3355 lines
No EOL
204 KiB
HTML
3355 lines
No EOL
204 KiB
HTML
<!doctype html>
|
|
<html lang="en" class="no-js">
|
|
<head>
|
|
<meta charset="UTF-8" /><meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1" /><meta name="viewport" content="width=device-width, initial-scale=1" />
|
|
<title>The Role of Continuing Disability Reviews in Child Supplemental Security Income Program Participation Patterns</title>
|
|
<meta name="DCTERMS:dateCreated" content="2024-11" />
|
|
<meta name="DCTERMS:contentOffice" content="ORDP:ORES" />
|
|
<meta name="DCTERMS:contentOwner" content="publications@ssa.gov" />
|
|
<meta name="DCTERMS:coderOffice" content="ORDP:ORES:OD" />
|
|
<meta name="DCTERMS:coder" content="op.webmaster@ssa.gov" />
|
|
<meta name="DCTERMS:dateCertified" content="2025-01-01" />
|
|
<meta name="description" content="Social Security Administration Research, Statistics, and Policy Analysis" />
|
|
<meta property="og:site_name" content="Social Security Administration Research, Statistics, and Policy Analysis"/>
|
|
<link rel="stylesheet" href="/policy/styles/doc.css" />
|
|
<link rel="stylesheet" href="/policy/styles/global.css" />
|
|
<!-- SSA INTERNET HEAD SCRIPTS -->
|
|
<script src="https://code.jquery.com/jquery-3.7.1.min.js" integrity="sha256-/JqT3SQfawRcv/BIHPThkBvs0OEvtFFmqPF/lYI/Cxo=" crossorigin="anonymous"></script>
|
|
<script src="/framework/js/ssa.internet.head.js"></script>
|
|
<script type="text/javascript" id="MathJax-script" async src="https://cdn.jsdelivr.net/npm/mathjax@3/es5/mml-chtml.js"></script>
|
|
|
|
<script>(window.BOOMR_mq=window.BOOMR_mq||[]).push(["addVar",{"rua.upush":"false","rua.cpush":"false","rua.upre":"false","rua.cpre":"false","rua.uprl":"false","rua.cprl":"false","rua.cprf":"false","rua.trans":"SJ-3a3bb884-f513-47e3-a86c-84bab05e21dc","rua.cook":"true","rua.ims":"false","rua.ufprl":"false","rua.cfprl":"false","rua.isuxp":"false","rua.texp":"norulematch","rua.ceh":"false","rua.ueh":"false","rua.ieh.st":"0"}]);</script>
|
|
<script>!function(e){var n="https://s.go-mpulse.net/boomerang/";if("False"=="True")e.BOOMR_config=e.BOOMR_config||{},e.BOOMR_config.PageParams=e.BOOMR_config.PageParams||{},e.BOOMR_config.PageParams.pci=!0,n="https://s2.go-mpulse.net/boomerang/";if(window.BOOMR_API_key="LERZW-HECFS-R8H4E-23UQ7-ERMQB",function(){function e(){if(!o){var e=document.createElement("script");e.id="boomr-scr-as",e.src=window.BOOMR.url,e.async=!0,i.parentNode.appendChild(e),o=!0}}function t(e){o=!0;var n,t,a,r,d=document,O=window;if(window.BOOMR.snippetMethod=e?"if":"i",t=function(e,n){var t=d.createElement("script");t.id=n||"boomr-if-as",t.src=window.BOOMR.url,BOOMR_lstart=(new Date).getTime(),e=e||d.body,e.appendChild(t)},!window.addEventListener&&window.attachEvent&&navigator.userAgent.match(/MSIE [67]\./))return window.BOOMR.snippetMethod="s",void t(i.parentNode,"boomr-async");a=document.createElement("IFRAME"),a.src="about:blank",a.title="",a.role="presentation",a.loading="eager",r=(a.frameElement||a).style,r.width=0,r.height=0,r.border=0,r.display="none",i.parentNode.appendChild(a);try{O=a.contentWindow,d=O.document.open()}catch(_){n=document.domain,a.src="javascript:var d=document.open();d.domain='"+n+"';void(0);",O=a.contentWindow,d=O.document.open()}if(n)d._boomrl=function(){this.domain=n,t()},d.write("<bo"+"dy onload='document._boomrl();'>");else if(O._boomrl=function(){t()},O.addEventListener)O.addEventListener("load",O._boomrl,!1);else if(O.attachEvent)O.attachEvent("onload",O._boomrl);d.close()}function a(e){window.BOOMR_onload=e&&e.timeStamp||(new Date).getTime()}if(!window.BOOMR||!window.BOOMR.version&&!window.BOOMR.snippetExecuted){window.BOOMR=window.BOOMR||{},window.BOOMR.snippetStart=(new Date).getTime(),window.BOOMR.snippetExecuted=!0,window.BOOMR.snippetVersion=12,window.BOOMR.url=n+"LERZW-HECFS-R8H4E-23UQ7-ERMQB";var i=document.currentScript||document.getElementsByTagName("script")[0],o=!1,r=document.createElement("link");if(r.relList&&"function"==typeof r.relList.supports&&r.relList.supports("preload")&&"as"in r)window.BOOMR.snippetMethod="p",r.href=window.BOOMR.url,r.rel="preload",r.as="script",r.addEventListener("load",e),r.addEventListener("error",function(){t(!0)}),setTimeout(function(){if(!o)t(!0)},3e3),BOOMR_lstart=(new Date).getTime(),i.parentNode.appendChild(r);else t(!1);if(window.addEventListener)window.addEventListener("load",a,!1);else if(window.attachEvent)window.attachEvent("onload",a)}}(),"".length>0)if(e&&"performance"in e&&e.performance&&"function"==typeof e.performance.setResourceTimingBufferSize)e.performance.setResourceTimingBufferSize();!function(){if(BOOMR=e.BOOMR||{},BOOMR.plugins=BOOMR.plugins||{},!BOOMR.plugins.AK){var n="false"=="true"?1:0,t="cookiepresent",a="eyd7g6aaiaaamjqacqdfqaaaabt3moqe-f-f74b82fce-clienttons-s.akamaihd.net",i="false"=="true"?2:1,o={"ak.v":"39","ak.cp":"1204614","ak.ai":parseInt("728289",10),"ak.ol":"0","ak.cr":3,"ak.ipv":6,"ak.proto":"h2","ak.rid":"14c8452c","ak.r":19138,"ak.a2":n,"ak.m":"dsca","ak.n":"essl","ak.bpcip":"2607:f378:40:6::","ak.cport":40596,"ak.gh":"23.60.168.62","ak.quicv":"","ak.tlsv":"tls1.3","ak.0rtt":"","ak.0rtt.ed":"","ak.csrc":"-","ak.acc":"","ak.t":"1739995652","ak.ak":"hOBiQwZUYzCg5VSAfCLimQ==rnod8gfkiDL+5I08lIVgDoiUfvnRqPlD2TUBuZjfF12KYMqbrTjiiutpAyunUlhc66Njcchz+U6jBED2APWKHBE4PYatdu8i06v1ZeaiNJuh/nIkWhNKmWmftIBia1upyYttKA42doKwgq3/BAgrNZ++xzK4v/wNShaDow+puh4scB/Q4H+Ef1iGykq1RBEZhbwLR9UET9V92xATfZ+rtJ3cFNSr0CfiJyxr2Monf7y+1v37/ALcKo/yaKXdoklTFnwlA1LrO5qpsGTdzgwcoNxRYqkFGKJvQfzlmydzNbJXV2cFqBuQNkE+vNL7y4AI3VgwhZwFM4nUQY50STYOm0+IjYisQor3SDORlVOVqH/ht/2aCoeLOZkvYAzXuDFUh5lBVhj7yxrZJ3L2YHlRD4vHypcqSQL9eckuMYKkkUs=","ak.pv":"98","ak.dpoabenc":"","ak.tf":i};if(""!==t)o["ak.ruds"]=t;var r={i:!1,av:function(n){var t="http.initiator";if(n&&(!n[t]||"spa_hard"===n[t]))o["ak.feo"]=void 0!==e.aFeoApplied?1:0,BOOMR.addVar(o)},rv:function(){var e=["ak.bpcip","ak.cport","ak.cr","ak.csrc","ak.gh","ak.ipv","ak.m","ak.n","ak.ol","ak.proto","ak.quicv","ak.tlsv","ak.0rtt","ak.0rtt.ed","ak.r","ak.acc","ak.t","ak.tf"];BOOMR.removeVar(e)}};BOOMR.plugins.AK={akVars:o,akDNSPreFetchDomain:a,init:function(){if(!r.i){var e=BOOMR.subscribe;e("before_beacon",r.av,null,null),e("onbeacon",r.rv,null,null),r.i=!0}return this},is_complete:function(){return!0}}}}()}(window);</script></head>
|
|
<body class="research">
|
|
<article itemscope itemtype="http://schema.org/ScholarlyArticle"> <meta itemprop="datePublished" content="2024-11" /><meta itemprop="image" content="cover.jpg" />
|
|
<header>
|
|
<div id="hLogo"><a class="navLogo" href="/policy/index.html">Social Security</a><a class="navSearch" href="https://search.ssa.gov/search?affiliate=ssa">SEARCH</a></div>
|
|
<div id="hRedBar">
|
|
<div id="hDocInfo">
|
|
<h1 itemprop="headline">The Role of Continuing Disability Reviews in Child Supplemental Security Income Program Participation Patterns</h1>
|
|
<div id="hByline">by <span itemprop="author">Jeffrey Hemmeter, Michael Levere, and David C. Wittenburg</span><br>Social Security Bulletin, <abbr title="Volume">Vol.</abbr> 84 <abbr title="Number">No.</abbr> 4, 2024 (released November 2024)</div>
|
|
</div>
|
|
</div>
|
|
</header>
|
|
<nav>
|
|
<div id="breadcrumbs" itemscope itemtype="http://schema.org/BreadcrumbList">You are here: <span itemprop="itemListElement" itemscope itemtype="http://schema.org/ListItem"><a href="/" itemprop="item"><span itemprop="name">Social Security Administration</span></a><meta itemprop="position" content="1" /></span> > <span itemprop="itemListElement" itemscope itemtype="http://schema.org/ListItem"><a href="/policy/index.html" itemprop="item"><span itemprop="name">Research, Statistics & Policy Analysis</span></a><meta itemprop="position" content="2" /></span> > <span itemprop="itemListElement" itemscope itemtype="http://schema.org/ListItem"><a href="/policy/docs/ssb/index.html" itemprop="item"><span itemprop="name">Social Security Bulletin</span></a><meta itemprop="position" content="3" /></span> > <span itemprop="itemListElement" itemscope itemtype="http://schema.org/ListItem"><a href="index.html" itemprop="item"><span itemprop="name"><abbr title="Volume">Vol.</abbr> 84 <abbr title="Number">No.</abbr> 4</span></a><meta itemprop="position" content="4" /></span></div>
|
|
<div id="rspaUtil"><ul><li id="mail"><a class="js-ga-event" href="#" rel="nofollow" data-event="outbound-link" data-event-action="click" data-event-label="email-this">Email</a></li><li id="print"><a href="#" rel="nofollow">Save/Print</a></li></ul></div>
|
|
</nav>
|
|
<div class="innards">
|
|
<div class="introBox">
|
|
<p id="synopsis" itemprop="description">The Social Security Administration conducts periodic continuing disability reviews (<abbr class="spell">CDR</abbr>s) to determine ongoing medical eligibility for children receiving Supplemental Security Income (<abbr class="spell">SSI</abbr>) payments. <abbr class="spell">CDR</abbr> volumes have varied over time because of funding availability. This article examines longitudinal patterns in the characteristics of and outcomes for child <abbr class="spell">SSI</abbr> recipients whose payments ceased because of a <abbr class="spell">CDR</abbr>. It also quantifies the extent to which <abbr class="spell">CDR</abbr> cessation patterns affect child <abbr class="spell">SSI</abbr> caseloads over time. We find that <abbr class="spell">CDR</abbr>s strongly influence child <abbr class="spell">SSI</abbr> caseloads. <abbr class="spell">CDR</abbr> cessations can explain <span class="nobr">three-fifths</span> to <span class="nobr">two-thirds</span> of changes in the number of <abbr class="spell">SSI</abbr> recipients, both as the program grew from 2002 through 2013 and as it subsequently declined. Despite variation in <abbr class="spell">CDR</abbr> cessation frequency, the characteristics of children with payments ceased because of a <abbr class="spell">CDR</abbr> were mostly stable, with relatively few children returning to <abbr class="spell">SSI</abbr>. Minimizing <abbr class="spell">CDR</abbr> volume fluctuations may help families plan for the potential loss of <abbr class="spell">SSI</abbr> payments.</p>
|
|
<hr />
|
|
<div class="eightypercent">
|
|
<p>Jeffrey Hemmeter is the Acting Deputy Associate Commissioner for the Office of Research, Demonstration, and Employment Support, Office of Retirement and Disability Policy, Social Security Administration. Michael Levere is an assistant professor of economics at Colgate University and a senior researcher at Mathematica. David Wittenburg is the Vice President and Practice Director for Social Policy and Economics Research at Westat. </p>
|
|
<p><i>Acknowledgments:</i> We are grateful to David Mann and participants at an <abbr class="spell">SSA</abbr> work-in-progress seminar for feedback on early findings. The research reported herein was pursuant to a grant (<abbr title="Number">No.</abbr> <span class="nobr">5RDR18000004-05-00)</span> from <abbr class="spell">SSA</abbr>, funded as part of the Retirement and Disability Research Consortium through the Michigan Retirement and Disability Research Center.</p>
|
|
<p>Contents of this publication are <a href="/policy/accessibility.html">not copyrighted</a>; any items may be reprinted, but citation of the <i>Social Security Bulletin</i> as the source is requested. The findings and conclusions presented in the <i>Bulletin</i> are those of the authors and do not necessarily represent the views of the Social Security Administration.</p>
|
|
</div>
|
|
</div>
|
|
<h2>Introduction</h2>
|
|
<div class="abbrtable">
|
|
<table>
|
|
<caption>Selected Abbreviations</caption>
|
|
<colgroup span="1" style="width:25%"></colgroup>
|
|
<colgroup span="1"></colgroup>
|
|
<tbody>
|
|
<tr>
|
|
<td><abbr class="spell">CDR</abbr></td>
|
|
<td>continuing disability review</td>
|
|
</tr>
|
|
<tr>
|
|
<td><abbr class="spell">SSA</abbr></td>
|
|
<td>Social Security Administration</td>
|
|
</tr>
|
|
<tr>
|
|
<td><abbr class="spell">SSI</abbr></td>
|
|
<td>Supplemental Security Income</td>
|
|
</tr>
|
|
</tbody>
|
|
</table>
|
|
</div>
|
|
<p>The number of child Supplemental Security Income (<abbr class="spell">SSI</abbr>) recipients has declined since 2013, falling by more than 25 percent through December 2023 (Social Security Administration [<abbr class="spell">SSA</abbr>] 2024). The agency periodically conducts continuing disability reviews (<abbr class="spell">CDR</abbr>s) to determine whether <abbr class="spell">SSI</abbr> recipients remain medically eligible for payments, and the number of <abbr class="spell">CDR</abbr>s conducted during that period increased substantially—particularly after 2015—perhaps contributing to the decline in child <abbr class="spell">SSI</abbr> participation.<sup><a href="#mn1" id="mt1">1</a></sup> Recent research suggests that the increase in <abbr class="spell">CDR</abbr> frequency might have reduced duration of payments for affected <abbr class="spell">SSI</abbr> award cohorts (Hemmeter and others 2021). However, the effects of increased <abbr class="spell">CDR</abbr> volume on the overall <abbr class="spell">SSI</abbr> caseload, receipt of payments, and other outcomes are not well understood.</p>
|
|
<p>In this article, we analyze the characteristics of and outcomes for children who were removed from the <abbr class="spell">SSI</abbr> rolls during a recent uptick in the number of <abbr class="spell">CDR</abbr>s conducted and the role <abbr class="spell">CDR</abbr>s play in explaining trends in the number of child <abbr class="spell">SSI</abbr> recipients. Although previous analyses provided insights into outcomes for children and families following a <abbr class="spell">CDR</abbr> cessation (Deshpande 2016b; Hemmeter and Bailey 2015), they did not consider the substantial increase in <abbr class="spell">CDR</abbr>s conducted beginning in 2015, when <abbr class="spell">SSA</abbr> began working through a substantial <abbr class="spell">CDR</abbr> backlog. In 2002, there was no <abbr class="spell">CDR</abbr> backlog, but the <abbr class="spell">CDR</abbr> volume began declining in 2003 because of funding shortfalls and priority shifts. By the end of fiscal year 2014, the <abbr class="spell">CDR</abbr> backlog had grown to nearly 350,000 cases (<abbr class="spell">SSA</abbr> 2018).<sup><a href="#mn2" id="mt2">2</a></sup></p>
