Fact Sheet: President Clinton Announces New Action to Expand Medicaid Coverage for People With Disabilties (10/27/00)
|                                                                         |
|    Invests Approximately $1 Billion To Provide a New Coverage Option    |
|                               Nationwide                                |
|                            October 27, 2000                             |
|                                                                         |

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

?    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.

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.

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

?    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.

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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