Paying for healthcare will become more difficult for tens of thousands of disabled Americans if the Trump administration succeeds in subjecting people receiving disability benefits to stepped-up medical scrutiny.
The plan, offered by the Social Security Administration last November, would shift 20% of the nation’s 8.5 million Social Security Disability Insurance beneficiaries into a newly created category called “medical improvement likely.” Everyone put in the category will undergo additional medical reviews over the next decade.
The SSA, already shorthanded and facing a huge backlog of disability applications, claims it will save $2.6 billion through disqualifications. Outside analysts estimate tens of thousands of people will get thrown off the rolls every year. Unless they find work that provides health insurance, they could wind up uninsured since most states put SSDI recipients on Medicaid until they qualify for Medicare.
Critics charge that SSDI, which offers financial support to people with severe mental and physical handicaps, became a disguised unemployment system over the past few decades. Enrollment spiked in the late 2000s during the Great Recession and has receded only modestly.
That role is no longer necessary as we are near full employment, they say. Citing the large share of recent enrollees who have musculoskeletal impairments, USA Today endorsed the administration’s position by editorializing “that’s a category heavy on back issues, which can be debilitating, or not so much. Millions of working Americans have back problems.”
Disability rights activists have generated over 100,000 comments opposing the rule. They cite research showing two-thirds of people denied disability benefits never return to work. Those who do see a substantial drop in income, largely because their disabilities prevent them from taking a full-time job.
They also point to a similar effort during the Reagan administration, which terminated disability benefits for over 200,000 people. Nearly two-thirds were eventually reinstated. The program was abandoned after a public uproar.
The demographics of disability reveal more than economic dislocation lies behind the rise in disability enrollment. While applications moved in lockstep with the unemployment rate over the last four decades, the initial approval rate—just 1 in 3 applicants—remained unchanged.
The aging of baby boomers and women who entered the workforce in large numbers in the 1980s played a huge role in the spike. Over the last decade, that generation moved through the stage of life when disability rates are highest. It’s now moving into retirement and onto regular Social Security, which will naturally reduce the SSDI rolls.
Still, with 11.7% of all workers between the ages of 55 and 59 and 17.3% of all workers between the ages of 60 and 66 on disability, it’s tempting to think this is a “hidden workforce” that only needs to be “incentivized” by withdrawing benefits to return to work. But geography tells a different story. The four states with the highest share of disabled workers are Alabama, Kentucky, Maine and West Virginia. The next tier includes the de-industrializing states of Michigan, Ohio and Pennsylvania and much of the Mid- and Deep South.
These are states where less-educated workers once labored in back-breaking mine and factory jobs, breathed polluted air at work, and now, as they’ve grown older, suffer from chronic conditions like body injuries, COPD and asthma that lead to permanent disability. Given that two-thirds of the disabled have a high school degree or less, finding jobs suited to their disabilities won’t be an easy task, even with full employment.
Clearly, this rule wasn’t designed to eliminate fraud in a government program. It’s part of President Donald Trump’s relentless campaign to dismantle the nation’s safety net. Ironically, it’s aimed squarely at people whom polls suggest are among his strongest supporters.
