HEALTHCARE IN THE UNITED STATES

SPECIAL POPULATIONS

Figure 7.6: Health Insurance Status of Children With Special Healthcare Needs, 2017 Source: Kaiser Family Foundation

Attribution: Kaiser Family Foundation

License: © Kaiser Family Foundation. Used with permission.

The Tax Equity and Fiscal Responsibility Act (TEFRA)/Katie Beckett waiver offers another pathway for eligibility to the Medicaid program. Waiver programs, such as Katie Beckett, allows for Medicaid eligibility when a family’s income is too high and focuses solely on the income of the child. This waiver for eligibility provides much-needed funds to families who have a higher (whole family) income but are still required to pay high-cost care to support their disabled child. Below is a brief description of the Katie Beckett story and how this legislation helps children today receive paid care at home rather than an institution. Continuation of benefits into adulthood is possible. Disabled children who turn 18 could qualify for the Social Security Disability Insurance (SSDI) benefits if they continue to meet the definition of the SSA for qualifying conditions and prove the low-income criteria (SSA, 2019b). In addition, adult children may use Social Security benefits if their parents paid into the fund through employment taxes.

Katie Beckett

As a young five-month-old infant, Katie contracted viral encephalitis and went into a coma. She received ongoing inpatient care in a small hospital in Iowa for three years. Katie ultimately recovered from the infection but was left partially paralyzed and required a ventilator to assist with breathing. Medicaid paid for the hospitalization and treatments, but when Katie was cleared to return home she would do so without Medicaid financial support.

Page | 147