Between the two programs, nearly 16 million Americans received disability checks in 2013, according to the SSA. There has been criticism about the growth of the programs and their impact on the federal budget.
Federal spending on the SSI program in 2013 totaled $53.4 billion, up from $51.7 billion in 2012, according to the SSA. State expenditures for SSI have held steady at $3.3 billion for the last few years.
Federal law generally requires states to extend Medicaid to SSI recipients. But the law allows states to establish different eligibility requirements than the SSI disability program has. There are 11 states were people need to apply separately for SSI and Medicaid, and where they may be found eligible for one program but not the other. These states include Connecticut, Hawaii, Illinois, Indiana, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, and Virginia.
But since most states had automatic eligibility, childless adults often have used SSI as a gateway to Medicaid coverage. “It's long been thought that some applicants to SSI are more interested in Medicaid eligibility, but they apply to SSI as one sure way into Medicaid,” said Elizabeth Powers, an associate professor of economics at the University of Illinois. “Medicaid (is) the program they're really most interested in not SSI,” she said.
That's why she thinks the Medicaid expansion may have contributed to the drop in SSI claims.
“It's certainly plausible that expansion of public health insurance would reduce applications for SSI,” said David Autor, an economics professor at Massachusetts Institute of Technology. “People turn to SSI when they are desperate—no work, no income, no insurance. If Medicaid takes care of their medical costs, they may be able to continue seeking work or working at low wages.”
“A healthier worker is more capable of remaining in the workforce,” said Rob Jones, executive director of Community Action Kentucky, an anti-poverty advocacy organization.
But others, particularly those who oppose the Affordable Care Act, say the drop in SSI claims from the first six months of 2013 to the first six months of this year had nothing to do with Medicaid expansion. “More salient might be the economy's growth rates during 2013 and 2014 and the decline in unemployment,” said Jagadeesh Gokhale, a senior fellow with the libertarian Cato Institute, which opposes the reform law. “Recall that economic growth was considerably more anemic during 2013, especially during the first quarter, compared to 2014.”
Some experts cautioned that the drop in SSI claims would have to continue for several years at a greater pace in expansion states than non-expansion states to demonstrate that Medicaid expansion was the likely cause of the decline.
Arkansas State Sen. Jonathan Dismang, a Republican who supported Medicaid expansion, said he and his colleagues had hoped that expanding Medicaid would reduce the number of people in the SSI program. “It's too early to say with any certainty that that's the case,” he said. “I think that there's an indication that there has been an impact.”
—with Rachel Landen and Paul Demko
Follow Virgil Dickson on Twitter: @MHVDickson