Affordable Care Act Indirectly Affects SSI

The Affordable Care Act (ACA) requires that insurance companies offer coverage to young adults with disabilities – like all young people – through their parents’ employer coverage until age 26.

So, up to this point, many adults with disabilities now have a viable way to get health services, independent of any government assistance. But at 26, that changes.

A Mathematica study finds that’s when some start applying to the federal Supplemental Security Income Program (SSI) – probably partly to gain access to Medicaid health coverage. Health insurance is critically important to people with disabilities, who often need expensive, specialized medical services. SSI’s purpose is to provide monthly cash assistance for living expenses if they lack financial resources and don’t have the work history required for federal disability insurance. SSI recipients also qualify automatically for Medicaid in a majority of states.

The researchers examined the trends in applications to SSI by people in their 20s before and after the Affordable Care Act’s 2010 passage. They found that the annual application rates among people right around their 26th birthdays have recently been 3.4 percent higher than what would be expected based on the steady pattern of overall age trends. This jump in applications at age 26 was not evident before the ACA – when people tended to lose parental insurance earlier in their 20s.

The number of SSI applications that were approved was also somewhat higher, according to the study, which was funded by the U.S. Social Security Administration.

The risk to young adults who go on SSI, the researchers said, is that they might develop a long-term dependence on the program’s cash assistance and Medicaid. And this, in turn, could discourage people with less severe disabilities from trying to work at a critical point in their lives, because SSI strictly limits how much money its recipients can earn.

One way to increase their self-reliance, the researchers said, might be to expand access to health insurance generally, including to people with disabilities, either through private or government insurance.

To read this study, authored by Michael Levere, Heinrich Hock, and Nancy Early, see “How Does Losing Health Insurance Affect Disability Claims? Evidence from the Affordable Care Act’s Dependent Care Mandate.”

The research reported herein was derived in whole or in part from research activities performed pursuant to a grant from the U.S. Social Security Administration (SSA) funded as part of the Retirement and Disability Research Consortium.  The opinions and conclusions expressed are solely those of the authors and do not represent the opinions or policy of SSA, any agency of the federal government, or Boston College.  Neither the United States Government nor any agency thereof, nor any of their employees, make any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of the contents of this report.  Reference herein to any specific commercial product, process or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply endorsement, recommendation or favoring by the United States Government or any agency thereof.