Supplemental Security Income Recipients Research Articles

Supplemental Nutrition Assistance Program and food expenditures: Evaluating California's cash‐out policy

AbstractThis paper investigates how Supplemental Nutrition Assistance Program (SNAP) eligibility affects food expenditures. A 2019 policy change in California granted SNAP eligibility to previously ineligible Supplemental Security Income (SSI) recipients. Using the Consumer Expenditure Survey, we find that after the policy change, affected SSI recipients increased their “food at home” budget share between 2.5 and 4.3 percentage points ($120 to $206 per quarter). The SNAP effect on total food expenditures is dampened by a decrease in “food away from home” which SNAP benefits cannot be spent on.

ABLE account use among supplemental security income recipients

BACKGROUND: The Stephen Beck Jr. Achieving a Better Life Experience Act of 2014 (ABLE Act) authorized state-administered tax-preferred savings programs for individuals with a disability called ABLE accounts. OBJECTIVE: Examine ABLE account participation rates and amounts held by Supplemental Security Income (SSI) recipients who are eligible for ABLE accounts and use the findings to identify methods to improve ABLE account participation. METHODS: Descriptive analysis using Social Security program data on the population of SSI recipients eligible for ABLE accounts to quantify: the prevalence of ABLE account use; participation rates among those eligible for ABLE accounts by demographic and socio-economic characteristics, state of residence, and state-level tax incentives; and amounts accumulated in ABLE accounts. RESULTS: As of December 2021, 36,610 SSI recipients owned ABLE accounts with a median value of $3,222, and the participation rate is 1.1 percent among SSI recipients whose disability occurred before age 26. We document substantial differences in participation rates by demographic and socioeconomic characteristics, across states, and by the availability of state-level tax incentives. CONCLUSION: ABLE account use among SSI recipients is relatively low. Differences in participation rates indicate that evidence-based methods to increase participation can improve savings and economic well-being.

Nudging Timely Wage Reporting: Field Experimental Evidence from the U.S. Supplemental Security Income Program

We study a large-scale (n = 50,000) natural field experiment implemented by the U.S. Social Security Administration aimed at increasing the timely and accurate self-reporting of wages by Supplemental Security Income (SSI) recipients. A letter reminding SSI recipients of their wage reporting responsibilities significantly increased both the likelihood of reporting any earnings and the total earnings reported. However, the specific letter content—providing social information or highlighting the salience of penalties—had no systematic effect. We develop a conservative estimate that the letters generated roughly $5.91 in savings per dollar spent, highlighting the value of such a nudge in this important context. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2022.4645 .

"Now I Feel a Little Bit More Secure": The Impact of SNAP Enrollment on Older Adult SSI Recipients.

In June 2019, California expanded Supplemental Nutrition Assistance Program (SNAP) eligibility to Supplemental Security Income (SSI) beneficiaries for the first time. This research assesses the experience and impact of new SNAP enrollment among older adult SSI recipients, a population characterized by social and economic precarity. We conducted semi-structured, in-depth interviews with 20 SNAP participants to explore their experiences with new SNAP benefits. Following initial coding, member-check groups allowed for participants to provide feedback on preliminary data analysis. Findings demonstrate that SNAP enrollment improved participants’ access to nutritious foods of their choice, contributed to overall budgets, eased mental distress resulting from poverty, and reduced labor spent accessing food. For some participants, SNAP benefit amounts were too low to make any noticeable impact. For many participants, SNAP receipt was associated with stigma, which some considered to be a social “cost” of poverty. Increased benefit may be derived from pairing SNAP with other public benefits. Together, the impacts of and barriers to effective use of SNAP benefits gleaned from this study deepen our understanding of individual- and neighborhood-level factors driving health inequities among low-income, disabled people experiencing food insecurity and SNAP recipients.

Pursuing Graduation: Differences in Work Experience Supports for Young SSI Recipients Pursuing Diplomas or Certificates

Students with Individualized Education Programs (IEPs) or Section 504 Plans may earn a diploma or a certificate of completion when leaving secondary education. This study examined differences in career- and work-based learning services and work experiences of students who earned a high school diploma or a certificate of completion upon exiting high school. Case service data of 969 students with disabilities were analyzed. Results suggested groups differed in the number and types of career- and work-based services, work experiences, post-high school expectations, and work-related concerns expressed by parents. Differences between groups were observed by types of career and work experiences. Significantly greater proportions of diploma-earners expressed expectations to work and attend college. Parents of both groups expressed concerns about their youth losing Supplemental Security Income (SSI) benefits and about their youths’ safety and ability to work independently. Limitations and implications for research, policy, and practice are provided.

