OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
HB-6937
AN ACT CONCERNING MEDICAID COVERAGE FOR MEDICALLY
NECESSARY CHILDREN'S DIAPERS.
Primary Analyst: ES 3/17/25
Contributing Analyst(s): LD
Reviewer: RW
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 26 $ FY 27 $
Social Services, Dept. GF - Cost at least $20
million
at least $20
million
Note: GF=General Fund
Municipal Impact: None
Explanation
The bill results in a state Medicaid cost to the Department of Social
Services (DSS) of at least $20 million annually due to expanding
Medicaid coverage for medically necessary diapers for children ages
three and younger.
For context, there were approximately 69,600 children ages three and
under on Medicaid in September 2024. Based on the Medicaid fee
schedule, diapers range in cost from $0.48 to $0.70 per diaper depending
on size. For pediatric and youth sized diapers and pull-ups, coverage is
currently limited to 250 per month. The estimate assumes a percentage
of children within the relevant age group would meet the definition of
medical necessity based on the conditions specified by the bill.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to inflation.