Word From Washington: Pandemic Unemployment Compensation, Supplement Security Income & Medicaid

HFA has received several questions regarding whether the enhanced unemployment benefits that the federal government provides during the national coronavirus emergency could adversely impact people who have Medicaid coverage by virtue of the fact that they receive disability benefits under the Supplemental Security Income (SSI) program.

SSI recipients are allowed to work in limited situations.  If they have worked enough to be eligible for standard unemployment in their state, they will also be eligible for the Pandemic Unemployment Compensation (PUC) created by Congress under the second of the two relief bills, the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

PUC provides a very generous $600/week boost to state unemployment benefits.   However, because unemployment benefits are considered “unearned income” under SSI rules, accepting PUC will put SSI recipients above the $803/month unearned income limit and cause them to no longer be eligible for the SSI cash benefit, at least until the PUC expires on July 31st.

The most recent information received by HFA indicates that SSI recipients will not lose their Medicaid coverage, at least for the duration of the emergency (currently slated to extend into late October).  This is based on Centers for Medicare and Medicaid Services guidance last updated April 13th. The CMS guidance makes clear: states that accept the enhanced federal Medicaid matching funds that Congress provided under the Families First Coronavirus Response Act may “not terminate individuals from Medicaid if such individuals were enrolled in the program as of the date of the beginning of the emergency period [March 18th].” This is true even if the individuals otherwise “lose receipt of benefits that may affect their [Medicaid] eligibility (e.g., SSI)“.  In short, a state that accepts enhanced federal Medicaid funding cannot cut anyone off of Medicaid for the duration of the emergency. (HFA is not aware of any state that has refused this extra Medicaid funding.)

By contrast, SSI recipients who receive PUC are likely to have their SSI cash benefits suspended as a result of accepting the temporary PUC benefit (though again, this will not result in the loss of their Medicaid coverage). But the Social Security Administration’s Red Book makes clear that SSI recipients who lose their eligibility due to work can have their cash benefit reinstated at any time once they again become eligible, without the need for a new application (see pg. 39). However, reinstatement is not automatic and depends on each individual’s situation.  As a result, SSI recipientsmay wish to consult with an attorney experienced in federal disability prior to deciding whether to accept the PUC benefit. (As a reminder, the ACCESS Program provides legal advice on such issues at no cost to members of the bleeding disorders community.)

Please contact Miriam Goldstein (m.goldstein@hemophiliafed.org) or Mark Hobraczk (m.hobraczk@hemophiliafed.org) for any additional information regarding the impact that federal coronavirus relief legislation may have upon SSI recipients with bleeding disorders.