SSI Youth and Family Case Management: A Taxonomy of Critical Factors, Competencies, and Translation to Practice

Youth who receive Supplemental Security Income (SSI) benefits experience disparate educational, employment, and economic outcomes when compared to youth with disabilities who do not receive these entitlements. Promoting the Readiness of Minors in Supplemental Security Income (PROMISE) was a 6-year national research demonstration project that designed, implemented, and evaluated interventions that led to more successful postschool outcomes for youth SSI recipients ages 14 to 16. Although prior research demonstrations have been conducted testing the combination of case management with other services and supports with SSI populations, research on the taxonomy of those case management strategies considered most effective in supporting positive postschool outcomes is very limited. This article presents a comprehensive taxonomy of case management that provides a common frame of reference for future research on effective case management strategies and translation to practice by discussing implications for policy, practice, and further research when supporting successful postschool outcomes of youth SSI recipients.

Evaluating the Effect of Work Incentives Benefits Counseling on Employment Outcomes of Transition-Age and Young Adult Supplemental Security Income Recipients with Intellectual Disabilities: A Case Control Study.

Purpose Work incentives benefits counseling (WIBC) can be a strong facilitator contributing to improved employment outcomes for individuals with intellectual disabilities (ID) by providing information about how income may affect disability benefits eligibility. The purpose of this study is to evaluate the effect of WIBC as a VR intervention to improve on employment outcomes and earnings of transition-age youth and young adults with ID who are Supplemental Security Income benefits recipients using a propensity score matching analysis approach. Propensity score matching using logistic regression analysis and the nearest neighbour method was conducted to equalize the treatment (received WIBC) and control groups (not received WIBC) on the six prominent demographic covariates. The treatment group had higher rates of employment, higher hourly wages than the control group, while the treatment group worked less hours per week than the control group. Methods Propensity score matching using logistic regression analysis and the nearest neighbour method was conducted to equalize the treatment (received WIBC) and control groups (not received WIBC) on the six prominent demographic covariates. Results The treatment group had higher rates of employment, higher hourly wages than the control group, while the treatment group worked less hours per week than the control group. Conclusions Findings of the present study can be used by policy makers, transition specialists, rehabilitation counselors, and other disability service providers to increase employment outcomes and earnings for individuals with ID through WIBC services. Future research and practice implications are provided.

Federalizing benefits: The introduction of Supplemental Security Income and the size of the safety net

In 1974, Supplemental Security Income (SSI) federalized cash welfare programs for the elderly, blind, and individuals with disabilities, imposing a national minimum benefit, and differentially raising payment levels in states that paid below its benefit floor. We show that this increased disability participation, but shrank non-disability cash transfer programs. For every four new SSI recipients, three came from other welfare programs. Each dollar of per capita SSI income increased total per capita transfer income by just over 50 cents. Federalizing part of a patchwork safety net need not increase redistribution by as much as traditional models of fiscal federalism suggest.

Nudging Timely Wage Reporting: Field Experimental Evidence from the United States Social Supplementary Income Program

We study a large-scale (n=50,000) natural field experiment implemented by the U.S. Social Security Administration that was aimed at increasing the timely and accurate self-reporting of wages by Supplemental Security Income (SSI) recipients. Sending a letter reminding SSI recipients of their wage reporting responsibilities significantly increased both the likelihood of reporting any earnings and the total amount of earnings reported, though this effect decays slightly over time. However, the specific letter content—providing social information or highlighting the salience of penalties—had no systematic effect. We develop a conservative estimate that the letters generated roughly $5.91 in savings on average per dollar spent for the U.S. government. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

When One Size Does Not Fit All: Modernizing the Supplemental Security Income Program

The federal Supplemental Security Income (SSI) program is an important part of the safety net in the United States, paying means-tested benefits to children with disabilities, nonelderly adults with disabilities, and elderly individuals. In this article, we describe the eligibility criteria for the program, how these have changed over time, and the impact of these changes on SSI enrollment. We also show that over time, SSI has grown to serve a heterogenous population, with an array of life experiences and needs. In this context, we discuss potential reforms intended to modernize the program and increase its ability to achieve its goals. These include a proposal to raise the generosity of benefits for elderly SSI recipients, increase the incentive to work among nonelderly adult SSI recipients, and harmonize disability decision-making across medical examiners and administrative law judges.