|
|
<p>This article addresses three research questions:</p>
|
|
<ol>
|
|
<li>What are the characteristics of children whose <abbr class="spell">SSI</abbr> payments are ceased because of a <abbr class="spell">CDR</abbr>?</li>
|
|
<li>What are the outcomes for children in the years following a <abbr class="spell">CDR</abbr> cessation?</li>
|
|
<li>How do <abbr class="spell">CDR</abbr> cessation patterns affect child <abbr class="spell">SSI</abbr> caseload trends?</li>
|
|
</ol>
|
|
<p>To answer these questions, we relied primarily on descriptive analyses of <abbr class="spell">SSA</abbr>'s administrative data. To answer the first question, we compared the characteristics of children whose payments ceased because of a <abbr class="spell">CDR</abbr><sup><a href="#mn3" id="mt3">3</a></sup> with those of child <abbr class="spell">SSI</abbr> recipients overall. To answer the second question, we looked at the rates at which children with ceased payments later return to the <abbr class="spell">SSI</abbr> rolls and at their earnings patterns in the years following cessation. For both questions, we focused on pattern shifts as the <abbr class="spell">CDR</abbr> frequencies changed. To answer the third question, we conducted a policy simulation exercise to predict the likelihood that children with specific characteristics would have had <abbr class="spell">CDR</abbr> cessations if the <abbr class="spell">CDR</abbr> cessation pattern held constant in a given year. That simulation also enables us to account for whether a child might have returned to the <abbr class="spell">SSI</abbr> rolls following a <abbr class="spell">CDR</abbr> cessation. We compare <abbr class="spell">CDR</abbr> cessation patterns from 2008 and 2017. The 2008 cessation cohort was atypically low because of budget constraints and the resulting shift in administrative priorities away from conducting <abbr class="spell">CDR</abbr>s, which generated a growing <abbr class="spell">CDR</abbr> backlog. By contrast, the 2017 cessation cohort typified a stable pattern, reflecting the regular processing volume after the backlog had been reduced. Comparing the distinct <abbr class="spell">CDR</abbr> cessation patterns of the 2008 and 2017 cohorts enabled us to assess how <abbr class="spell">CDR</abbr> cessations affect overall caseload dynamics. We then used our policy simulation to compare the trends in predicted child <abbr class="spell">SSI</abbr> participation over that period with actual trends.</p>
|
|
<p>We find that most characteristics of children with ceased payments stayed constant over time (except for age at <abbr class="spell">CDR</abbr>), irrespective of the frequency of cessations. This suggests that, regardless of the volume of <abbr class="spell">CDR</abbr>s conducted, the profiles of children most at risk of losing <abbr class="spell">SSI</abbr> payments stay largely the same, with only the number of affected children fluctuating with the rate at which reviews are completed. Children who are expected to improve medically, who live in areas with high socioeconomic deprivation, and who have certain primary diagnoses (such as developmental or respiratory disorders) were disproportionately likely to experience cessation of payments in all years we examined. One notable shift over time was the age at which <abbr class="spell">CDR</abbr> cessations were likely to occur. From 2003 through 2008, children aged <span class="nobr">1–5</span> more frequently had a <abbr class="spell">CDR</abbr> cessation than children aged <span class="nobr">11–13,</span> whereas from 2011 through 2017, the reverse was true.</p>
|
|
<p>For children whose <abbr class="spell">SSI</abbr> payments ceased, returns to the <abbr class="spell">SSI</abbr> rolls were infrequent and earnings potential was limited, indicating the many challenges those children face (both in the short term and when they become adults). About 8 percent of children returned to the <abbr class="spell">SSI</abbr> program within 5 years of payment cessation. Those patterns differ somewhat by the year of cessation—slightly more than 10 percent of children with ceased payments from 2003 through 2008 returned to the program, compared with about 6 percent of children whose payments ceased because of a <abbr class="spell">CDR</abbr> from 2011 through 2017. Earnings outcomes were also limited. For example, in the fifth year after payment cessation (the year with the highest earnings outcomes), only about 60 percent of youths aged 16 or older at the time of earnings measurement had any earnings. Additionally, in the fifth year after payment cessation, the average annual earnings among this group aged 16 or older at the time of earnings measurement were less than $7,000. These findings suggest that youths whose payments ceased because of a <abbr class="spell">CDR</abbr> might have struggled to achieve economic self-sufficiency because they could no longer rely on <abbr class="spell">SSI</abbr> payments and did not earn much money.<sup><a href="#mn4" id="mt4">4</a></sup> That evidence is consistent with findings from Hemmeter, Kauff, and Wittenburg (2009), Deshpande (2016b), and Deshpande and Mueller-Smith (2022).</p>
|
|
<p>Finally, our policy simulations indicate that <abbr class="spell">CDR</abbr> cessation patterns play an important role in the overall child <abbr class="spell">SSI</abbr> caseload over time. From 2003 through 2013, that caseload grew by about 365,000. By comparing the patterns between the low and stable cessation cohorts, we find that a stable pattern of <abbr class="spell">CDR</abbr> volume may have led to slightly more than 220,000 additional cessations. Thus, <abbr class="spell">CDR</abbr> frequency can explain about 60 percent of the child <abbr class="spell">SSI</abbr> participation growth during that period. Subsequently, from 2014 through 2021, <abbr class="spell">CDR</abbr>s explain about <span class="nobr">two-thirds</span> of the observed program decline: the caseload dropped by 283,000, while the cessation differential between years with stable and low volumes was about 194,000.<sup><a href="#mn5" id="mt5">5</a></sup> Notably, childhood <abbr class="spell">SSI</abbr> participation would have been more consistent over time in both the low and stable patterns of cessations, compared with actual patterns of cessations. Given that <abbr class="spell">SSA</abbr>'s annual budgets include dedicated program integrity funding to support medical <abbr class="spell">CDR</abbr>s, <abbr class="spell">SSI</abbr> redeterminations, and fraud investigations and prosecutions, those results have potential policy implications.</p>
|
|
<h2>Background</h2>
|
|
<p>This section provides information about <abbr class="spell">SSI</abbr> eligibility requirements, child <abbr class="spell">SSI</abbr> participation rates, <abbr class="spell">CDR</abbr> frequency criteria, and annual <abbr class="spell">CDR</abbr> volumes.</p>
|
|
<p><abbr class="spell">SSI</abbr> provides monthly cash payments to children with disabilities and low income and resources. To qualify as having a disability, a child must have “a medically determinable physical or mental impairment or impairments which result in marked and severe functional limitations” (42 <abbr>U.S.</abbr>C. §1382c[C][i]). These limitations must come from an impairment that is expected to last at least 12 months or result in death. Children must also meet a means test, which includes the portion of their parents' income and resources that is considered available to them. Resources available to the child cannot exceed $2,000 (after accounting for certain exemptions such as the value of a residential home). <abbr class="spell">SSI</abbr> payments are offset by $1 for every $2 in earned income available to a child above $65 and by $1 for every $1 in unearned income above $20, with many exclusions. If the amount due is $0, the child does not receive a payment that month. In 2024, the maximum monthly <abbr class="spell">SSI</abbr> cash payment for an individual is $943.<sup><a href="#mn6" id="mt6">6</a></sup></p>
|
|
<p><abbr class="spell">SSI</abbr> recipients face a <abbr class="spell">CDR</abbr> every few years to determine whether they meet the disability criteria to remain eligible. If <abbr class="spell">SSA</abbr> determines that a child no longer has a “marked and severe functional limitation” and has no other impairments that meet the definition of disability, then the child's payments are ceased. If <abbr class="spell">SSA</abbr> determines that a child's medical condition has not improved to that level (or has stayed the same or worsened), or if the child is determined to have a disability because of other impairments, then the child's payments continue.<sup><a href="#mn7" id="mt7">7</a></sup> Families of children whose payments are ceased can appeal the initial <abbr class="spell">CDR</abbr> decision.</p>
|
|
<p>The frequency with which child <abbr class="spell">SSI</abbr> recipients face <abbr class="spell">CDR</abbr>s depends on the expectation of their medical improvement, which is assigned when they receive an initial award or undergo a prior <abbr class="spell">CDR</abbr>.<sup><a href="#mn8" id="mt8">8</a></sup> If medical improvement is expected, a <abbr class="spell">CDR</abbr> typically occurs within 6 to 18 months of award. If medical improvement is deemed possible, a <abbr class="spell">CDR</abbr> typically occurs every 3 years. If medical improvement is not expected, a <abbr class="spell">CDR</abbr> typically occurs every 7 years, although <abbr class="spell">SSA</abbr> typically does not conduct <abbr class="spell">CDR</abbr>s for children in that group before their <span class="nobr">age-18</span> redeterminations. These “medical diaries,” or assessments of how likely a child's medical condition is to improve, enable <abbr class="spell">SSA</abbr> to review millions of recipients' eligibility statuses efficiently. From calendar years 2003 through 2017, the share of child <abbr class="spell">SSI</abbr> recipients for whom medical improvement was deemed possible was about 70 percent, while roughly 15 percent were expected to experience medical improvement and about 15 percent were not expected to experience medical improvement.</p>
|
|
<p>Although the medical diaries generally determine <abbr class="spell">CDR</abbr> frequency, their volumes have varied over the years along with the availability of program integrity funding.<sup><a href="#mn9" id="mt9">9</a></sup> Chart 1 shows that from fiscal year 1998 through fiscal year 2022, the annual number of <abbr class="spell">CDR</abbr>s conducted varied substantially.<sup><a href="#mn10" id="mt10">10</a></sup> From 1998 through 2002, <abbr class="spell">SSA</abbr> conducted an annual average of 134,934 <abbr class="spell">CDR</abbr>s. In 2003, <abbr class="spell">SSA</abbr> began conducting substantially fewer <abbr class="spell">CDR</abbr>s, which caused a backlog of overdue <abbr class="spell">CDR</abbr>s to start to accumulate. Then, from 2006 through 2010, <abbr class="spell">SSA</abbr> conducted only 11,169 <abbr class="spell">CDR</abbr>s per year on average, fewer than <span class="nobr">one-tenth</span> as many as were conducted from 1998 through 2002. In 2015, <abbr class="spell">SSA</abbr> began to reduce the <abbr class="spell">CDR</abbr> backlog (nearly 350,000 as of 2014) and had eliminated it by the end of 2018 (<abbr class="spell">SSA</abbr> 2018). <abbr class="spell">CDR</abbr> decisions resulting in payment cessations followed a similar pattern of a decline after 2003, with particularly low numbers from 2006 through 2010, followed by increases thereafter. In a typical year, the number of initial payment cessations resulting from a <abbr class="spell">CDR</abbr> is about 35 percent higher than the number of final payment cessations that follow a <abbr class="spell">CDR</abbr>, indicating that a substantive share of initial cessation decisions are successfully appealed.</p>
|
|
<div class="svgChart chart700" id="chart1"> <img src="v84n4p1-chart01.svg" role="img" alt="Chart 1. Line chart with tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 1. </span><abbr class="spell">CDR</abbr> volume for child <abbr class="spell">SSI</abbr> recipients: Initial decisions and initial and final cessations, <span class="nobr">1998–2022</span></caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="3" style="width:6em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year</th>
|
|
<th scope="col">Initial decisions</th>
|
|
<th scope="col">Initial cessations</th>
|
|
<th scope="col">Final cessations</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">1998</th>
|
|
<td>91,157</td>
|
|
<td>23,954</td>
|
|
<td>18,193</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1999</th>
|
|
<td>183,211</td>
|
|
<td>53,791</td>
|
|
<td>41,852</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2000</th>
|
|
<td>140,699</td>
|
|
<td>34,116</td>
|
|
<td>26,254</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2001</th>
|
|
<td>95,835</td>
|
|
<td>22,939</td>
|
|
<td>17,358</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2002</th>
|
|
<td>163,768</td>
|
|
<td>33,334</td>
|
|
<td>24,724</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>127,444</td>
|
|
<td>26,922</td>
|
|
<td>19,525</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>103,437</td>
|
|
<td>22,689</td>
|
|
<td>16,637</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>61,387</td>
|
|
<td>15,790</td>
|
|
<td>11,900</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>19,384</td>
