Why It Matters

Some adults with disabilities who would otherwise qualify for Supplemental Security Income (SSI) can lose access to SSI-based Medicaid because of the way Social Security's disabled adult child (DAC) benefits interact with SSI eligibility, according to a new Congressional Research Service (CRS) report. ​

Under current law, states must generally continue Medicaid coverage for people who lose SSI because they become entitled to DAC benefits, a protection known as the "DAC passalong." That protection applies only to people who were already receiving SSI when their DAC benefits began.

Some policymakers have expressed interest in extending the passalong to DAC recipients who were not enrolled in SSI beforehand but would otherwise be SSI-eligible. The report frames this as a question for Congress and does not recommend a position.

The Big Picture

DAC benefits are Social Security auxiliary payments for adults 18 or older whose qualifying disabilities began before age 22, based on a parent's work record. Because DAC benefits reduce SSI payments dollar for dollar, entitlement to them can push a recipient's SSI payment to zero, ending both the cash benefit and SSI-based Medicaid.

The DAC passalong was established in 1986 as part of the Employment Opportunities for Disabled Americans Act (P.L. 99-643). Some Members of Congress at the time expressed concern that people losing SSI due to DAC entitlement faced an immediate loss of Medicaid but had to wait 24 months before qualifying for Medicare.

In May 2026, there were about 1.2 million DAC beneficiaries, representing 1.7% of all Social Security beneficiaries, with an average monthly benefit of $1,105.

Proponents of expanding the passalong argue that current law denies Medicaid to people with disabilities because of circumstances that may be beyond their control, such as the timing of a parent's death. Others argue the passalong was designed to bridge a coverage gap for people who lost Medicaid and had to wait for Medicare, and that there is no need to extend it to people who were not receiving coverage to begin with.

H.R. 9846, introduced by Rep. Debbie Dingell (D-MI) in the 119th Congress, would extend Medicaid to all Social Security child beneficiaries with qualifying disabilities who would be SSI-eligible absent those benefits. The bill was referred to the House Committee on Ways and Means and the Committee on Energy and Commerce on July 22 and remains at the introduced stage.

The Bottom Line

No public data are available on how many DAC beneficiaries currently qualify for the passalong, leaving the scale of the eligibility gap unquantified.

Access the Legis1 platform for comprehensive political news, data, and insights

Spot something wrong? Report an issue with this article