CaPromise: Training interventions for parents and guardians of young recipients of Supplemental Security Income

CaPromise: Training interventions for parents and guardians of young recipients of Supplemental Security Income

Career and work-based learning interventions for young recipients of Supplemental Security Income

Career and work-based learning interventions for young recipients of Supplemental Security Income

Contemporaneous and long-term effects of children’s public health insurance expansions on Supplemental Security Income participation

This study explores the interplay between two important public programs for vulnerable children: Medicaid and the Supplemental Security Income (SSI) program. Children’s public health insurance eligibility increased dramatically during the late 1990s with the launch of the Children’s Health Insurance Program along with concurrent Medicaid expansions. We use a measure of simulated eligibility as an exogenous source of variation in Medicaid generosity to identify the effects of the eligibility expansions on SSI outcomes. Though increases in eligibility for public health insurance did not affect contemporaneous youth SSI applications or awards on average, expansions in coverage significantly decreased both applications and awards in states where SSI recipients did not automatically receive Medicaid. We attribute the difference in findings to the higher transactions costs associated with entering Medicaid via SSI in such states. In the long-term, increased public insurance eligibility during childhood reduces young adult SSI applications to some extent, consistent with recent findings that Medicaid coverage in youth improves adult health and economic outcomes.

Supplemental Security Income and the Transition to Adulthood in the United States: State Variations in Outcomes Following the Age-18 Redetermination

AbstractPolicy makers have raised concerns about the outcomes of former child Supplemental Security Income (SSI) recipients following the redetermination of eligibility at age 18 using an adult disability definition. We use Social Security administrative data to track state-level benefit receipt and employment outcomes of all former child SSI recipients who received an age-18 redetermination from 1998 through 2006, through age 24. We find that (1) state cessation rates ranged from 20 to 47 percent, (2) ceased recipients had higher employment rates and lower rates of SSI receipt than continued recipients, and (3) continued recipients who lived in states with higher employment rates also had higher Disability Insurance benefit receipt rates than those who lived in states with lower employment rates. The findings raise questions about the state-level variation in SSI’s role in the overall safety net and the variations in options available to former child SSI recipients following the age-18 redetermination.

State-to-State Variation in SSI Enrollment for Children With Mental Disabilities: An Administrative and Ethical Challenge.

The study examined state variation in rates of Supplemental Security Income (SSI) determinations, allowances, and receipt of benefits for ten selected child mental disabilities in 2013. SSI administrative and U.S. Census Bureau data collected by a multidisciplinary consensus committee convened by the National Academies of Science, Engineering, and Medicine in 2015 were examined. Less than 1% of children in 2013 were recipients of SSI for mental disabilities. Determination rates ranged from 1,441 to 251 per 100,000 low-income children, an almost sixfold difference. Allowance rates varied from 16% to 78%, a fivefold difference. Receipt of benefits ranged from .7% to 5.3%, a sevenfold difference. Large unexplained discrepancies across states were found in review and receipt of SSI benefits for low-income children with mental disabilities. Inequities that cannot be explained by disability severity or financial need violate the ethos of equitable access to federally entitled services.

Representativeness of the Low-Income Population in the Health and Retirement Study with Supplementary Analyses for 1991 and 1997

We study to what extent the Health and Retirement Study (HRS) is representative of all income groups, but with a particular emphasis on low-income groups. To focus on the HRS sample composition and abstract from potential measurement issues associated with measures of income and program participation, we exploit the SSA administrative data matched to the HRS sample and compare their distribution against the distribution of the same variables for the same population in the SSA databases. We find that overall, for cohorts and years that can be most reliably compared, the distributions are very similar and conclude that the HRS is representative for the population it covers. However, for some subgroups in the low-income population (e.g., recipients of Supplemental Security Income, Medicaid beneficiaries), there are some differences and thus we caution against estimating population totals for such small subpopulations. The HRS samples for which restricted matched administrative data are available are often not representative of a broad population of interest, because not all HRS respondents were asked permission to match in any given year. Therefore, the restricted HRS datafiles are generally not suitable for estimating population distributions, although they are still very useful for modeling purposes.

Representativeness of the Low-Income Population in the Health and Retirement Study

We study to what extent the Health and Retirement Study (HRS) is representative of all income groups, but with a particular emphasis on low-income groups. To focus on the HRS sample composition and abstract from potential measurement issues associated with measures of income and program participation, we exploit the SSA administrative data matched to the HRS sample and compare their distribution against the distribution of the same variables for the same population in the SSA databases. We find that overall, for cohorts and years that can be most reliably compared, the distributions are very similar and conclude that the HRS is representative for the population it covers. However, for some subgroups in the low-income population (e.g., recipients of Supplemental Security Income, Medicaid beneficiaries), there are some differences and thus we caution against estimating population totals for such small sub-populations. The HRS samples for which restricted matched administrative data are available are often not representative of a broad population of interest, because not all HRS respondents were asked permission to match in any given year. Therefore, the restricted HRS data-files are generally not suitable for estimating population distributions, although they are still very useful for modeling purposes.

