Up to 480,000 More Children May Eligible for SSI – Center for Retirement Research

In most states, when low-income families of a child with a disability receive cash payments from the federal Supplemental Security Income (SSI) program, the child automatically qualifies for Medicaid health insurance.

In fact, up to 480,000 children on Medicaid who might also be eligible for SSI are not getting it, according to a new study by researchers at Colgate University, Westat, and Mathematica. This means that only about seven out of 10 children who might be eligible for SSI are currently enrolled.

These are children whose disabilities often require intensive medical care and who could benefit from an additional $943 per month to help their families pay for their care.

The increase in more eligible children comes after a decade of declining SSI enrollment. When the program was established in 1974, enrollment increased steadily until 2013. Since then, it has declined sharply, a trend that accelerated during the pandemic when applications were denied as families were isolated from COVID and Social Security offices closed.

Researchers surveyed 32 states to identify areas with the greatest potential to increase SSI rolls across the country. Using sophisticated statistical tools, they analyzed health care utilization among Medicaid-enrolled children who might be eligible for SSI, compared to current recipients, more than half of whom have intellectual or developmental disabilities.

There are great opportunities to improve SSI enrollment across the country, from New York, Maryland and Ohio to Arizona, California and Washington State. In these states, less than 70 percent of potentially eligible children are enrolled. Adoption rates in several other large states including Florida, Pennsylvania, and Texas are between 70 percent and 72.4 percent.

Findings at the district level in this study show variations in SSI registration from one district to another. In many states in Arkansas, for example, less than 70 percent of potentially eligible children receive SSI. But enrollment is over 75 percent in most of Colorado.

The researchers estimate of more than 480,000 potential SSI recipients considering those with at least a 5% chance of eligibility.

Although this 5 percent chance sounds low, even children with the lowest probability of SSI eligibility make the most of their Medicaid coverage in ways that are similar to — and sometimes exceed — the use of children who already receive SSI and Medicaid. In one example of their analysis, potentially eligible children used ADHD medications at higher rates than children receiving SSI.

The measure also adjusts for the range of possibilities. It is assumed that only five out of 100 children with a 5 percent chance of eligibility would qualify, while 40 out of 100 children with a 40 percent chance — whose health care spending is the most important — would qualify.

Medicaid is jointly funded by state and federal governments, but states are responsible for access and enrollment and how they administer their programs. The researchers suggest that states could use similar modeling techniques to identify more Medicaid-enrolled children who might be eligible for SSI.

“Children with similar circumstances have significantly different chances of receiving an SSI receipt depending on the state in which they live,” they concluded.

Reading this learn by Michael Levere and David Wittenburg, see “How Many Medicaid Recipients May Eligible for SSI?”

The research reported here was conducted in accordance with a grant from the US Social Security Administration (SSA) funded as part of the Retirement and Disability Research Consortium. The views and conclusions expressed are solely those of the authors and do not necessarily represent the views or policy of SSA or any agency of the Federal Government. Neither the United States government nor any of its agencies, nor any of its employees, makes any warranty, express or implied, or assumes any legal responsibility or liability for the accuracy, completeness, or usefulness of the contents of this report. Reference herein to any particular commercial product, process or service by trade name, trademark, manufacturer, or otherwise does not imply endorsement, recommendation or favor by the United States Government or any agency thereof.