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Which states offer medical expense deductions or deductions for disabled SNAP recipients?
Executive summary
About half the states let elderly or disabled SNAP households claim a simplified or “standard” medical deduction instead of documenting every expense, and federal SNAP rules allow an excess medical expense deduction for households with an elderly or disabled member once unreimbursed costs exceed $35/month (counts only expenses beyond $35) [1] [2]. Fifteen states had USDA waivers to run standard‑deduction demonstrations historically, and advocacy groups say the standard option is underused though it can raise benefits for seniors and people with disabilities [3] [4].
1. Federal baseline: the excess medical expense deduction that applies everywhere
SNAP’s national rule is straightforward: if a household includes an elderly (60+) or disabled person, unreimbursed medical expenses for that person that exceed $35 per month can be deducted from income when calculating SNAP benefits; only expenses not paid by insurance or a third party count [2]. That federal framework establishes the floor: all states must apply the basic excess medical expense deduction for eligible households even as states may adopt different administrative approaches [2].
2. State flexibility: standard deductions vs. itemized verification
States have leeway in how they operationalize the federal rule. To reduce paperwork and encourage uptake, many states have sought and used USDA waivers to offer a standard monthly medical deduction — a fixed amount applied once a household shows at least $35 in medical costs — rather than requiring itemized verification of every expense [4] [3]. CBPP and other analysts report about half of states had set such standard monthly medical deductions to simplify claiming by elderly and disabled households [1].
3. How many states and which ones — what the record shows and what it doesn’t
Available reporting documents two concrete data points: a historic USDA waiver program covered 15 states for formal standard‑deduction demonstration projects (CBPP analysis) and about half of states now use some form of standard monthly medical deduction to simplify claiming (CBPP/analysis summaries) [3] [1]. Precise, up‑to‑date lists of which states currently apply a standard deduction are not provided in the search results you supplied; state practice varies and has changed over time as waivers and administrative choices evolved [3] [1]. Therefore: available sources do not mention a complete, current state-by-state list in this packet.
4. Examples from the states we do have reporting on
Massachusetts’ SNAP/DTA practice is a useful illustration: DTA applies a standard medical deduction ($155/month) automatically for self‑declared unreimbursed medical expenses between $35 and $190, and allows households with higher verified costs to deduct the actual amount (after the first $35) [5] [6]. California’s CalFresh guidance also documents use of a standard deduction option and references extensions of standard medical deduction waivers through 2025 — showing states both adopt and administratively extend these practices [7].
5. Why this matters: impact and underuse
Policy analysts and advocates stress the medical deduction can materially increase benefits for seniors and people with disabilities, but it’s underutilized because of verification burdens and low awareness; that’s the core rationale behind standard deductions and waiver demonstrations [4] [3]. CBPP’s materials and NCOA guidance argue that simplifying the process — for example by applying a standard amount once a household qualifies — can raise takeup and reduce administrative friction [3] [4].
6. Competing perspectives and trade‑offs
Advocates emphasize improved access and benefit adequacy when states adopt a standard medical deduction; administrative advocates say waivers reduce paperwork and verify fewer small claims [4] [3]. The countervailing concern (not detailed in these search results) typically raised in policy debates is fiscal cost and program integrity — whether a standard flat deduction over‑pays some households relative to their actual costs — but available sources in this set do not provide state fiscal estimates or a deep cost‑benefit analysis. Therefore: available sources do not mention state cost studies or comprehensive opposition arguments in this packet [4] [3].
7. Practical next steps for readers seeking state‑specific answers
If you need to know your state’s current practice, the sources imply the right steps: check your state SNAP/agency website or guidance (for example Massachusetts DTA or state CalFresh pages) and ask about a standard medical deduction or the process to claim actual excess medical expenses; federal FNS materials and state manuals explain the baseline $35 threshold and allowable expenses [2] [7] [6]. CBPP and NCOA guidance recommend asking caseworkers to apply the standard deduction if available or to document expenses to claim the full deduction when costs exceed the standard amount [4] [3].
Limitations: the search results here document program rules, examples (Massachusetts, California references) and national analyses (CBPP, NCOA) but do not include a current, authoritative state‑by‑state roster of which states are offering standard medical deductions as of late 2025; for a definitive list you must consult your state SNAP agency or recent USDA waiver notices [3] [1].