Cognition and Take-up of Subsidized Drug Benefits by Medicare Beneficiaries

Take-up of the Medicare Part D low-income subsidy (LIS) by eligible beneficiaries has been low despite the attractive drug coverage it offers at no cost to beneficiaries and outreach efforts by the Social Security Administration. To examine the role of beneficiaries' cognitive abilities in explaining this puzzle. Analysis of survey data from the nationally representative Health and Retirement Study. Elderly Medicare beneficiaries who were likely eligible for the LIS, excluding Medicaid and Supplemental Security Income recipients who automatically receive the subsidy without applying. Using survey assessments of overall cognition and numeracy from 2006 to 2010, we examined how cognitive abilities were associated with self-reported Part D enrollment, awareness of the LIS, and application for the LIS. We also compared out-of-pocket drug spending and premium costs between LIS-eligible beneficiaries who did and did not report receipt of the LIS. Analyses were adjusted for sociodemographic characteristics, household income and assets, health status, and presence of chronic conditions. Compared with LIS-eligible beneficiaries in the top quartile of overall cognition, those in the bottom quartile were significantly less likely to report Part D enrollment (adjusted rate, 63.5% vs 52.0%; P = .002), LIS awareness (58.3% vs 33.3%; P = .001), and LIS application (25.5% vs 12.7%; P < .001). Lower numeracy was also associated with lower rates of Part D enrollment (P = .03) and LIS application (P = .002). Reported receipt of the LIS was associated with significantly lower annual out-of-pocket drug spending (adjusted mean difference, -$256; P = .02) and premium costs (-$273; P = .02). Among Medicare beneficiaries likely eligible for the Part D LIS, poorer cognition and numeracy were associated with lower reported take-up. Current educational and outreach efforts encouraging LIS applications may not be sufficient for beneficiaries with limited abilities to process and respond to information. Additional policies may be needed to extend the financial protection conferred by the LIS to all eligible seniors.

English

n December 7, 2012, Nicholas Kristof, two-time Pulitzer Prize winning journalist, wrote a compelling article about people in poverty in the United States. The article, which appeared in the New York Times, describes the plight of young children who are failing in school and who are not acquiring the skills needed to move forward in their education, and tragically, in some cases, parents are allowing them to fail. It is their children’s illiteracy that enables the parents to receive Supplemental Security Income (SSI) payments from the government. These payments, meant for supporting families of children with severe functional limitations, are funds that the family uses to survive. The parents were most likely members of an educational system that failed them as well, leaving them without the academicbased life skills needed to get better paying jobs. And so a vicious cycle results with far-reaching consequences, including an abysmal education, unemployment, poorer health, and inadequate healthcare. Solutions to breaking this cycle seem impossible, but we cannot accept failure and give up. Solutions will begin with small steps, which is how every journey begins. And confidence must be drawn from what Mark Twain once said: ‘They didn’t know it was impossible, so they did it.’ Ruffing and Pavetti criticize Kristof’s article, stating that his information on SSI ‘should be rooted in facts and data, not impressions, misimpressions, and anecdotes,’ and go on to iterate, ‘This is not to say no such incidents occur, or that all families take full advantage of supplemental literacy or tutoring programs that may be available (though not always accessible) to them.’ But they would prefer commentary based on ‘actual research’ versus ‘anecdotal stories.’ Kristof, never averse to raising the specter of social problems of the minority, leaves the conducting and analyzing of research to the academics and think tanks. However, he does, in fact, cite research he believes supports his claims. A 2011 report from the Committee on Ways and Means found that four decades ago, approximately 1% of poor children had support from the SSI payment system. A 2012 report from the Social Security Administration cited that 8% of children in poverty today are enrolled in SSI. This increase in SSI support correlates with less stringent eligibility requirements for families in the program and ends up with the majority of beneficiaries transitioning into SSI in adulthood and the others being largely unprepared for life without SSI. Of significance is a finding by DeCesaro and Hemmeter. ‘The choice to return to work might be especially difficult for many child SSI recipients who have unmet health needs and fear losing future access to health benefits through Medicaid’. Save the Children is taking steps to improve literacy by striving to find answers for children whose poverty has affected their education. Save the Children is a non-profit organization dedicated to helping children both in the United States and around the world. They respond to emergency situations, where medical aid, shelter, and other relief are needed, and they also administer strategic programs to improve the education of children. They posit that ‘Education is the road that children follow to reach their full potential in life’. They have initiated education projects training teachers in the use of more effective teaching strategies, offering ways for volunteers to get children to read and do math outside of school hours, and promoting the power of artistic expression to help children heal, learn, and do better in school. In the United States, they are working in poverty-stricken areas, teaching parenting skills and providing parents with their greatest need hope. Kristof is getting the message out, believing that helping struggling children should be a national priority. He contends, ‘They’re too small to fail.’ The implications of illiteracy factor into all facets of a person’s life, including their healthcare. People require health literacy, which is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Individuals with literacy problems are unable to take full advantage of healthcare services. Weir cogently delineates the literacy spectrum and offers a reflection:

Federal Report Probes Increased Demand for Services

Federal Report Probes Increased Demand for Services