Katie Beckett Medicaid waiver

Last updated
President Ronald Reagan meets Katie Beckett, along with her parents, Julie and Mark Beckett as the President exits Air Force One on the tarmac of Cedar Rapids Municipal Airport, Iowa, 20 September 1984. Photograph by official White House photographer Michael Evans, courtesy of the Ronald Reagan Presidential Library. Ronald-Reagan-Katie-Beckett-Cedar-Rapids-20-Sep-1984-NARA-C24412-14.tif
President Ronald Reagan meets Katie Beckett, along with her parents, Julie and Mark Beckett as the President exits Air Force One on the tarmac of Cedar Rapids Municipal Airport, Iowa, 20 September 1984. Photograph by official White House photographer Michael Evans, courtesy of the Ronald Reagan Presidential Library.

A Katie Beckett waiver or TEFRA waiver is a Medicaid waiver concerning the income eligibility for home-based Medicaid services for children under the age of nineteen. Prior to the Katie Beckett waiver, if a child with significant medical needs received treatment at home, the child's income would be deemed to include the parents' entire financial resources for the purposes of determining Medicaid eligibility. Only after a hospitalization lasting more than thirty days would the parents' income no longer be associated with the child, allowing the child to then qualify for Medicaid coverage. The effect was that many families, unable to afford home treatment, kept their children in costly hospital settings in order to meet the Medicaid 30-day requirement. Katie Beckett waivers allow Medicaid to cover medical services for children in the home, regardless of the parents' income, in cases where home-based treatment will cost less than or the same as treatment in a hospital. [1]

Contents

The waiver is named for Katie Beckett, a three-year-old who was hospitalized from infancy so she could receive ventilator assistance after a viral encephalitis infection left her partially paralyzed in a way that affected her ability to breathe. [2] When her situation came to the attention of the newly elected Reagan administration, then preparing its first budget, the administration seized the story as a way to deregulate and reduce the costs of Medicaid.

The waiver is also called a TEFRA waiver because it was passed as a provision of the Tax Equity and Fiscal Responsibility Act of 1982. Disabled people can transition to Medicaid Home and Home and Community-Based Services Waivers after age nineteen.

Background and enactment

Mary Katherine Beckett was born on 9 March 1978 in St. Luke's Hospital, Cedar Rapids, Iowa, to parents Julie and Mark Beckett. At four months, she contracted viral encephalitis. The brain inflammation put her in a coma and left her partially paralyzed in a way that affected her ability to breathe and with grand mal seizures. Her difficulty breathing required her to be on a ventilator most hours of the day.

Beckett lived until age 34, triple the age forecasted by her physicians. She died on 18 May 2012 in the same hospital in which she was born. [2]

See also

Related Research Articles

Medicaid United States social health care program for families and individuals with limited resources

Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and personal care services. The main difference between the two programs is that Medicaid covers healthcare costs for people with low incomes while Medicare provides health coverage for the elderly. There are also dual health plans for people who have both Medicaid and Medicare. The Health Insurance Association of America describes Medicaid as "a government insurance program for persons of all ages whose income and resources are insufficient to pay for health care."

Supplemental Security Income (SSI) is a means-tested program that provides cash payments to disabled children, disabled adults, and individuals aged 65 or older who are citizens or nationals of the United States. SSI was created by the Social Security Amendments of 1972 and is incorporated in Title 16 of the Social Security Act. The program is administered by the Social Security Administration (SSA) and began operations in 1974.

Tax Equity and Fiscal Responsibility Act of 1982 United States federal law

The Tax Equity and Fiscal Responsibility Act of 1982, also known as TEFRA, is a United States federal law that rescinded some of the effects of the Kemp-Roth Act passed the year before. Between summer 1981 and summer 1982, tax revenue fell by about 6% in real terms, caused by the dual effects of the economy dipping back into recession and Kemp-Roth's reduction in tax rates, and the deficit was likewise rising rapidly because of the fall in revenue, and the rise in government expenditures. The rapid rise in the budget deficit created concern among many in Congress. TEFRA was created in order to reduce the budget gap by generating revenue through closure of tax loopholes, introduction of tougher enforcement of tax rules, rescinding some of Kemp-Roth's reductions in marginal personal income tax rates that had not yet gone into effect, and raising some rates, especially corporate rates. TEFRA was introduced November 13, 1981 and was sponsored by Representative Pete Stark of California. After much deliberation, the final version was signed by President Ronald Reagan on September 3, 1982.

Long-term care Services for the elderly or those with chronic illness or disability

Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long term care is focused on individualized and coordinated services that promote independence, maximize patients' quality of life, and meet patients' needs over a period of time.

Residential care refers to long-term care given to adults or children who stay in a residential setting rather than in their own home or family home.

Baby Doe Law

The Baby Doe Law or Baby Doe Amendment is an amendment to the Child Abuse Prevention and Treatment Act of 1974, passed in 1984, that sets forth specific criteria and guidelines for the treatment of disabled newborns in the United States, regardless of the wishes of the parents.