|
|
<td>4,956</td>
|
|
<td>3,745</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>4,440</td>
|
|
<td>1,279</td>
|
|
<td>930</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>4,707</td>
|
|
<td>1,234</td>
|
|
<td>921</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>10,637</td>
|
|
<td>2,282</td>
|
|
<td>1,681</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>16,677</td>
|
|
<td>4,176</td>
|
|
<td>3,253</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>25,166</td>
|
|
<td>8,009</td>
|
|
<td>6,358</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>64,834</td>
|
|
<td>23,565</td>
|
|
<td>18,888</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>52,998</td>
|
|
<td>19,238</td>
|
|
<td>15,481</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>88,993</td>
|
|
<td>31,933</td>
|
|
<td>25,065</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>223,607</td>
|
|
<td>73,489</td>
|
|
<td>56,300</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>261,185</td>
|
|
<td>77,964</td>
|
|
<td>58,837</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>208,500</td>
|
|
<td>57,673</td>
|
|
<td>42,667</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>229,341</td>
|
|
<td>52,264</td>
|
|
<td>37,748</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>173,923</td>
|
|
<td>36,025</td>
|
|
<td>25,957</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>106,636</td>
|
|
<td>19,841</td>
|
|
<td>15,015</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>136,371</td>
|
|
<td>29,657</td>
|
|
<td>22,888</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2022</th>
|
|
<td>148,027</td>
|
|
<td>30,369</td>
|
|
<td>25,849</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="onlyNote" colspan="4">SOURCE: <abbr class="spell">SSA</abbr> (2023a).</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>Chart 2 shows that child <abbr class="spell">SSI</abbr> participation increased from the start of the program in 1974 through 2013 (with a dip in the late 1990s) and has since declined. Over the years, legislative changes, Supreme Court decisions, and the <span class="nobr"><abbr>COVID</abbr>-19</span> pandemic have contributed to changes in the participation rate. For example, the 1990 <i>Sullivan v. Zebley</i> Supreme Court decision loosened the criteria for children—particularly those with mental disorders—to qualify as having a disability (Levere 2021). However, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 reversed some of the changes that followed the <i>Zebley</i> decision, resulting in more restrictive disability criteria and <abbr class="spell">CDR</abbr> rules for children. <abbr class="spell">SSA</abbr> implemented those rules in 1997 and finalized them in 2000. Then, during the Great Recession, a weakening economy likely contributed to enrollment growth (Schmidt and Sevak 2017). The unanticipated decline in program participation from 2014 through 2019 has not yet been extensively studied. Finally, during the <span class="nobr"><abbr>COVID</abbr>-19</span> pandemic, the decline in child <abbr class="spell">SSI</abbr> participation was differentially larger than the <span class="nobr">2014–2019</span> decline (Levere, Hemmeter, and Wittenburg 2024a), with school closures potentially explaining a substantial share of the decline (Levere, Hemmeter, and Wittenburg 2024b).</p>
|
|
<div class="svgChart chart700" id="chart2"> <img src="v84n4p1-chart02.svg" role="img" alt="Chart 2. Line chart with tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 2. </span>Child <abbr class="spell">SSI</abbr> participation rate: Number of recipients in current-payment status per 1,000 children in the total Social Security area population <sup>a</sup>, <span class="nobr">1975–2021</span></caption>
|
|
<colgroup span="1" style="width:8em"></colgroup>
|
|
<colgroup span="1" style="width:8em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year</th>
|
|
<th scope="col">Rate</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">1975</th>
|
|
<td>1.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1976</th>
|
|
<td>1.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1977</th>
|
|
<td>2.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1978</th>
|
|
<td>2.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1979</th>
|
|
<td>2.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1980</th>
|
|
<td>2.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1981</th>
|
|
<td>3.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1982</th>
|
|
<td>3.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1983</th>
|
|
<td>3.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1984</th>
|
|
<td>3.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1985</th>
|
|
<td>3.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1986</th>
|
|
<td>3.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1987</th>
|
|
<td>3.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1988</th>
|
|
<td>3.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1989</th>
|
|
<td>4.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1990</th>
|
|
<td>4.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1991</th>
|
|
<td>5.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1992</th>
|
|
<td>8.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1993</th>
|
|
<td>10.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1994</th>
|
|
<td>11.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1995</th>
|
|
<td>12.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1996</th>
|
|
<td>13.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1997</th>
|
|
<td>12.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1998</th>
|
|
<td>12.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1999</th>
|
|
<td>11.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2000</th>
|
|
<td>11.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2001</th>
|
|
<td>11.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2002</th>
|
|
<td>12.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>12.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>13.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>13.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>14.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>14.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>15.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>15.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>16.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>16.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>17.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>17.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>17.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>16.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>16.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>15.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>15.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>15.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>14.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>14.1</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="2">SOURCE: <abbr class="spell">SSA</abbr> (2023a).</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="2">a. Includes residents of the 50 states and the District of Columbia; civilian residents of Puerto Rico, the <abbr>U.S.</abbr> Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands; federal civilian employees and persons in the armed forces abroad and their dependents; and all other <abbr>U.S.</abbr> citizens abroad.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>The recent declines in child <abbr class="spell">SSI</abbr> participation have led to targeted outreach to children and families. Concern that <abbr class="spell">SSI</abbr> was not reaching all eligible children emerged as the number of child <abbr class="spell">SSI</abbr> recipients began to decline after 2013 (National Academies of Sciences, Engineering, and Medicine 2015). During the <span class="nobr"><abbr>COVID</abbr>-19</span> pandemic, <abbr class="spell">SSA</abbr> increased its <abbr class="spell">SSI</abbr> outreach efforts and designated certain staff as Vulnerable Population Liaisons in field and regional offices to help potentially eligible people apply for payments.<sup><a href="#mn11" id="mt11">11</a></sup> Such efforts might be most effective in narrow geographic areas where sociodemographic or health claims data indicate many eligible children might not be receiving <abbr class="spell">SSI</abbr> payments (Levere, Wittenburg, and Hemmeter 2022; Levere and Wittenburg 2024).</p>
|
|
<p>A key goal of our research is to identify the extent to which patterns in the frequency of <abbr class="spell">CDR</abbr>s (and accompanying payment cessations) might have contributed to broader changes in child <abbr class="spell">SSI</abbr> participation. Simple correlational patterns indicate that <abbr class="spell">CDR</abbr>s might play an important role in changes to child <abbr class="spell">SSI</abbr> participation. For example, although the number of new child <abbr class="spell">SSI</abbr> awards declined each year from fiscal year 2004 through fiscal year 2007 (before the Great Recession), the number of child <abbr class="spell">SSI</abbr> recipients rose by 9 percent from 2004 through 2007 (<abbr class="spell">SSA</abbr> 2023c). Those years correspond to the years when the <abbr class="spell">CDR</abbr> backlog started to grow, resulting in fewer child <abbr class="spell">SSI</abbr> recipients exiting the program. Similarly, as <abbr class="spell">SSA</abbr> processed the <abbr class="spell">CDR</abbr> backlog from fiscal year 2015 through fiscal year 2018, the number of child <abbr class="spell">SSI</abbr> recipients declined by about 10 percent. Hemmeter and others (2021) showed that the prevalence with which certain award year cohorts face <abbr class="spell">CDR</abbr>s might explain a substantial share of the difference in program participation across those cohorts.</p>
|
|
<h2>Data</h2>
|
|
<p>We used program participation and earnings data from various <abbr class="spell">SSA</abbr> data files to examine the outcomes for children whose <abbr class="spell">SSI</abbr> payments ceased because of a medical <abbr class="spell">CDR</abbr>. First, we identified the population of children with ceased payments from 2003 to 2021<sup><a href="#mn12" id="mt12">12</a></sup> using the <abbr class="spell">CDR</abbr> Waterfall file. We then used the Disability Analysis File to obtain information about those children's characteristics, such as age, date of first <abbr class="spell">SSI</abbr> payment, medical diary category, primary diagnosis, and <abbr>ZIP</abbr> Code and county of residence. The Disability Research File provides information on subsequent returns to the <abbr class="spell">SSI</abbr> rolls in the 5 years after payment cessation, while the Master Earnings File provides data on earnings in the 5 calendar years following cessation. We included earnings observations only for youths who were aged 16 or older; therefore, the earnings analyses do not include anyone whose payments ceased before age 11.</p>
|
|
<p>We used the date of the final <abbr class="spell">CDR</abbr> decision, rather than the date of the initial <abbr class="spell">CDR</abbr> decision, to classify the year a child's <abbr class="spell">SSI</abbr> payments were ceased.<sup><a href="#mn13" id="mt13">13</a></sup> Chart 3 shows that the cessation counts we derive using this methodology differ slightly from those published in the <i>Annual Report of the Supplemental Security Income Program</i> (<abbr class="spell">SSA</abbr> 2023a), which reflect the year of initial decisions. In particular, Chart 3 shows that in recent years, when cessations increased, this approach led to a slight lag in reporting. Classifying cessations by the year in which payments were officially ceased aligns more closely with the actual changes in the caseload, which is important for our simulation exercise.</p>
|
|
<div class="svgChart chart700" id="chart3"> <img src="v84n4p1-chart03.svg" role="img" alt="Chart 3. Line chart with tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 3. </span>Number of <abbr class="spell">CDR</abbr> cessations, by data source, <span class="nobr">2003–2021</span></caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="2" style="width:10em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year</th>
|
|
<th scope="col">From the <i>Annual Report of the Supplemental Security Income Program</i> (initial cessation date)</th>
|
|
<th scope="col">From administrative records (final cessation date)</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>19,525</td>
|
|
<td>19,133</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>16,637</td>
|
|
<td>17,113</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>11,900</td>
|
|
<td>12,758</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>3,745</td>
|
|
<td>6,198</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>930</td>
|
|
<td>3,471</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>921</td>
|
|
<td>2,121</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1,681</td>
|
|
<td>2,421</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>3,253</td>
|
|
<td>2,993</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>6,358</td>
|
|
<td>5,853</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>18,888</td>
|
|
<td>13,958</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>15,481</td>
|
|
<td>12,305</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>25,065</td>
|
|
<td>22,586</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>56,300</td>
|
|
<td>42,534</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>58,837</td>
|
|
<td>49,455</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>42,667</td>
|
|
