BEYOND THE NUMBERS
Speaking at today’s release of recommendations by the SSDI (Social Security Disability Insurance) Solutions Initiative, I explained that while policymakers should continue exploring ways to help people with disabilities stay at or return to work, successful interventions won’t be easy, quick, or cheap. (For more on these points, see my recent paper.)
It won’t be easy. The Social Security Administration (SSA) has conducted many work-incentive experiments on beneficiaries over the past 25 years, and none has led to a significant number of beneficiaries earning enough to support themselves and leave DI. That’s no surprise: DI eligibility is strict, and the rules are designed to weed out applicants who could support themselves through work. Beneficiaries suffer from poor health and functional limitations, which are their main barriers to work — not Social Security rules.
The most promising way to encourage work may be to intervene early enough to help people stay at their jobs or return quickly to the workforce, rather than to help current beneficiaries get off the program. But doing so is complicated. Reaching current workers requires coordination with government agencies at all levels, employers, and health care providers.
It won’t be quick. A good experiment takes years to design, conduct, and evaluate; most of SSA’s DI work demonstrations have taken at least seven years. Last fall’s bipartisan budget agreement, which renews SSA’s authority to conduct demonstrations, extends the DI trust fund’s solvency only into 2022. SSA probably can’t fully evaluate any groundbreaking ideas in the next six years.
Though early intervention is a promising approach, for example, it isn’t a fast fix. The earlier you intervene, the wider the net you must cast, which will include many people who would never have qualified for benefits. Identifying the right set of beneficiaries and tailoring appropriate interventions for very diverse needs will take time. Following up on demonstration participants will also take time — but it’s necessary to find out whether people apply for DI down the road.
It won’t be cheap. While the SSDI Solutions Initiative has explored ideas to strengthen DI and improve the lives of people with disabilities more generally, many lawmakers mainly want to cut costs. But interventions cost money. Any savings are highly uncertain and would only materialize in the long term.
Some hope to save money by getting large numbers of beneficiaries to work their way off DI and shrink the program. SSA’s past demonstrations, and the experience of the many experts who consulted with this project, suggest that such dramatic impacts are highly unlikely.
We can do much more to support workers with disabilities long before they apply for DI, but it costs money. Expanding Medicaid in those states that haven’t yet done so would improve access to needed health care and ease the financial burden of disability. Improving access to the long-term services and supports that many people with disabilities need in order to work could help some of them rise above poverty. Boosting the Earned Income Tax Credit, particularly for childless workers, could benefit workers with disabilities. Other possibilities outside Social Security are adequately funding vocational rehabilitation, creating subsidized employment opportunities, and updating the asset limits in Supplemental Security Income, Medicaid, and other public programs.