Health-related unmet needs after age 18

After the age-18 medical redetermination of Supplemental Security Income (SSI) eligibility, most youth with disabilities who exit SSI lose access to medical care. This paper compares the health-related unmet needs of those who exit to those who remain on SSI after age 18 using a nationally-representative survey of youth who received SSI, the National Survey of SSI Children and Families. Youth who exit SSI are almost twice as likely to have health-related unmet needs as those who remain on SSI after age 18. Access to care, particularly insurance coverage (Medicaid or non-Medicaid), accounts for much of the difference between these two groups; measures of health status have little effect on the presence of unmet needs. However, even controlling for insurance coverage, there remains a large difference in the prevalence of health-related unmet needs. This is especially true for prescription drug unmet needs, for which the gap between youth ineligible for and eligible for SSI remains 12 percentage points. These results support the need for transition-related health planning for youth on the verge of adulthood in the SSI population.