<td>42,614</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>37,748</td>
|
|
<td>43,675</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>25,957</td>
|
|
<td>37,143</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>15,015</td>
|
|
<td>23,042</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>22,888</td>
|
|
<td>21,250</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="onlyNote" colspan="3">SOURCES: <abbr class="spell">SSA</abbr> (2023a) and authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>To identify the overall child <abbr class="spell">SSI</abbr> recipient population, we used data from the Disability Analysis File. We collected age, date of first <abbr class="spell">SSI</abbr> payment, medical diary category, primary diagnosis, and <abbr>ZIP</abbr> Code and county of residence for all children. We compare the characteristics of children whose payments were ceased with those of current <abbr class="spell">SSI</abbr> recipients to gauge whether recipients with certain characteristics differentially face payment cessation. Our policy simulations also rely on estimating a probability of <abbr class="spell">SSI</abbr> payment cessation and a probability of payment continuation using those characteristics.</p>
|
|
<p>Finally, we used American Community Survey <span class="nobr">5-year</span> estimates for <span class="nobr">2015–2019</span> on all inputs to the Area Deprivation Index and followed the process described in Singh (2003) to estimate a level of deprivation at the <abbr>ZIP</abbr> Code and county levels.<sup><a href="#mn14" id="mt14">14</a></sup> Deprivation is expressed as a percentile between 1 and 100 that we divided into quartiles; in this context, it represents a single indicator of the various disadvantages a community faced in <span class="nobr">2015–2019.</span> This process mirrors our approach in Levere, Wittenburg, and Hemmeter (2022). In addition, we measured the distribution of race and ethnicity for each <abbr>ZIP</abbr> Code or county from the same <span class="nobr">5-year</span> estimates.</p>
|
|
<h2>Methodology</h2>
|
|
<p>We structured our methodological approach to address our three research questions. The first question addresses the demographic and socioeconomic characteristics of children whose <abbr class="spell">SSI</abbr> payments were ceased because of a <abbr class="spell">CDR</abbr> from 2003 through 2021. We divided our study population into annual cohorts based on the calendar year of <abbr class="spell">CDR</abbr> cessation, enabling us to track trends over the observation period, such as the shares of child <abbr class="spell">SSI</abbr> recipients with particular primary medical diagnoses who experienced a <abbr class="spell">CDR</abbr> cessation. Examining longitudinal patterns of children with particular characteristics whose payments ceased allows us to show whether, and how, the characteristics of such children have changed as program funding and <abbr class="spell">CDR</abbr> frequency have changed. However, the characteristics of child <abbr class="spell">SSI</abbr> participants overall might have changed over time as well. Therefore, we also benchmarked the characteristics of the study population to the overall child <abbr class="spell">SSI</abbr> recipient population each year.<sup><a href="#mn15" id="mt15">15</a></sup> We divided the share of children with a particular characteristic whose payments ceased by the share of the overall child <abbr class="spell">SSI</abbr> population with that characteristic. Those descriptive analyses indicate whether certain groups were disproportionately likely to have their <abbr class="spell">SSI</abbr> payments ceased over time. </p>
|
|
<p>To address our second research question on the outcomes for children in the years after a <abbr class="spell">CDR</abbr> cessation, we investigated the share of children with ceased payments that returned to <abbr class="spell">SSI</abbr> and examined three earnings outcomes for each annual cessation cohort. The outcomes we examined are average annual earnings amount, the prevalence of having any annual earnings, and the prevalence of having earnings above $16,200, which equals the 2022 level that signifies substantial gainful activity for nonblind recipients. The insights this analysis provides about postcessation well-being and financial stability are pivotal for understanding the economic and social ramifications of cessation for children and their families.</p>
|
|
<p>Finally, to answer the question of how <abbr class="spell">CDR</abbr> patterns affect the child <abbr class="spell">SSI</abbr> caseload overall, we employed policy simulations to explore the hypothetical effects of applying consistent <abbr class="spell">CDR</abbr> patterns across the study period. We assessed the influence of different <abbr class="spell">CDR</abbr> cessation rates on the overall trends in child <abbr class="spell">SSI</abbr> participation, using 2008 (a year with very few <abbr class="spell">CDR</abbr> cessations) and 2017 (representing a typical year with “stable” <abbr class="spell">CDR</abbr> patterns) as our base analysis years. This comparison reveals the potential effects of varying <abbr class="spell">CDR</abbr> frequencies on <abbr class="spell">SSI</abbr> caseload fluctuations, offering critical perspectives on the policy and programmatic implications of prioritizing (or deemphasizing) <abbr class="spell">CDR</abbr> workloads. From the models, we estimated both the share of children who would have had payments ceased because of a <abbr class="spell">CDR</abbr>, and the share of children whose payments had been previously ceased who would have returned to the <abbr class="spell">SSI</abbr> program.</p>
|
|
<p>Our modeling procedure estimates cessations and returns in all years from 2003 through 2021 using a model estimated among a specific base year cohort. The stable cessation cohort (2017) most closely approximates what might happen in a year with no <abbr class="spell">CDR</abbr> backlog and enabled us to observe postcessation outcomes for at least 5 years.<sup><a href="#mn16" id="mt16">16</a></sup> The low-cessation cohort (2008) provides a sharp contrast because few <abbr class="spell">CDR</abbr>s were conducted—only 4,707 initial decisions and 921 final cessations, compared with 208,500 and 42,402, respectively, in 2017.</p>
|
|
<p>Chart 4 shows observed and probabilistic year-to-year patterns of the child <abbr class="spell">SSI</abbr> caseload. The actual <abbr class="spell">SSI</abbr> caseload evolves each year because of continuations, cessations, and new applicants (Panel A). Children receiving <abbr class="spell">SSI</abbr> payments at the start of the year could either continue receiving <abbr class="spell">SSI</abbr> payments at the start of the next year or have their payments ceased during that year. We distinguish <abbr class="spell">CDR</abbr> cessations from other program exits—including aging out of the program and having excess resources or income. In addition, new awardees could start to receive <abbr class="spell">SSI</abbr> payments during the year and thus be added to the rolls by the start of the next year. To understand how <abbr class="spell">CDR</abbr> frequencies affect <abbr class="spell">SSI</abbr> caseloads, our estimation procedure holds the <abbr class="spell">CDR</abbr> cessation count fixed by applying the base year <abbr class="spell">CDR</abbr> cessation patterns.</p>
|
|
<div class="svgChart chart700" id="chart4"> <img src="v84n4p1-chart04.svg" role="img" alt="Chart 4. Flowchart fully described in the main narrative."></div>
|
|
<p>Rather than using the observed patterns, our simulation models estimated the likelihood of a <abbr class="spell">CDR</abbr> cessation in each year, assuming the child <abbr class="spell">CDR</abbr> cessation rate remained consistent over time. We began with the number of child <abbr class="spell">SSI</abbr> recipients whose payments were not terminated at the start of the base year and estimated a logistic regression to predict the likelihood of cessation in that year by specific demographic characteristics. We then applied those coefficients to all other years to estimate the probability of a child's <abbr class="spell">SSI</abbr> payments being ceased, holding the cessation trends constant. In equation 1 (the regression equation), the outcome variable is equal to 1 if the child's payments ceased because of a <abbr class="spell">CDR</abbr> and is equal to 0 otherwise:</p>
|
|
<div class="equation">
|
|
<div class="float-right">(1)</div>
|
|
<div class="scrollMath"> <math display='inline'><mrow> <msub><mi mathvariant="italic">CDR cessation</mi> <mi>i</mi> </msub> <mo>=</mo><mi>α</mi><mo>+</mo><mi>β</mi><msub> <mi>X</mi> <mi>i</mi> </msub> <mo>+</mo><msub> <mi>ε</mi> <mi>i</mi> </msub> </mrow></math> .</div>
|
|
</div>
|
|
<p>We controlled for sex, age at year end, age at initial <abbr class="spell">SSI</abbr> entry, duration of <abbr class="spell">SSI</abbr> payment receipt, medical diary category, and primary disability diagnosis in <i>X <sub>i</sub></i> . With a logistic regression, the predicted value of the outcome based on the coefficients—which represents the probability of cessation—is guaranteed to fall between 0 and 1. This offers an important advantage over a linear probability model—with which the predicted value need not fall between 0 and 1—because predicted values within that range are essential to our models.</p>
|
|
<p>We used our policy simulation to estimate the probability of a <abbr class="spell">CDR</abbr> cessation (Panel B). We started with the sample of child <abbr class="spell">SSI</abbr> recipients on January 1, 2003, and estimated the probability of <abbr class="spell">CDR</abbr> cessation in 2003 by applying the coefficients from equation 1, estimated among the base year (2008 or 2017) population, to all child <abbr class="spell">SSI</abbr> recipients in 2003. By applying the same base year coefficients, the analysis assumes constant <abbr class="spell">CDR</abbr> cessation patterns over time. The total number of estimated cessations is the sum of the probabilities of cessation across all child recipients. For example, if 1,000 children each have a payment cessation probability of 0.03, we would expect 30 cessations among that group. The likelihood of continuation into 2004 is 1 minus the probability of cessation.</p>
|
|
<p>Then, to identify the number of child <abbr class="spell">SSI</abbr> recipients at the start of 2004, we added newly awarded children and subtracted children who stopped receiving <abbr class="spell">SSI</abbr> payments for non-<abbr class="spell">CDR</abbr> reasons during 2003. Thus, for every child receiving <abbr class="spell">SSI</abbr> payments at the beginning of 2003, we now had the probability that they were still on the <abbr class="spell">SSI</abbr> rolls at the start of 2004.<sup><a href="#mn17" id="mt17">17</a></sup></p>
|
|
<p>Finally, we applied the same procedure for all subsequent study years to estimate the number of cessations each year. We applied coefficients from equation 1 estimated in the base year (2008 or 2017) to the children whose payments were not terminated in 2004—increasing their age and payment duration by 1 year relative to those at the start of 2003—to estimate the probability of cessation in 2004 and the probability of continuation into 2005. We then subtracted children whose payments ceased for reasons other than a <abbr class="spell">CDR</abbr> and added new awardees. The probability of receiving <abbr class="spell">SSI</abbr> at the start of 2005 is therefore the probability of <abbr class="spell">SSI</abbr> payment receipt at the start of 2004 multiplied by the probability of continuation into 2005. That procedure, which accounts for the probability of continuation at the beginning of each year, is critical for reliably estimating the number of cessations: The dynamic nature of <abbr class="spell">CDR</abbr> patterns means that the caseload at the beginning of each year might have shifted had <abbr class="spell">CDR</abbr> cessation patterns been consistent. For example, if <abbr class="spell">CDR</abbr> cessations were more frequent, like the 2017 pattern, more children would have had payments ceased in earlier years, meaning they would not have faced a potential <abbr class="spell">CDR</abbr> cessation in later years. Estimating the flow of cessations each year therefore requires knowing how many children could have faced a cessation at the start of the year—that is, the probability of payment receipt. We repeated this procedure for each year to estimate the probability of payment receipt at the start of each year from 2006 through 2022.</p>
|
|
<p>Our models also account for the potential return to <abbr class="spell">SSI</abbr> participation of children who experienced a prior <abbr class="spell">CDR</abbr> cessation. Specifically, among children with payments ceased in the base year, we estimated a separate logistic regression using equation 2, which differs from equation 1 only in the outcome variable being an indicator for returning to <abbr class="spell">SSI</abbr> in the 5 years following <abbr class="spell">CDR</abbr> cessation.</p>
|
|
<div class="equation">
|
|
<div class="float-right">(2)</div>
|
|
<div class="scrollMath"> <math display='inline'><mrow> <msub> <mi mathvariant="italic">SSI return</mi> <mi>i</mi> </msub> <mo>=</mo><mi>α</mi><mo>+</mo><mi>β</mi><msub> <mi>X</mi> <mi>i</mi> </msub> <mo>+</mo><msub> <mi>ε</mi> <mi>i</mi> </msub> </mrow></math> .</div>
|
|
</div>
|
|
