Definitions of Disability, Current Federal Standards and Implications of Reform for Medical Coverage

This Resource Paper examines the concept of disability across various fields of public policy and assesses the extent to which the Medicaid definition--borrowed from Social Security Act ('SSA') income replacement programs--merits reexamination in light of the evolution in thinking on matters of public policy and persons with disabilities. While Medicaid's definition might possibly continue to have some validity in the context of income replacement for adults (or in the case of children, their families and caregivers) whose disabilities are so extensive as to preclude the normal life activities of
work and education, and while recent efforts to broaden Medicaid's reach in a disability context show promise, this paper concludes that a more fundamental examination of the meaning of disability in a Medicaid context is warranted.

This analysis begins with a Background and Overview section which examines the SSA's definition of disability (which guides Medicaid policy), as well as Medicaid options under which states can alter this definition. It then examines disability definitions drawn from a range of social welfare programs and assesses these definitions against the essential elements of the ADA. The analysis concludes with a discussion of the implications of revising the concept of disability under Medicaid. (Excerpted from report).