The Marriage Paradigm: Finding Love. Losing Eligibility.

Spring 2020 Disability RAPP: The Intersection of Disability and Sexuality

The Marriage Paradigm: Finding Love. Losing Eligibility.

By Stephanie Patrick, Executive Director of Disability Rights Center – New Hampshire

Over the past decade, marriage equality has become part of the common vernacular. Marriage is a choice for people of all races, genders, and sexual orientations. The only people routinely left out of this conversation are people with disabilities.

Living with a disability can be incredibly expensive. Many people with disabilities depend on Medicaid to access the services and supports they need every day to get dressed, eat, and take care of basic needs. These supports can cost thousands of dollars a month and are not typically covered by private insurance. Many people with disabilities who are unable to work rely on Supplemental Security Income (SSI), or Social Security Disability Income (SSDI), to cover their basic living expenses.

People with and without disabilities get married so they can formally profess their commitment to another person. People with disabilities should not be forced to contemplate divorce in order to obtain the healthcare that they need. However, marriage – or sometimes even a committed relationship – is off limits for many who depend on Medicaid, SSI, and SSDI because the joining together of income and resources can make a couple’s income and assets too high for the person with a disability to remain eligible for the services they rely on.

In New Hampshire, when only one spouse of a married couple is applying for nursing home Medicaid or a Medicaid waiver, only the income of the applicant is counted. However, this is not the case for regular Medicaid, which many people with disabilities rely on, where the income of both spouses is included towards the income limit of the applicant. Only a few assets are exempt from the asset calculations that determine eligibility for programs used by people with disabilities; depending on the specific program, only a minimal amount of cash and personal property, a vehicle, or a home may be excluded. Additionally, many of the income and asset limits used in determining eligibility are prohibitively low as they have been in place since 1989, with few adjustments for inflation.

The right of people with disabilities to marry is undermined by current policies around eligibility. People with disabilities are being forced to remain single or divorce so that they can keep the services they rely on to live. As laws are implemented to ensure marriage equality for all, policy makers need to recognize that the current eligibility calculations for Medicaid and other programs are outdated and equate to a marriage penalty for people with disabilities.

Stephanie Patrick is the Executive Director of Disability Rights Center – New Hampshire

For more NH-specific information on this topic, visit:

Spring 2020 Disability RAPP: The Intersection of Disability and Sexuality


Welcome to the newly renamed and redesigned Disability RAPP. The themes explored in each issue, like this issues’ focus on the intersection of disability and sexuality, inform us and empower us to break barriers and challenge traditional ideas of what it means to live with a disability. We updated the Disability RAPP design to be more accessible in both its print and digital formats.

Certain content contains sensitive material which may not be appropriate for all readers.

DRC-NH, in collaboration with the UNH Institute on Disability and the New Hampshire Council on Developmental Disabilities, distribute a quarterly RAP sheet to educate community members and policy makers about the latest research, policy, practice, and advocacy issues affecting individuals with disabilities and their families.


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