<p>The controls include the same demographic characteristics used in equation 1, measured at the time of cessation. We can therefore apply the coefficients to estimate the probability of returning to the <abbr class="spell">SSI</abbr> program each year, conditional on payments being ceased.<sup><a href="#mn18" id="mt18">18</a></sup> We can then sum those probabilities across the population to estimate the total number of child recipients who had experienced a <abbr class="spell">CDR</abbr> cessation and would have returned to the <abbr class="spell">SSI</abbr> program each year. Thus, the probability of being a recipient at the start of each year is the sum of (1) the probability of having been a recipient for the entirety of that year and (2) the probability of returning to the <abbr class="spell">SSI</abbr> program in that year after experiencing a <abbr class="spell">CDR</abbr> cessation in a prior year.</p>
|
|
<p>We then used those estimates to create a counterfactual caseload. First, we calculated the net reduction in the caseload resulting from <abbr class="spell">CDR</abbr> cessations in each year under a given model, which is the total number of cessations minus the total number of program returns. Next, we calculated the actual net reduction in the caseload from <abbr class="spell">CDR</abbr> cessations. To estimate the counterfactual caseload under a given model, we modified the year-to-year changes in child <abbr class="spell">SSI</abbr> participation by replacing the actual net reduction because of <abbr class="spell">CDR</abbr>s with the model-based net reduction because of <abbr class="spell">CDR</abbr>s.<sup><a href="#mn19" id="mt19">19</a></sup> That process isolates the role of <abbr class="spell">CDR</abbr>s from all other programmatic factors contributing to changes in the caseload (new applications, other cessations, and other factors) by holding all other year-to-year changes fixed. One limitation of that approach is that our analysis does not control for or otherwise incorporate economic, sociocultural, environmental, medical, or other factors. As a result, we do not predict non-<abbr class="spell">CDR</abbr>-related changes in <abbr class="spell">SSI</abbr> program participation, such as those stemming from outreach efforts or the overall decline in childhood poverty in recent years.</p>
|
|
<p>In addition, the differential pattern between the low cessation (2008) cohort and the stable cessation (2017) cohort enables us to estimate the share of <abbr class="spell">SSI</abbr> caseload fluctuations that stem from <abbr class="spell">CDR</abbr> cessation patterns. The difference in net cessations between those two models represents the change in the number of <abbr class="spell">SSI</abbr> recipients that can be attributed to the variance in <abbr class="spell">CDR</abbr> frequencies. Benchmarking that number to the total change in the <abbr class="spell">SSI</abbr> caseload each year, or over a multiyear period, indicates what share of <abbr class="spell">SSI</abbr> caseload fluctuations stems from <abbr class="spell">CDR</abbr> cessations alone.</p>
|
|
<h2>Results</h2>
|
|
<p>We arrange our findings in the order of our three research questions.</p>
|
|
<h3>Research Question 1: What Are the Characteristics of Children Whose <abbr class="spell">SSI</abbr> Payments Are Ceased Because of a <abbr class="spell">CDR</abbr>?</h3>
|
|
<p>A child <abbr class="spell">SSI</abbr> recipient's medical diary category is an important predictor of <abbr class="spell">CDR</abbr> cessation. As noted earlier, the three medical diary categories are medical improvement expected, medical improvement possible, and medical improvement not expected. In a typical calendar year from 2003 through 2021, medical improvement was deemed possible for about 70 percent of children with ceased payments, about 30 percent were expected to experience medical improvement, and a negligible share were not expected to experience medical improvement (Chart 5, Panel A). The share of children with ceased payments who were expected to experience medical improvement was elevated from 2012 through 2014, coinciding with the initial increase in <abbr class="spell">CDR</abbr> frequency shown in <a href="#chart1">Chart 1</a>.</p>
|
|
<div class="svgChart chart700" id="chart5"> <img src="v84n4p1-chart05.svg" role="img" alt="Chart 5. Two panels of line charts with consolidated tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 5. </span>Child <abbr class="spell">CDR</abbr> cessations by medical diary category, <span class="nobr">2003–2021</span></caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="3" style="width:10em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th rowspan="2" class="stubHeading" scope="colgroup">Year of cessation</th>
|
|
<th colspan="3" class="spanner" scope="colgroup">Medical improvement—</th>
|
|
</tr>
|
|
<tr>
|
|
<th scope="col">Possible</th>
|
|
<th scope="col">Expected</th>
|
|
<th scope="col">Not expected</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel A: Percentage distribution</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>74.2</td>
|
|
<td>25.7</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>69.8</td>
|
|
<td>30.1</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>69.0</td>
|
|
<td>30.9</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>71.6</td>
|
|
<td>28.3</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>71.1</td>
|
|
<td>28.8</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>67.7</td>
|
|
<td>32.2</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>68.3</td>
|
|
<td>31.7</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>72.3</td>
|
|
<td>27.6</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>64.5</td>
|
|
<td>35.4</td>
|
|
<td>0.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>52.3</td>
|
|
<td>47.7</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>55.8</td>
|
|
<td>44.2</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>56.5</td>
|
|
<td>43.5</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>71.6</td>
|
|
<td>28.4</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>76.4</td>
|
|
<td>23.6</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>77.7</td>
|
|
<td>22.3</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>78.5</td>
|
|
<td>21.5</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>80.8</td>
|
|
<td>19.2</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>81.2</td>
|
|
<td>18.8</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>81.7</td>
|
|
<td>18.3</td>
|
|
<td>0.0</td>
|
|
</tr>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel B: Cessation share relative to all-recipient share <sup>a</sup> (proportional share)</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>1.04</td>
|
|
<td>1.92</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>0.98</td>
|
|
<td>2.25</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>0.97</td>
|
|
<td>2.27</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>1.00</td>
|
|
<td>2.01</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>1.00</td>
|
|
<td>1.93</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>0.96</td>
|
|
<td>1.99</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>0.97</td>
|
|
<td>1.91</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>1.02</td>
|
|
<td>1.63</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.91</td>
|
|
<td>2.05</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>0.73</td>
|
|
<td>2.88</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>0.77</td>
|
|
<td>2.75</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>0.78</td>
|
|
<td>2.86</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>0.98</td>
|
|
<td>2.05</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>1.05</td>
|
|
<td>1.87</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>1.08</td>
|
|
<td>1.86</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>1.09</td>
|
|
<td>1.93</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>1.13</td>
|
|
<td>1.85</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>1.14</td>
|
|
<td>1.98</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>1.14</td>
|
|
<td>1.98</td>
|
|
<td>0.00</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="onlyNote" colspan="4">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.
|
|
<div class="newNote">a. The share of child <abbr class="spell">SSI</abbr> recipients with a given medical diary category who experience a <abbr class="spell">CDR</abbr> cessation divided by the share of all child <abbr class="spell">SSI</abbr> recipients in that medical diary category.</div>
|
|
</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>When we benchmark those trends versus the shares of all child <abbr class="spell">SSI</abbr> recipients in each medical diary category, it becomes evident that those expected to experience medical improvement constitute a disproportionately high share of children with ceased payments each year (Chart 5, Panel B). As noted earlier, about 15 percent of child <abbr class="spell">SSI</abbr> recipients are expected to experience medical improvement. With those children making up about 30 percent of the annual cessation (Chart 5, Panel A), they are twice as likely to have their payments ceased as the average child <abbr class="spell">SSI</abbr> recipient. By contrast, the share of child <abbr class="spell">SSI</abbr> recipients with medical improvement possible who had their payments ceased aligns closely with their representation in the overall child <abbr class="spell">SSI</abbr> recipient population. Given an expectation of medical improvement, which causes more frequent <abbr class="spell">CDR</abbr>s, it is predictable that the rates of <abbr class="spell">CDR</abbr> cessation are differentially higher among this group. Charts <span class="nobr">6–8</span> and the accompanying discussion use the benchmarked trends as shown in Chart 5, Panel B. That is, the results are expressed as the share of children with a given characteristic whose payments ceased (such as 30 percent who are expected to experience medical improvement in the example above) divided by the share of all child <abbr class="spell">SSI</abbr> recipients with that characteristic (15 percent in the example above; thus, 30 divided by 15 equals the benchmarked proportion of 2).<sup><a href="#mn20" id="mt20">20</a></sup></p>
|
|
<p>Chart 6 shows that age patterns of children with ceased payments have been mostly stable since 2010, despite the large increase in <abbr class="spell">CDR</abbr> frequency during the later part of the period. In the early part of the period, children aged <span class="nobr">1–5</span> were disproportionately more likely than those in other age groups to have their payments ceased. However, this pattern began changing in 2009. In all years after 2010, the youngest <span class="nobr">(1–5)</span> and oldest <span class="nobr">(14–17)</span> age groups were least likely to have <abbr class="spell">SSI</abbr> payments ceased, while children aged <span class="nobr">6–10</span> and <span class="nobr">11–13</span> faced differentially higher cessation rates.</p>
|
|
<div class="svgChart chart700" id="chart6"> <img src="v84n4p1-chart06.svg" role="img" alt="Chart 6. Line chart with tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 6. </span>Child <abbr class="spell">CDR</abbr> cessations by age at cessation: Cessation share relative to all-recipient share,<sup>a</sup> <span class="nobr">2003–2021</span> (proportional share)</caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="4" style="width:6em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year of cessation</th>
|
|
<th scope="col">Aged <span class="nobr">1–5</span></th>
|
|
<th scope="col">Aged <span class="nobr">6–10</span></th>
|
|
<th scope="col">Aged <span class="nobr">11–13</span></th>
|
|
<th scope="col">Aged <span class="nobr">14–17</span></th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>1.36</td>
|
|
<td>1.24</td>
|
|
<td>0.93</td>
|
|
<td>0.66</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>1.85</td>
|
|
<td>1.38</td>
|
|
<td>0.75</td>
|
|
<td>0.29</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>1.89</td>
|
|
<td>1.48</td>
|
|
<td>0.74</td>
|
|
<td>0.17</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>1.81</td>
|
|
<td>1.58</td>
|
|
<td>0.74</td>
|
|
<td>0.16</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>1.91</td>
|
|
<td>1.56</td>
|
|
<td>0.71</td>
|
|
<td>0.14</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>1.89</td>
|
|
<td>1.63</td>
|
|
<td>0.66</td>
|
|
<td>0.10</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1.36</td>
|
|
<td>1.60</td>
|
|
<td>0.93</td>
|
|
<td>0.30</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>0.81</td>
|
|
<td>1.50</td>
|
|
<td>1.14</td>
|
|
<td>0.66</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.82</td>
|
|
<td>1.45</td>
|
|
<td>1.16</td>
|
|
<td>0.67</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>0.68</td>
|
|
<td>1.55</td>
|
|
<td>1.42</td>
|
|
<td>0.47</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>0.85</td>
|
|
<td>1.45</td>
|
|
<td>1.17</td>
|
|
<td>0.62</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>0.85</td>
|
|
<td>1.46</td>
|
|
<td>1.14</td>
|
|
<td>0.63</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>0.73</td>
|
|
<td>1.33</td>
|
|
<td>1.29</td>
|
|
<td>0.75</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>0.76</td>
|
|
<td>1.27</td>
|
|
<td>1.31</td>
|
|
<td>0.77</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>0.87</td>
|
|
<td>1.30</td>
|
|
<td>1.24</td>
|
|
<td>0.73</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>0.96</td>
|
|
<td>1.28</td>
|
|
<td>1.21</td>
|
|
<td>0.70</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>0.94</td>
|
|
<td>1.30</td>
|
|
<td>1.19</td>
|
|
<td>0.70</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>0.98</td>
|
|
<td>1.33</td>
|
|
<td>1.17</td>
|
|
<td>0.65</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>1.01</td>
|
|
<td>1.30</td>
|
|
<td>1.20</td>
|
|
<td>0.64</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="onlyNote" colspan="5">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.