The California Medical Assistance Program is California's Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level. Benefits include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder treatment, dental (Denti-Cal), vision, and long term care and supports. Approximately 13.3 million people were enrolled in Medi-Cal as of January 2018, or about one-third of California's population; in Tulare County and Merced County, more than 50% of county residents were enrolled as of September 2015.

The Oregon Health Plan is Oregon's state Medicaid program. It is overseen by the Oregon Health Authority.

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is the child health component of Medicaid. Federal statutes and regulations state that children under age 21 who are enrolled in Medicaid are entitled to EPSDT benefits and that States must cover a broad array of preventive and treatment services. Unlike private insurance, EPSDT is designed to address problems early, ameliorate conditions, and intervene as early as possible. For the 25 million children enrolled in Medicaid and entitled to EPSDT in 2012, the program is a vital source of coverage and a means to improve the health and well-being of beneficiaries.

Florida has several Medicaid Waiver Programs. Medicaid Waiver Programs allow recipients to 'waive' institutionalization and instead choose to direct services to assist them to live in the community. Waiver program services may offer additional supports and services than provided by traditional Medicaid.

The Missouri Department of Social Services (DSS) is a state agency of Missouri. It has its headquarters in the Broadway State Office Building in Jefferson City. The department operates the state's social services.

Welfare in Finland Overview of welfare in Finland

Social security or welfare in Finland is very comprehensive compared to what almost all other countries provide. In the late 1980s, Finland had one of the world's most advanced welfare systems, which guaranteed decent living conditions to all Finns. Since then social security has been cut back, but the system is still one of the most comprehensive in the world. Created almost entirely during the first three decades after World War II, the social security system was an outgrowth of the traditional Nordic belief that the state is not inherently hostile to the well-being of its citizens and can intervene benevolently on their behalf. According to some social historians, the basis of this belief was a relatively benign history that had allowed the gradual emergence of a free and independent peasantry in the Nordic countries and had curtailed the dominance of the nobility and the subsequent formation of a powerful right wing. Finland's history was harsher than the histories of the other Nordic countries but didn't prevent the country from following their path of social development.

This disability rights timeline lists events relating to the civil rights of people with disabilities in the United States of America, including court decisions, the passage of legislation, activists' actions, significant abuses of people with disabilities, and the founding of various organizations. Although the disability rights movement itself began in the 1960s, advocacy for the rights of people with disabilities started much earlier and continues to the present.

Mental health reform in North Carolina

The state of North Carolina is undertaking a comprehensive policy shift on how the government budgets for and manages resources for mental health, developmental disability, and substance abuse services. The 1915 (b)(c) Medicaid Waiver Program was chosen by the North Carolina Department of Health & Human Services, Division of Medical Assistance as a way to control and more accurately budget for the rising costs of Medicaid funded services. The 1915 (b)(c) Waiver Program was initially implemented at one pilot site in 2005 and evaluated for several years. Two expansion sites were then added in 2012. Full statewide implementation is expected by July 1, 2013.

Children with Special Healthcare Needs (CSHCN) are defined by the Maternal and Child Health Bureau as:

The Affordable Care Act (ACA) is divided into 10 titles and contains provisions that became effective immediately, 90 days after enactment, and six months after enactment, as well as provisions phased in through to 2020. Below are some of the key provisions of the ACA. For simplicity, the amendments in the Health Care and Education Reconciliation Act of 2010 are integrated into this timeline.

Medicaid Waiver programs help provide services to people who would otherwise be in an institution, nursing home, or hospital to receive long-term care in the community. Prior to 1991, the Federal Medicaid program paid for services only if a person lived in an institution. The approval of Federal Medicaid Waiver programs allowed states to provide services to consumers in their homes and in their communities.

Nick Dupree

Nicholas Folk Dupree was an American disability rights activist and writer. His campaign labeled "Nick's Crusade" resulted in a special program for 30 ventilator-dependent Alabamians to continue home care after they turn 21 years old.

As of 2017, approximately 1.4 million Americans live in a nursing home, two-thirds of whom rely on Medicaid to pay for their care. Residential nursing facilities receive Medicaid federal funding and approvals through a state health department. These facilities may be overseen by various types of state agency.

Julie Beckett American disability rights activist (1949–2022)

Julianne Ethel Beckett was an American teacher and disability rights activist. She lobbied for changes to Medicaid that allowed hundreds of thousands of disabled children to be cared for by their families at home. Her efforts, and those of other activists, led to the legislation and establishment of the Katie Beckett Medicaid waiver, named for her daughter Mary Katherine Beckett (1978–2012), who used a ventilator after surviving viral encephalitis in infancy. The waiver was included as a provision of the Tax Equity and Fiscal Responsibility Act of 1982.

References

  1. Smith & Moore 2015, p. 151.
  2. 1 2 Hevesi, Dennis (May 22, 2012). "Katie Beckett, Who Inspired Health Reform, Dies at 34". The New York Times. Retrieved January 6, 2019.

Bibliography