Aging out of coverage: young adults with special health needs.

Young adults with disabilities and chronic conditions have high uninsurance rates, while Medicaid and Medicare are closed to many of them. Federal legislation to allow states to offer Medicaid to employed persons with disabilities has met with an unenthusiastic reaction thus far in the states, with few using the Medicaid options and low enrollment levels even in those states. Nevertheless, these Medicaid changes do move us toward a more basic solution: replacing employability with insurability and dependence on health interventions as the eligibility standards for public coverage for adults.