|
|
<div class="newNote">a. The share of child <abbr class="spell">SSI</abbr> recipients in a given age group who experience a <abbr class="spell">CDR</abbr> cessation divided by the share of all child <abbr class="spell">SSI</abbr> recipients in that age group.</div>
|
|
</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>Chart 7 shows that children with certain primary medical diagnoses were much more likely to face payment cessation than children with selected other diagnoses.<sup><a href="#mn21" id="mt21">21</a></sup> Among children with mental disorders (Panel A), those with developmental disorders were consistently more likely to have payments ceased prior to 2021. Those with intellectual disorders and autism spectrum disorders were less likely to have a <abbr class="spell">CDR</abbr> cessation. In the later years, the pattern slightly shifted, as children with other mental disorders<sup><a href="#mn22" id="mt22">22</a></sup> became slightly more likely than children with developmental disorders<sup><a href="#mn23" id="mt23">23</a></sup> to have a <abbr class="spell">CDR</abbr> cessation. Among nonmental diagnoses (Panel B), children with respiratory system diseases were more likely to have <abbr class="spell">SSI</abbr> payments ceased while children with nervous system and sense organ diseases were less likely to have <abbr class="spell">SSI</abbr> payments ceased.</p>
|
|
<div class="svgChart chart700" id="chart7"> <img src="v84n4p1-chart07.svg" role="img" alt="Chart 7. Two panels of line charts with consolidated tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 7. </span>Child <abbr class="spell">CDR</abbr> cessations by selected primary diagnosis: Cessation share relative to all-recipient share,<sup>a</sup> <span class="nobr">2003–2021</span> (proportional share)</caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="4" style="width:6em"></colgroup>
|
|
<colgroup span="4" style="width:6em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th rowspan="2" class="stubHeading" scope="colgroup">Year of cessation</th>
|
|
<th colspan="4" class="spanner" scope="colgroup">Panel A: Mental disorders</th>
|
|
<th colspan="4" class="spanner" scope="colgroup">Panel B: Other diagnoses</th>
|
|
</tr>
|
|
<tr>
|
|
<th scope="col">Developmental disorders</th>
|
|
<th scope="col">Intellectual disorders</th>
|
|
<th scope="col">Autism spectrum disorders</th>
|
|
<th scope="col">Other mental disorders</th>
|
|
<th scope="col">Respiratory system diseases</th>
|
|
<th scope="col">Congenital anomalies</th>
|
|
<th scope="col">Nervous system and sense organ diseases</th>
|
|
<th scope="col">Other</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>1.68</td>
|
|
<td>0.75</td>
|
|
<td>0.22</td>
|
|
<td>1.00</td>
|
|
<td>5.40</td>
|
|
<td>1.36</td>
|
|
<td>0.52</td>
|
|
<td>1.73</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>2.07</td>
|
|
<td>0.62</td>
|
|
<td>0.22</td>
|
|
<td>0.88</td>
|
|
<td>6.10</td>
|
|
<td>1.67</td>
|
|
<td>0.53</td>
|
|
<td>1.50</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>2.20</td>
|
|
<td>0.56</td>
|
|
<td>0.19</td>
|
|
<td>0.90</td>
|
|
<td>6.36</td>
|
|
<td>1.63</td>
|
|
<td>0.53</td>
|
|
<td>1.44</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>2.37</td>
|
|
<td>0.59</td>
|
|
<td>0.17</td>
|
|
<td>0.97</td>
|
|
<td>5.98</td>
|
|
<td>1.42</td>
|
|
<td>0.50</td>
|
|
<td>1.35</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>2.26</td>
|
|
<td>0.59</td>
|
|
<td>0.19</td>
|
|
<td>0.93</td>
|
|
<td>6.82</td>
|
|
<td>1.33</td>
|
|
<td>0.49</td>
|
|
<td>1.26</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>2.27</td>
|
|
<td>0.60</td>
|
|
<td>0.11</td>
|
|
<td>0.96</td>
|
|
<td>6.52</td>
|
|
<td>1.07</td>
|
|
<td>0.57</td>
|
|
<td>1.13</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>2.30</td>
|
|
<td>0.57</td>
|
|
<td>0.19</td>
|
|
<td>0.97</td>
|
|
<td>4.46</td>
|
|
<td>1.36</td>
|
|
<td>0.46</td>
|
|
<td>1.45</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>2.33</td>
|
|
<td>0.50</td>
|
|
<td>0.21</td>
|
|
<td>1.01</td>
|
|
<td>2.96</td>
|
|
<td>1.07</td>
|
|
<td>0.40</td>
|
|
<td>1.47</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>2.04</td>
|
|
<td>0.27</td>
|
|
<td>0.16</td>
|
|
<td>0.89</td>
|
|
<td>5.52</td>
|
|
<td>1.26</td>
|
|
<td>0.37</td>
|
|
<td>1.30</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>2.77</td>
|
|
<td>0.20</td>
|
|
<td>0.10</td>
|
|
<td>1.31</td>
|
|
<td>3.96</td>
|
|
<td>0.88</td>
|
|
<td>0.25</td>
|
|
<td>0.81</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>2.10</td>
|
|
<td>0.22</td>
|
|
<td>0.13</td>
|
|
<td>0.88</td>
|
|
<td>5.52</td>
|
|
<td>1.20</td>
|
|
<td>0.39</td>
|
|
<td>1.21</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>2.15</td>
|
|
<td>0.23</td>
|
|
<td>0.14</td>
|
|
<td>0.89</td>
|
|
<td>4.91</td>
|
|
<td>1.35</td>
|
|
<td>0.44</td>
|
|
<td>0.93</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>2.21</td>
|
|
<td>0.28</td>
|
|
<td>0.18</td>
|
|
<td>0.97</td>
|
|
<td>4.21</td>
|
|
<td>1.14</td>
|
|
<td>0.48</td>
|
|
<td>0.73</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>2.02</td>
|
|
<td>0.29</td>
|
|
<td>0.30</td>
|
|
<td>1.14</td>
|
|
<td>3.72</td>
|
|
<td>0.94</td>
|
|
<td>0.55</td>
|
|
<td>0.68</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>1.94</td>
|
|
<td>0.32</td>
|
|
<td>0.30</td>
|
|
<td>1.16</td>
|
|
<td>3.92</td>
|
|
<td>0.82</td>
|
|
<td>0.63</td>
|
|
<td>0.63</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>1.87</td>
|
|
<td>0.34</td>
|
|
<td>0.29</td>
|
|
<td>1.17</td>
|
|
<td>4.35</td>
|
|
<td>0.85</td>
|
|
<td>0.62</td>
|
|
<td>0.55</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>1.74</td>
|
|
<td>0.37</td>
|
|
<td>0.28</td>
|
|
<td>1.30</td>
|
|
<td>4.40</td>
|
|
<td>0.78</td>
|
|
<td>0.62</td>
|
|
<td>0.53</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>1.61</td>
|
|
<td>0.42</td>
|
|
<td>0.32</td>
|
|
<td>1.36</td>
|
|
<td>4.89</td>
|
|
<td>0.70</td>
|
|
<td>0.60</td>
|
|
<td>0.52</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>1.47</td>
|
|
<td>0.41</td>
|
|
<td>0.33</td>
|
|
<td>1.51</td>
|
|
<td>3.87</td>
|
|
<td>0.75</td>
|
|
<td>0.61</td>
|
|
<td>0.46</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="onlyNote" colspan="9">SOURCE: Author's calculations using administrative records from <abbr class="spell">SSA</abbr>.
|
|
<div class="newNote">a. The share of child <abbr class="spell">SSI</abbr> recipients with a given diagnosis who experience a <abbr class="spell">CDR</abbr> cessation divided by the share of all child <abbr class="spell">SSI</abbr> recipients with that diagnosis.</div>
|
|
</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>Finally, Chart 8 shows that children with ceased payments disproportionately lived in areas of high socioeconomic deprivation. For example, 36.8 percent of children with ceased payments in 2017 lived in <abbr>ZIP</abbr> Codes in the fourth quartile of socioeconomic deprivation (indicating worse economic outcomes). Yet only 30.7 percent of all child <abbr class="spell">SSI</abbr> recipients lived in such <abbr>ZIP</abbr> Codes. Thus, the proportional cessation rate was 1.2 for the fourth quartile in 2017. By contrast, 14.1 percent of children with ceased payments in 2017 lived in <abbr>ZIP</abbr> Codes in the first (or most advantaged) quartile of socioeconomic deprivation, compared with 19.4 percent of all child <abbr class="spell">SSI</abbr> recipients living in those <abbr>ZIP</abbr> Codes (a 0.7 proportional cessation rate). The general patterns hold true whether measuring socioeconomic deprivation at the <abbr>ZIP</abbr> Code or county level.<sup><a href="#mn24" id="mt24">24</a></sup> We explore whether appeals might play a role in this finding: In theory, one might expect that children in areas with lower socioeconomic deprivation might be more likely to appeal an initial cessation because of greater knowledge of the appeal process or greater resources to go through that process. However, we found that, in each of the four socioeconomic deprivation quartiles, the percentage of children with ceased payments who appealed that cessation was roughly equal to the percentage of the overall child <abbr class="spell">SSI</abbr> population, indicating no differential patterns in appeals (results available on request).</p>
|
|
<div class="svgChart chart700" id="chart8"> <img src="v84n4p1-chart08.svg" role="img" alt="Chart 8. Two panels of line charts with consolidated tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 8. </span>Child <abbr class="spell">CDR</abbr> cessations by socioeconomic deprivation quartile: Cessation share relative to all-recipient share,<sup>a</sup> <span class="nobr">2003–2021</span> (proportional share)</caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="4" style="width:6em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year of cessation</th>
|
|
<th scope="col">Quartile 1</th>
|
|
<th scope="col">Quartile 2</th>
|
|
<th scope="col">Quartile 3</th>
|
|
<th scope="col">Quartile 4</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="4" class="panel" scope="rowgroup">Panel A: At <abbr>ZIP</abbr> Code level</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td colspan="4"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td colspan="4"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>0.77</td>
|
|
<td>0.95</td>
|
|
<td>1.01</td>
|
|
<td>1.14</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>0.72</td>
|
|
<td>0.88</td>
|
|
<td>1.01</td>
|
|
<td>1.22</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>0.65</td>
|
|
<td>0.83</td>
|
|
<td>1.03</td>
|
|
<td>1.27</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>0.66</td>
|
|
<td>0.82</td>
|
|
<td>1.04</td>
|
|
<td>1.27</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>0.72</td>
|
|
<td>0.89</td>
|
|
<td>1.03</td>
|
|
<td>1.22</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>0.80</td>
|
|
<td>0.93</td>
|
|
<td>0.99</td>
|
|
<td>1.17</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.69</td>
|
|
<td>0.91</td>
|
|
<td>1.08</td>
|
|
<td>1.17</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>0.59</td>
|
|
<td>0.85</td>
|
|
<td>1.13</td>
|
|
<td>1.24</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>0.65</td>
|
|
<td>0.87</td>
|
|
<td>1.13</td>
|
|
<td>1.19</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>0.72</td>
|
|
<td>0.95</td>
|
|
<td>1.10</td>
|
|
<td>1.12</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>0.76</td>
|
|
<td>0.96</td>
|
|
<td>1.07</td>
|
|
<td>1.12</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>0.78</td>
|
|
<td>0.94</td>
|
|
<td>1.04</td>
|
|
<td>1.15</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>0.73</td>
|
|
<td>0.93</td>
|
|
<td>1.04</td>
|
|
<td>1.19</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>0.72</td>
|
|
<td>0.93</td>
|
|
<td>1.05</td>
|
|
<td>1.19</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>0.68</td>
|
|
<td>0.92</td>
|
|
<td>1.04</td>
|
|
<td>1.23</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>0.67</td>
|
|
<td>0.90</td>
|
|
<td>1.05</td>
|
|
<td>1.25</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>0.72</td>
|
|
<td>0.93</td>
|
|
<td>1.03</td>
|
|
<td>1.21</td>
|
|
</tr>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="4" class="panel" scope="rowgroup">Panel B: At county level</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>0.91</td>
|
|
<td>0.97</td>
|
|
<td>1.16</td>
|
|
<td>1.11</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>0.88</td>
|
|
<td>1.01</td>
|
|
<td>1.14</td>
|
|
<td>1.15</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>0.88</td>
|
|
<td>1.03</td>
|
|
<td>1.17</td>
|
|
<td>1.02</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>0.86</td>
|
|
<td>0.98</td>
|
|
<td>1.17</td>
|
|
<td>1.18</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>0.81</td>
|
|
<td>0.98</td>
|
|
<td>1.25</td>
|
|
<td>1.20</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>0.75</td>
|
|
<td>1.12</td>
|
|
<td>1.37</td>
|
|
<td>0.94</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>0.73</td>
|
|
<td>1.02</td>
|
|
<td>1.30</td>
|
|
<td>1.28</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>0.86</td>
|
|
<td>1.09</td>
|
|
<td>1.07</td>
|
|
<td>1.13</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.76</td>
|
|
<td>1.09</td>
|
|
<td>1.16</td>
|
|
<td>1.29</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>0.69</td>
|
|
<td>1.08</td>
|
|
<td>1.20</td>
|
|
<td>1.46</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>0.72</td>
|
|
<td>1.05</td>
|
|
<td>1.13</td>
|
|
<td>1.55</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>0.80</td>
|
|
<td>1.08</td>
|
|
<td>1.14</td>
|
|
<td>1.23</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>0.88</td>
|
|
<td>1.05</td>
|
|
<td>1.11</td>
|
|
<td>1.09</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>0.89</td>
|
|
<td>1.05</td>
|
|
<td>1.04</td>
|
|
<td>1.20</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>0.84</td>
|
|
<td>1.09</td>
|
|
<td>1.05</td>
|
|
<td>1.24</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>0.85</td>
|
|
<td>1.08</td>
|
|
<td>1.09</td>
|
|
<td>1.18</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>0.83</td>
|
|
<td>1.05</td>
|
|
<td>1.12</td>
|
|
<td>1.26</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>0.79</td>
|
|
<td>1.07</td>
|
|
<td>1.16</td>
|
|
<td>1.25</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>0.84</td>
|
|
<td>1.08</td>
|
|
<td>1.14</td>
|
|
<td>1.14</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="onlyNote" colspan="5">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr> and American Community Survey data.
