10/16/2026
Told your income is too high for your autistic child to get Medicaid? This is the rule most families never hear about, and it started with one little girl in 1981.
Katie Beckett caught viral encephalitis at five months old and needed a ventilator to breathe. Medicaid would only pay for her care if she stayed in hospital, so she spent most of her first three years in an Iowa hospital room, even though caring for her at home cost about a sixth as much. Her mother, Julie, fought it. Just before Christmas 1981, the federal rule was changed so Katie could go home.
In 1982 it became law. States can now cover a disabled child’s care at home “without regard to parental income or resources.”
By 2012, more than half a million children had received care at home this way.
Here’s where autistic children come in. Many states run a Katie Beckett or TEFRA program, and autistic children can qualify. Georgia’s program manual names autism and autism spectrum disorder in its eligibility assessments. In South Carolina, a child must:
✅ Be 18 or under
✅ Meet the Social Security definition of disability
✅ Need a level of care usually given in a hospital, nursing facility or intermediate care facility
Only the child’s own income counts, and children who qualify get full Medicaid coverage alongside your private insurance.
It’s not automatic and not every state offers it, but if your child has high support needs, it’s worth one search: “[your state] Katie Beckett” or “[your state] TEFRA.”
📰: NPR; Medicaid.gov; Georgia Department of Community Health; South Carolina DHHS
