Medicaid Expansion — Coverage for Persons with Disabilities

Recent regulations issued by CMS allow children with serious emotional disturbances, individuals with disabling mental disorders, and individuals with mental disabilities that prevent them from performing tasks of daily living to be exempted from enrolling in Medicaid benchmark plans. While most individuals who are newly eligible for Medicaid under health reform will be enrolled in benchmark coverage, these individuals with severe needs may instead be enrolled in standard comprehensive Medicaid. The National Council fact sheet, “Medicaid Benchmark Benefits in Health Reform: Improvements and Exemptions,” describes the differences between benchmark and standard coverage, the improvements to benchmark coverage under health reform, and the implications of these changes for individuals with disabilities. States will need to develop processes to identify which individuals meet the criteria of having a disabling mental disorder or functional impairment. Download the National Council Fact Sheet now.