|
|
<div class="newNote">a. The share of child <abbr class="spell">SSI</abbr> recipients in a given socioeconomic deprivation quartile who experience a <abbr class="spell">CDR</abbr> cessation divided by the share of all child <abbr class="spell">SSI</abbr> recipients in that quartile.</div>
|
|
</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<h3>Research Question 2: What Are the Outcomes for Children in the Years Following a <abbr class="spell">CDR</abbr> Cessation?</h3>
|
|
<p>Among children whose payments were ceased, a modest share returned to the <abbr class="spell">SSI</abbr> program within 5 years of the cessation (Chart 9).<sup><a href="#mn25" id="mt25">25</a></sup> On average during the study period, 1.7 percent of children returned to <abbr class="spell">SSI</abbr> in the first year after a cessation, 5.6 percent returned in the first 3 years, and 8.0 percent returned in the first 5 years. The <abbr class="spell">SSI</abbr> return rates began to drop with the 2009 cessation cohort. For the 2011 and later cessation cohorts, the average annual rates of return were 1.2 percent after 1 year, 4.1 percent after 3 years, and 5.7 percent after 5 years.<sup><a href="#mn26" id="mt26">26</a></sup> Interestingly, even as the frequency of <abbr class="spell">CDR</abbr>s substantially increased starting in 2015, the <abbr class="spell">SSI</abbr> return rates did not change noticeably.</p>
|
|
<div class="svgChart chart700" id="chart9"> <img src="v84n4p1-chart09.svg" role="img" alt="Chart 9. Line chart with tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 9. </span>Percentage of children with ceased payments who later returned to the <abbr class="spell">SSI</abbr> rolls, by year of cessation and window of return, <span class="nobr">2003–2017</span></caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="3" style="width:6em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year of cessation</th>
|
|
<th scope="col">Within 1 year</th>
|
|
<th scope="col">Within 3 years</th>
|
|
<th scope="col">Within 5 years</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>2.0</td>
|
|
<td>6.9</td>
|
|
<td>10.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>2.1</td>
|
|
<td>6.8</td>
|
|
<td>9.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>2.2</td>
|
|
<td>6.9</td>
|
|
<td>10.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>2.3</td>
|
|
<td>7.3</td>
|
|
<td>11.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>2.4</td>
|
|
<td>8.3</td>
|
|
<td>11.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>3.2</td>
|
|
<td>8.5</td>
|
|
<td>11.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1.8</td>
|
|
<td>6.0</td>
|
|
<td>8.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>1.6</td>
|
|
<td>4.8</td>
|
|
<td>6.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.8</td>
|
|
<td>3.4</td>
|
|
<td>5.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>1.1</td>
|
|
<td>3.5</td>
|
|
<td>5.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>1.3</td>
|
|
<td>4.3</td>
|
|
<td>6.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>1.3</td>
|
|
<td>4.4</td>
|
|
<td>6.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>1.3</td>
|
|
<td>4.1</td>
|
|
<td>5.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>1.3</td>
|
|
<td>4.3</td>
|
|
<td>5.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>1.5</td>
|
|
<td>4.6</td>
|
|
<td>5.9</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="onlyNote" colspan="4">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>Our analysis of postcessation earnings focuses exclusively on youths who had reached working age at the time of measurement, specifically those aged 16 or older. This analysis helps us to understand the economic outcomes of former child <abbr class="spell">SSI</abbr> recipients as they transition into the workforce. Given the typical progression of career development, we anticipate an increase in earnings as those youths age, particularly when comparing earnings 5 years after cessation with earnings in the first year after cessation.</p>
|
|
<p>Chart 10 shows that earnings increased in the years following cessation, but it also suggests that the earnings potential for former child <abbr class="spell">SSI</abbr> recipients was fairly limited. For the 2017 cessation cohort, average annual earnings increased from $2,716 in the first calendar year after cessation to $9,608 5 years after cessation (Panel A). Correspondingly, the shares of former recipients with any postcessation annual earnings (Panel B) and with substantive earnings amounts (more than $16,200, the 2022 annualized substantial gainful activity amount; Panel C) wavered in the early cessation cohorts but increased with the passage of time for the later cohorts. The effects of the Great Recession are evident: earnings amounts 3 years after cessation were lowest for the 2007 and 2008 cohorts, while earnings amounts 5 years after cessation were lowest for the 2005 and 2006 cohorts—aligning with earnings accrued in calendar years 2010 and 2011. Interestingly, it seems the <span class="nobr"><abbr>COVID</abbr>-19</span> pandemic had minimal effects on those cohort-based patterns, as 2020 calendar year earnings aligned closely with adjacent years.</p>
|
|
<div class="svgChart chart700" id="chart10"> <img src="v84n4p1-chart10.svg" role="img" alt="Chart 10. Three panels of line charts with consolidated tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 10. </span>Earnings following a <abbr class="spell">CDR</abbr> cessation, by year of cessation, <span class="nobr">2003–2017</span></caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="3" style="width:10em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year of cessation</th>
|
|
<th scope="col">1 year after cessation</th>
|
|
<th scope="col">3 years after cessation</th>
|
|
<th scope="col">5 years after cessation</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel A: Average annual earnings amount (dollars)</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>2,061</td>
|
|
<td>4,190</td>
|
|
<td>5,024</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>2,961</td>
|
|
<td>4,151</td>
|
|
<td>3,422</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>3,045</td>
|
|
<td>3,188</td>
|
|
<td>2,953</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>3,622</td>
|
|
<td>2,571</td>
|
|
<td>2,940</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>2,372</td>
|
|
<td>1,957</td>
|
|
<td>3,226</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>1,209</td>
|
|
<td>2,010</td>
|
|
<td>3,446</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1,212</td>
|
|
<td>2,464</td>
|
|
<td>4,298</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>1,018</td>
|
|
<td>2,491</td>
|
|
<td>5,219</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>947</td>
|
|
<td>2,959</td>
|
|
<td>5,758</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>924</td>
|
|
<td>2,660</td>
|
|
<td>5,200</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>1,150</td>
|
|
<td>3,551</td>
|
|
<td>6,299</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>1,472</td>
|
|
<td>3,806</td>
|
|
<td>6,858</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>1,553</td>
|
|
<td>4,242</td>
|
|
<td>6,894</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>1,950</td>
|
|
<td>4,837</td>
|
|
<td>8,395</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>2,716</td>
|
|
<td>5,457</td>
|
|
<td>9,608</td>
|
|
</tr>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel B: Share with annual earnings (greater than $0) (percent)</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>42.9</td>
|
|
<td>54.2</td>
|
|
<td>52.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>49.4</td>
|
|
<td>50.6</td>
|
|
<td>39.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>47.9</td>
|
|
<td>41.5</td>
|
|
<td>35.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>50.3</td>
|
|
<td>32.2</td>
|
|
<td>36.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>36.0</td>
|
|
<td>31.5</td>
|
|
<td>41.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>25.9</td>
|
|
<td>32.3</td>
|
|
<td>43.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>25.2</td>
|
|
<td>36.1</td>
|
|
<td>49.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>23.3</td>
|
|
<td>37.0</td>
|
|
<td>54.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>23.9</td>
|
|
<td>43.5</td>
|
|
<td>56.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>23.2</td>
|
|
<td>42.1</td>
|
|
<td>56.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>28.6</td>
|
|
<td>49.4</td>
|
|
<td>60.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>34.5</td>
|
|
<td>51.6</td>
|
|
<td>62.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>34.5</td>
|
|
<td>54.3</td>
|
|
<td>60.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>38.5</td>
|
|
<td>55.8</td>
|
|
<td>65.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>45.3</td>
|
|
<td>56.6</td>
|
|
<td>67.3</td>
|
|
</tr>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel C: Share with earnings above the substantial gainful activity threshold <sup>a</sup> (percent)</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>2.5</td>
|
|
<td>7.5</td>
|
|
<td>10.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>4.3</td>
|
|
<td>7.9</td>
|
|
<td>7.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>5.0</td>
|
|
<td>6.3</td>
|
|
<td>5.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>6.2</td>
|
|
<td>5.0</td>
|
|
<td>4.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>5.0</td>
|
|
<td>3.0</td>
|
|
<td>5.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>1.7</td>
|
|
<td>3.5</td>
|
|
<td>7.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1.2</td>
|
|
<td>4.7</td>
|
|
<td>9.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>1.0</td>
|
|
<td>3.9</td>
|
|
<td>11.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.6</td>
|
|
<td>4.8</td>
|
|
<td>12.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>0.7</td>
|
|
<td>4.0</td>
|
|
<td>10.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>0.8</td>
|
|
<td>5.9</td>
|
|
<td>13.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>1.1</td>
|
|
<td>6.3</td>
|
|
<td>15.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>1.2</td>
|
|
<td>7.3</td>
|
|
<td>15.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>1.8</td>
|
|
<td>9.1</td>
|
|
<td>19.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>3.4</td>
|
|
<td>11.3</td>
|
|
<td>22.8</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="4">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr> and American Community Survey data.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="4">NOTES: All earnings are converted to real 2022 dollars.
