e. Definition of Dependent Child

Section 1902(xx)(9)(A)(ii)(III) of the Act provides an exclusion from the community engagement requirement for an individual who is a parent, guardian, caretaker relative, or family caregiver of a “dependent child 13 years of age and under.” In § 435.554(a), we define dependent child to mean a child 13 years of age or under who relies on another individual for care.

“Dependent child” already has a specific Medicaid definition; in developing definitions for this community engagement exclusion, we considered whether it is appropriate to apply the existing definition of dependent child, and decided it is not, for the reasons discussed below.

In 2012, we established a definition of a “dependent child” in § 435.4, [ 52 ] noting that our definition was grounded in section 1931 of the Act. (“Consistent with section 1931 of the Act, we propose Medicaid definitions of `caretaker relative' and `dependent child' at § 435.4”). [ 53 ] In implementing the mandate under subsections (a) and (b) of section 1931 of the Act to apply the eligibility requirements of the former AFDC program (as it existed on July 16, 1996) to low-income families, the definition of “dependent child” in § 435.4 incorporates each State's choice with regard to the AFDC “deprivation” requirement. A dependent child under § 435.4 must be “deprived of parental support by reason of the death, absence from the home, physical or mental incapacity, or unemployment of at least one parent, unless the State has elected in its State plan to eliminate such deprivation requirement.” When we implemented the final rule defining “caretaker relative” in 2012, we noted that many States had elected to eliminate the deprivation requirement from their definition of “dependent child,” applying only an age standard to the term. In addition, section 1902(xx)(9)(A)(ii)(III) of the Act provides an exclusion from the community engagement requirement for an individual who is a parent of a dependent child 13 years of age and under, which is in conflict with the deprivation requirement. Because section 1902(xx)(9)(A)(ii)(III) of the Act does not refer to section 1931 of the Act and is in conflict with the deprivation requirement in § 435.4, and because most States have eliminated the deprivation requirement, we decided against adopting the existing definition of dependent child at § 435.4 for purposes of section 1902(xx)(9)(A)(ii)(III) of the Act.

In establishing a definition of dependent child for purposes of exclusion from the community ( printed page 33369) engagement requirement, we also considered how “dependent” is defined as it relates to the work requirements in the SNAP program. Notably, the WFTC legislation made changes to the exemptions for the SNAP time limit work requirement that align with the exclusion established at section 1902(xx)(9)(A)(ii)(III) of the Act. Section 10102 of the WFTC legislation amended section 6(o) of the Food and Nutrition Act of 2008 to apply an exemption from the time limit work requirement to “a parent or other member of a household with responsibility for a dependent child under 14 years of age” (the exemption previously applied to those responsible for a dependent under 18 years of age). Unlike the existing definition in Medicaid, SNAP does not apply a deprivation requirement for a child 13 years of age and under to be considered a dependent.

While we determined it was not appropriate to apply the deprivation requirement to the new definition of “dependent child” at § 435.554(a) for the reasons we discuss in the preceding paragraphs, we recognize that dependent children still rely on adults for care (for example, housing, food, medical care, education, etc.). Therefore, we include a child's reliance on another individual for care in the new definition. Because most States have removed their deprivation requirement for dependent children under Medicaid and to align policy with SNAP (as was done in the WFTC legislation that aligned the age limits for dependent children for community engagement exclusions in Medicaid and time-limit work requirement exemptions in SNAP), we establish a new definition of “dependent child” at § 435.554(a) to mean a child 13 years of age or under who relies on another individual for care, and only for the purpose of determining if a person is a specified excluded individual under section 1902(xx)(9)(A)(ii)(III) of the Act.