Millions of Americans drawing thousand-dollar monthly payments from the federal government under Social Security's disability program — and sitting out of the workforce, which is a requirement to get the benefit — may have only signed up because a finding of disability also provides Medicare or Medicaid, which they need to pay doctors' bills.
Having medical issues that demand expensive treatment but still perfectly capable of working, many little-educated people weighed a $1,500-a-month job flipping burgers with no health insurance against $1,000-a-month-plus-free-health insurance for going on disability and chose the latter.
But if burger-flippers can now get affordable insurance under the Affordable Care Act, that arithmetic changes.
It’s an Obamacare success, but one that also should open the door for reducing the disability rolls — if the administration will acknowledge that the benefits of its signature legislation mean that parts of other troubled safety-net programs are now duplicative and wasteful.
For decades, poor people with medical problems have been incentivized to leave the workforce and stay on the dole for life. The disability program has, in turn, grown at an astonishing pace and is on track to go bankrupt in only two years.
“Would a person take a moderate-income job with no health benefits, or would they look at the health benefits and say, ‘I’ll just go on disability instead?’ If it’s easy for people to get health benefits in the future, it might reduce that appeal,” said Chris Edwards of the Cato Institute.
The Social Security Advisory Board has pointed to the lack of access to health insurance as a roadblock to reforming disability’s excesses: “Any valid model of a national system to encourage individuals to view work as a viable alternative to benefit dependency must find an effective way to address the need to access adequate and secure health insurance,” it wrote.
In other words, by providing less than most European countries in the way of universal health care, the U.S. inadvertently provided far more than was needed — and at much greater cost — to a subset of the population.
As of this month's rollout of the health care act, millions of poor who were previously only eligible for government-paid insurance if they were found totally disabled will now be eligible based on their income alone.
A Washington Examiner analysis of an SSA survey of disability benefits found that 17 percent of poor disability recipients said they're not working because they don't want to lose benefits such as Medicaid. One in five who are looking for a job say they can't find an acceptable one because the jobs lack health benefits.
It also showed that, as it stands now, many do work under the table, producing untaxable income, underscoring how important it is to get those who can work off of disability.
“If Obamacare stays in place, then this is a good opportunity for the SSA to take a detailed look at the disability programs and prune them,” Edwards said.
Obamacare should also improve people’s ability to obtain medical devices they need — and the goal of those devices, after all, is to cure or overcome the medical problem, rendering them able to work.
But the question remains whether the disability program will actually receive a much-needed contraction as a result.
Though Obamacare may reduce the real need for people to be sitting out of the workforce, a large portion won’t stop trying for the checks unless SSA makes policy changes that stop them, and those currently receiving them are unlikely to get off just because their prospects for benefits in the private sector improve.
“You won’t see many people voluntarily get off once they’re on disability,” Edwards said.
Disability judge Paul R. Armstrong said the SSA has no choice but to make changes, and of the possibilities, such as reducing everyone’s benefits or raising taxes, there is a clear winner: to eliminate everyone who is capable of working from the rolls.
But when shiny new government programs come out that claim to solve social problems, the feds rarely go back and trim or eliminate prior programs with the same goals, Edwards said, pointing to the fact that food stamps are still offered even though the Women, Infants and Children and free school meals programs all meet the same needs.
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