Medicaid Managed Care - U.S. Senate Special Committee on Aging

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the option of extending eligibility to people who receive state payments
that supplement sst benefits; 8 to some people whose incomes are above ss
levels but who are sufficiently disabled to need institutional care; and,
with federal approval, to some people who are at risk of needing
institutional care. For 1996, the federally specified maximum income level
for an 'ssi-relatedl individual was $1,410 per month.
More than half of all disabled people receiving ssi as of December 1994
were eligible on the basis of a mental disability. Such disabilities included
mental retardation, autism, schizophrenia, paranoia, and, under certain
circumstances, substance abuse.' For those who were eligible on the basis
of physical disabilities, the main categories were diseases of the nervous
system, sense organs, 8 musculoskeletal and connective tissues, or
circulatory system. Specific conditions in these categories included
blindness, muscular dystrophy, cerebral palsy, Parkinson's syndrome,
brain tumors, rheumatoid arthritis, osteoporosis, and chronic heart
disease.
Children constitute about 22 percent of disabled ssi recipients. Among
them, mental retardation is the leading cause for eligibility. Since a 1990
U.S. Supreme Court decision,' ml disability criteria for those 18 and
younger have been based on developmental delays and limitations in
ability to engage in age-appropriate activities.
Disabled People Many disabled <strong>Medicaid</strong> beneficiaries have a level of medical need that is
Disabled People
Account for Over
One-Third of <strong>Medicaid</strong>
Expenditures
atypical of the general population. A disabled person's degree of disability
can range from mild to very severe. At the more severe levels, individuals
may be technology-dependent, requiring medical devices to compensate
for loss of a vital body function. Many of them also require ongoing
nursing care to avert death or further disability.
Because of their atypical medical needs, disabled individuals have medical
costs that are generally higher than those of the typical <strong>Medicaid</strong>
beneficiary. In fiscal year 1994, disabled individuals were about 15 percent
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