disabilities rather than the provision of home and community based services. As a condition of receiving funds, states would actively involve people with disabilities and their families in the development of programs enabling people with disabilities to choose where they want to live and receive services. Senator Harkin has been a tireless advocate for this critically important initiative.
  • Finish the job on the Work Incentives Improvement Act. The bipartisan Work Incentives Improvement Act, enacted by the Clinton-Gore Administration last year, extends Medicare coverage for eight and a half years for people with disabilities who return to work, ensuring that everyone with a disability returning to work have access to health care coverage, even if they live in a state that does not take the Medicaid option. The President will urge the Congress to finish the job on the Work Incentives Improvement Act by providing permanent Medicare coverage to people with disabilities returning to work.
  • Additional health care priorities important to people with disabilities. The President will reiterate the importance of a series of other high-priority health care initiatives, including: a voluntary Medicare prescription drug benefit; a strong and enforceable Patients' Bill of Rights; a $3,000 long-term care tax credit for people of all ages; and a new $1,000 tax credit to offset the formal and informal employment related costs incurred by working people with disabilities.

THE CLINTON-GORE ADMINISTRATION'S LONGSTANDING COMMITMENT TO WORKING ON BEHALF OF AMERICANS WITH DISABILITIES. Throughout this Administration, President Clinton and Vice President Gore have worked hard to achieve the equality of opportunity, full participation, independent living, and economic self-sufficiency for people with disabilities. This Administration has vigorously defended the ADA in court cases across the Nation; collaborated with State Medicaid directors to implement the Supreme Court's 1999 Olmstead decision, which prohibits unjustified isolation of institutionalized persons with disabilities; helped ensure that 80 percent of America's public transit buses are now accessible; implemented the Ticket to Work and Work Incentives Improvement Act, which the President signed into law last December; and developed far-reaching policies for a comprehensive, coordinated employment agenda through the Task Force on Employment of Adults with Disabilities.

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