Social Security Disability and the Affordable Care Act

With the implementation of health care reform proceeding under the Affordable Care Act (ACA), the Department of Health and Human Services (HHS) recently published a Federal Register notice of a computer match with the Social Security Administration (SSA) to obtain certain information. 78 Fed. Reg. 48170 (Aug.7, 2013).

Obtaining this information may lead to more Social Security disability beneficiaries becoming eligible for health insurance coverage, especially during the 24-month waiting period.

The ACA requires HHS to establish, among other things, a program for determining eligibility for certain Insurance Affordability Programs and an online system for verification of eligibility. The data provided by SSA to the HHS Centers for Medicare & Medicaid (CMS) will be used to make initial eligibility determinations and other eligibility determinations (e.g., appeals, renewals, redeterminations) for Insurance Affordability Programs, which include:

1. Qualified Health Plan through an Exchange established under the ACA
2. Advance payments of the premium tax credit and cost sharing reductions
3. Medicaid
4. Children’s Health Insurance Program
5. Basic Health Program

According to the notice, SSA will provide CMS with the following information when relevant, including: (1) SSN verifications; (2) indicator of finding of disability under Title II; (3) monthly and annual Social Security Title II benefit information; (4) quarters of coverage; and (5) confirmation that an allegation of citizenship is consistent with SSA records.