MACPAC has initiated the second phase of work focused on children and youth with special health care needs (CYSHCN) and their transitions to adult coverage. The first phase of work focused on the transition from pediatric to adult care, and MACPAC published findings and recommendations from this work in the June 2025 Report to Congress. The second phase of work examines the transition from child to adult Medicaid coverage, including the age-18 Supplemental Security Income redetermination and the transition between child-only and adult Section 1915(c) home- and community-based services (HCBS) waivers.
In this session, staff provided an overview of CYSHCN-relevant Medicaid eligibility pathways and how they can receive HCBS. Then, it described key findings from the federal and state policy scan and how these policies apply to the processes of transitioning to adult Medicaid and transitioning between child-only and adult Section 1915(c) HCBS waivers.