How Many Medicaid Recipients Might Be Eligible for SSI?

Abstract

Children’s participation in the federal Supplemental Security Income (SSI) program has declined substantially over the past decade.  Many children with disabilities might be eligible for SSI, yet barriers such as a lack of knowledge of the program or perceived challenges with applying may limit participation.  In this paper, we use machine learning models on Medicaid administrative data to estimate the number and characteristics of children who are potentially eligible for SSI but do not currently receive benefits.

The paper found that:

• A substantial number of children are potentially eligible for SSI.  Depending on the exact probability used to define potential eligibility, the increase could likely range from 10 percent to 55 percent increase in enrollment (relative to the current number of SSI recipients).
• Children potentially eligible for SSI have intensive health care usage, often more intensive than current child SSI recipients.  This is particularly notable given the pattern that SSI recipients have much more intensive usage than non-SSI recipients, consistent with the requirement that SSI recipients must have a disability.

The policy implications of the findings are:

• Local-level estimates presented in this paper, which identify counties and states where many children are potentially eligible for SSI, might facilitate more effective outreach to families who are potentially eligible for SSI.  Especially when supplemented with additional data on socioeconomic deprivation, more narrowly targeting outreach to areas where many children are likely to be eligible might allow for an efficient use of limited resources.
• Creating a direct link between Medicaid and the Social Security Administration’s (SSA) data might improve the overall administration of the SSI program.  For example, SSA could use the data here to identify children who might be eligible based on their pattern of claims and conduct outreach to them.  Alternatively, the data might facilitate more streamlined disability determinations for new applications by allowing SSA to review recent patterns of health care claims.