Medicaid Coverage for I/DD: 5 Key Facts

Summary of teh Provided Text: Medicaid ⁢Spending & Individuals with intellectual and Developmental Disabilities (I/DD)

This text highlights the substantially higher healthcare costs associated with individuals with⁢ Intellectual and Developmental⁤ Disabilities⁣ (I/DD)⁤ within the Medicaid system, and the potential risks they face due to ‍impending ‍federal funding ⁢cuts. Here’s a breakdown of the key points:

1. Higher Medicaid Spending:

* under 19: ‍ Medicaid spends roughly four ⁢times more annually on ‍individuals with I/DD compared ⁣to those without ($12,571 vs $3,073).
* 19-64: Medicaid spending is seven times higher for those with I/DD ($50,086 vs. $6,873).
* This increased spending is likely due ‍to greater use of long-term care ‍and overall higher healthcare utilization.

2. Increased Co-occurring Conditions:

* ⁣ Individuals with⁢ I/DD⁣ are ⁢significantly more likely to have other chronic health⁣ conditions,both physical and behavioral,compared to those without I/DD,across all age groups studied:
⁢ * ⁢ Under⁤ 12: Nearly twice as likely ⁢to have a chronic condition (19% vs. 11%).
* 12-18: More likely to have chronic conditions (51% vs. 29%) and over twice as likely to have a behavioral health condition (37% vs. 17%).
* 19-64: More likely to have chronic conditions (67% vs.42%), twice as likely to⁤ have a behavioral health condition (46%⁢ vs.23%), and twelve times as likely to have a physical health condition (24% vs. 2%).

3. Potential Risks with Medicaid Funding Cuts:

* ⁢Reduced federal Medicaid funding may pressure states ‍to⁣ cut costs, possibly targeting‍ high-cost populations ⁤like those with I/DD.
* States might restrict eligibility for optional Medicaid groups or reduce coverage of optional benefits (like⁢ home⁣ care), which would disproportionately impact people with I/DD.

4. Data‍ & Methodology:

* The analysis uses data from two⁣ sources:
⁢⁢ * T-MSIS: 2021⁣ data from the Transformed Medicaid Statistical Details System, including claims data⁢ and ⁣demographic information.
* KFF HCBS⁤ Survey: Data from a⁢ 2024 survey on Home and Community-Based services.
* I/DD diagnoses were identified using ICD-9 and ICD-10 codes ⁣defined by ⁣the Assistant Secretary for Planning and Evaluation (ASPE).

In essence, the text paints a picture of a vulnerable population with complex healthcare needs who are at risk of ⁢losing access to vital services due to potential Medicaid budget constraints.