Medicaid Challenges for States with High Concentration of SSI Children

High concentrations of Supplemental Security Income children live in low-income minority communities. Most counties with the highest amounts of minority special needs children are lower income ($32K to $52K) but not below the federal poverty level. These children often have expensive, permanent, high-risk and life-long chronic illnesses.

According to a report released by physician-parent caregivers, almost 1 in 5 or 8.8 million American households include at least one child with chronic medical conditions or disabilities. The number of young people with chronic medical conditions and disabilities has increased over the past four decades to over 10 million children and 5 million young adults. In recent years the nation has seen disability growth in psycho-social diagnostic categories.

In a 2012 report, the Government Accountability Office found SSI for kids growing rapidly and a serious need for oversight of disability and benefits. They found more children becoming eligible because of the prevalence of certain diagnosed medical disorders, such as attention deficit hyperactivity disorder, speech and language delay and autism.

In 2011, SSA paid more than $9 billion for 1.3 million disabled children. In some states, SSI children's healthcare exceeds TANF (regular Medicaid) by 8 to 12 times. In 2010, the American Academy of Pediatrics published a supplement to Pediatrics, "Children and Youth with Disabilities and Special Needs from Traditionally Underserved Communities." The supplement presents 15 articles addressing inequities in accessing care for chronically ill minority children. Similar to the GAO report, behavioral disorders, such as ADHD, autism and depression, were higher in prevalence and incidence and least likely to be detected easily.

The consequences of these trends should caution all states with high concentrations of SSI children to consider the pros and cons of limiting or expanding Medicaid over the next several years. County governments should also examine the advantages and disadvantages of their states' decisions.

The chart below presents the top ten states with the largest SSI populations by age categories, median household income and current position on Medicaid expansion under the Patient Protection and Affordable Care Act.


References:
SSA Publication No. 13-11976, Social Security Administration, July 2012
http://www.statsamerica.org/profiles/us_profile_frame.html
Huffington Post, July 2012

Thomas W. Chapman, EdD, MPH has served as President and CEO for The HSC Foundation since 1998. He provides leadership and significant involvement in community service for the non-profit healthcare industry. These efforts have been achieved through developing and implementing a wide range of community-based programs, speaking at universities, public agencies and hospitals on a variety of health-related topics, writing articles for publications and interviews with the media about the importance of community services as a societal priority

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