What Happened?

Some adults with disabilities could lose their health coverage because of how two federal benefit programs interact. The Congressional Research Service (CRS), the nonpartisan research arm of Congress, examined this coverage gap in a report published this month. ​

Disabled adult child (DAC) benefits are Social Security payments for adults 18 or older whose qualifying disabilities began before age 22, based on a parent's work record. Because DAC benefits reduce Supplemental Security Income (SSI) payments dollar for dollar, receiving them can push a person's SSI payment to zero, ending both the cash benefit and SSI-based Medicaid.

A protection called the "DAC passalong," established in 1986, requires states to keep Medicaid for people who lose SSI because they became entitled to DAC benefits. That protection applies only to people who were already receiving SSI when their DAC benefits began.

Why Does it Matter to Me?

In May 2026, about 1.2 million people received DAC benefits, representing 1.7 percent of all Social Security beneficiaries, with an average monthly benefit of $1,105.

The passalong protects only people who were already receiving SSI when their DAC benefits began, so a person with a disability who was not enrolled in SSI beforehand gets no such protection.

Rep. Debbie Dingell (D-MI) introduced a bill that would extend Medicaid to all Social Security child beneficiaries with qualifying disabilities who would be SSI-eligible if not for those benefits. The bill would amend the Social Security Act to treat certain people receiving child's insurance benefits as receiving Supplemental Security Income (SSI) for determining Medicaid eligibility.

Both Sides, Now

Supporters of expanding the passalong argue that current law denies Medicaid to people with disabilities because of circumstances beyond their control, such as the timing of a parent's death.

Opponents argue the passalong was designed to bridge a specific gap for people who already had Medicaid and faced a 24-month Medicare wait, not to create new coverage for people never enrolled in SSI or Medicaid beforehand. The CRS illustrates this with a hypothetical pair of siblings: the one who was not receiving SSI before DAC benefits began would not qualify for the passalong and would face that wait with no Medicaid coverage.

The CRS report frames the question as one for Congress to decide and does not recommend a position.

What Happens Next?

The bill remains at the introduced stage after being referred to the House Committee on Ways and Means and the Committee on Energy and Commerce on July 22.

The unresolved question is whether Congress will act to close the gap, and for how many people that gap actually exists.

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