|
|
<div class="newNote">Earnings are included only for youths in the calendar year in which they are aged 16 or older.</div>
|
|
<div class="newNote">a. For non-blind recipients in 2022, this was $16,200 for the year ($1,350 per month).</div>
|
|
</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<h3>Research Question 3: How Do <abbr class="spell">CDR</abbr> Cessation Patterns Affect Child <abbr class="spell">SSI</abbr> Caseload Trends?</h3>
|
|
<p>As described earlier, we estimated the counterfactual caseload over time based on the likelihood that each child <abbr class="spell">SSI</abbr> recipient would have payments ceased because of a <abbr class="spell">CDR</abbr> each year. Then for those with payments ceased, we estimated the likelihood that they would return to the <abbr class="spell">SSI</abbr> program. By summing those probabilities, we estimated the number of total cessations and program returns that would have occurred in each calendar year if the cessation and return probabilities had followed the patterns of an individual annual cessation cohort over time—namely, if the rate of <abbr class="spell">CDR</abbr> cessations had been constant (rather than the variation in <abbr class="spell">CDR</abbr> frequency that occurred over the years). Finally, to obtain the counterfactual child <abbr class="spell">SSI</abbr> caseload, we replaced the observed net reduction from <abbr class="spell">CDR</abbr>s in each year (cessations minus returns) with the model-based prediction.</p>
|
|
<p>Chart 11 shows that the cessation cohort has substantial implications for the likelihood of a child being removed from the <abbr class="spell">SSI</abbr> program by a <abbr class="spell">CDR</abbr>. Each of the three medical diary categories is represented by one of the chart's panels. The red line in each panel shows the actual cessation rate for that category. Children expected to experience medical improvement had the highest cessation rates, followed by children for whom medical improvement was possible. Almost no one who was not expected to experience medical improvement had payments ceased in any year, consistent with <abbr class="spell">SSA</abbr> practice of generally not conducting <abbr class="spell">CDR</abbr>s for this population. Patterns over time match the frequency of child <abbr class="spell">CDR</abbr>s shown in <a href="#chart3">Chart 3</a>, with peaks in the years before and after the Great Recession, and almost no cessations from 2007 through 2010. The dark blue line represents the predicted probability of cessation using the 2017 cohort as the base year (stable cessations) in place of the observed cessation rate. Those probabilities are consistently higher than the light blue line representing the predicted probability of cessation using the 2008 cohort as the base year (low cessations). Both of the predicted probabilities exhibit smoother trends in cessation rates over time.</p>
|
|
<div class="svgChart chart700" id="chart11"> <img src="v84n4p1-chart11.svg" role="img" alt="Chart 11. Three panels of line charts with consolidated tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 11. </span>Predicted and actual <abbr class="spell">CDR</abbr> cessation rates, by medical diary category, <span class="nobr">2003–2021</span> (in percent)</caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="3" style="width:11em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year of cessation</th>
|
|
<th scope="col">Actual</th>
|
|
<th scope="col">Predicted, 2008 model</th>
|
|
<th scope="col">Predicted, 2017 model</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel A: Medical improvement expected</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>3.29</td>
|
|
<td>0.30</td>
|
|
<td>4.52</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>3.40</td>
|
|
<td>0.30</td>
|
|
<td>4.52</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>2.46</td>
|
|
<td>0.30</td>
|
|
<td>4.53</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>1.00</td>
|
|
<td>0.31</td>
|
|
<td>4.53</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>0.51</td>
|
|
<td>0.31</td>
|
|
<td>4.56</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>0.32</td>
|
|
<td>0.32</td>
|
|
<td>4.60</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>0.35</td>
|
|
<td>0.34</td>
|
|
<td>4.74</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>0.35</td>
|
|
<td>0.35</td>
|
|
<td>4.84</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.85</td>
|
|
<td>0.37</td>
|
|
<td>4.98</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>2.79</td>
|
|
<td>0.39</td>
|
|
<td>5.13</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>2.31</td>
|
|
<td>0.42</td>
|
|
<td>5.29</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>4.36</td>
|
|
<td>0.44</td>
|
|
<td>5.42</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>5.99</td>
|
|
<td>0.47</td>
|
|
<td>5.58</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>6.45</td>
|
|
<td>0.50</td>
|
|
<td>5.65</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>5.57</td>
|
|
<td>0.50</td>
|
|
<td>5.59</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>6.20</td>
|
|
<td>0.50</td>
|
|
<td>5.51</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>5.18</td>
|
|
<td>0.49</td>
|
|
<td>5.44</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>3.57</td>
|
|
<td>0.47</td>
|
|
<td>5.33</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>3.34</td>
|
|
<td>0.46</td>
|
|
<td>5.26</td>
|
|
</tr>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel B: Medical improvement possible</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>1.68</td>
|
|
<td>0.13</td>
|
|
<td>2.40</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>1.38</td>
|
|
<td>0.13</td>
|
|
<td>2.43</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>0.96</td>
|
|
<td>0.13</td>
|
|
<td>2.47</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>0.45</td>
|
|
<td>0.14</td>
|
|
<td>2.51</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>0.24</td>
|
|
<td>0.14</td>
|
|
<td>2.55</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>0.14</td>
|
|
<td>0.14</td>
|
|
<td>2.60</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>0.17</td>
|
|
<td>0.15</td>
|
|
<td>2.66</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>0.22</td>
|
|
<td>0.15</td>
|
|
<td>2.69</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.37</td>
|
|
<td>0.15</td>
|
|
<td>2.73</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>0.68</td>
|
|
<td>0.16</td>
|
|
<td>2.77</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>0.62</td>
|
|
<td>0.16</td>
|
|
<td>2.81</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>1.14</td>
|
|
<td>0.16</td>
|
|
<td>2.86</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>2.72</td>
|
|
<td>0.17</td>
|
|
<td>2.91</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>3.38</td>
|
|
<td>0.18</td>
|
|
<td>2.96</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>2.97</td>
|
|
<td>0.18</td>
|
|
<td>2.98</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>3.11</td>
|
|
<td>0.18</td>
|
|
<td>2.99</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>2.74</td>
|
|
<td>0.18</td>
|
|
<td>3.02</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>1.74</td>
|
|
<td>0.18</td>
|
|
<td>3.04</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>1.77</td>
|
|
<td>0.18</td>
|
|
<td>3.09</td>
|
|
</tr>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel C: Medical improvement not expected</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>0.03</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>0.02</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>0.00</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>0.00</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>0.00</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>0.00</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>0.01</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>0.00</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>0.00</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>0.00</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>0.04</td>
|
|
<td>0.00</td>
|
|
<td>0.01</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="4">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="4">NOTES: Omits cessations with a medical diary category missing, which accounted for 33.9 percent of child <abbr class="spell">SSI</abbr> recipients in 2003. By 2017 that share had declined to 15.0 percent.
|
|
<div class="newNote">2008 model, representing low cessation pattern, uses the 2008 cessation cohort as the base year; 2017 model, representing stable cessation pattern, uses the 2017 cessation cohort as the base year.</div>
|
|
</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>Chart 12 shows that the cessation cohort does not have as much of an effect on the likelihood of returning to the <abbr class="spell">SSI</abbr> program after a child <abbr class="spell">CDR</abbr> cessation. Return rates were slightly higher for children not expected to experience medical improvement. That group also had noisier observed rates of return because of the small sample of children who had payments ceased. However, return rates are more stable than cessation rates—both in the actual rates of return over time and in the difference between the patterns using the 2008 and 2017 cessation cohorts as the base year.</p>
|
|
<div class="svgChart chart700" id="chart12"> <img src="v84n4p1-chart12.svg" role="img" alt="Chart 12. Three panels of line charts with consolidated tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 12. </span>Predicted and actual postcessation <abbr class="spell">SSI</abbr> return rates, by medical diary category, <span class="nobr">2003–2021</span> (in percent)</caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="3" style="width:12em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year of cessation</th>
|
|
<th scope="col">Actual</th>
|
|
<th scope="col">Predicted, 2008 model</th>
|
|
<th scope="col">Predicted, 2017 model</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel A: Medical improvement expected</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>1.74</td>
|
|
<td>2.92</td>
|
|
<td>2.73</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>1.70</td>
|
|
<td>2.98</td>
|
|
<td>2.75</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>1.92</td>
|
|
<td>2.87</td>
|
|
<td>2.63</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>1.90</td>
|
|
<td>2.81</td>
|
|
<td>2.56</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>2.11</td>
|
|
<td>2.83</td>
|
|
<td>2.54</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>2.30</td>
|
|
<td>2.84</td>
|
|
<td>2.51</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1.44</td>
|
|
<td>2.79</td>
|
|
<td>2.41</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>1.04</td>
|
|
<td>2.71</td>
|
|
<td>2.30</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.99</td>
|
|
<td>2.68</td>
|
|
<td>2.22</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>1.07</td>
|
|
<td>2.59</td>
|
|
<td>2.13</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>1.29</td>
|
|
<td>2.55</td>
|
|
<td>2.06</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>1.28</td>
|
|
<td>2.49</td>
|
|
<td>2.00</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>1.21</td>
|
|
<td>2.39</td>
|
|
<td>1.90</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>1.26</td>
|
|
<td>2.28</td>
|
|
<td>1.82</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>1.33</td>
|
|
<td>2.20</td>
|
|
<td>1.77</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>1.19</td>
|
|
<td>2.10</td>
|
|
<td>1.71</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>0.83</td>
|
|
<td>2.00</td>
|
|
<td>1.65</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>0.72</td>
|
|
<td>1.93</td>
|
|
<td>1.61</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>0.29</td>
|
|
<td>1.80</td>
|
|
<td>1.53</td>
|
|
</tr>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel B: Medical improvement possible</th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>1.97</td>
|
|
<td>2.75</td>
|
|
<td>2.30</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>2.00</td>
|
|
<td>2.73</td>
|
|
<td>2.26</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>2.16</td>
|
|
<td>2.71</td>
|
|
<td>2.21</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>2.23</td>
|
|
<td>2.70</td>
|
|
<td>2.17</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>2.29</td>
|
|
<td>2.68</td>
|
|
<td>2.12</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>2.30</td>
|
|
<td>2.67</td>
|
|
<td>2.07</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1.65</td>
|
|
<td>2.65</td>
|
|
<td>2.02</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>1.22</td>
|
|
<td>2.64</td>
|
|
<td>1.99</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>0.99</td>
|
|
<td>2.63</td>
|
|
<td>1.96</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>0.95</td>
|
|
<td>2.62</td>
|
|
<td>1.92</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>1.13</td>
|
|
<td>2.61</td>
|
|
<td>1.88</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>1.13</td>
|
|
<td>2.59</td>
|
|
<td>1.83</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>1.07</td>
|
|
<td>2.56</td>
|
|
<td>1.78</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>1.11</td>
|
|
<td>2.54</td>
|
|
<td>1.74</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>1.14</td>
|
|
<td>2.52</td>
|
|
<td>1.70</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>1.04</td>
|
|
<td>2.49</td>
|
|
<td>1.67</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>0.82</td>
|
|
<td>2.46</td>
|
|
<td>1.63</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>0.71</td>
|
|
<td>2.41</td>
|
|
<td>1.58</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>0.29</td>
|
|
<td>2.35</td>
|
|
<td>1.52</td>
|
|
</tr>
|
|
<tr>
|
|
<td> </td>
|
|
<th colspan="3" class="panel" scope="rowgroup">Panel C: Medical improvement not expected <sup>a</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>7.06</td>
|
|
<td>7.84</td>
|
|
<td>8.19</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>4.38</td>
|
|
<td>7.83</td>
|
|
<td>8.10</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>6.32</td>
|
|
<td>7.82</td>
|
|
<td>8.02</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>7.27</td>
|
|
<td>7.76</td>
|
|
<td>7.89</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>11.43</td>
|
|
<td>7.67</td>
|
|
<td>7.74</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>10.00</td>
|
|
<td>7.57</td>
|
|
<td>7.61</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>0.00</td>
|
|
<td>7.46</td>
|
|
<td>7.45</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>6.67</td>
|
|
<td>7.41</td>
|
|
<td>7.39</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>1.82</td>
|
|
<td>7.36</td>
|
|
<td>7.34</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>2.50</td>
|
|
<td>7.34</td>
|
|
<td>7.32</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>2.86</td>
|
|
<td>7.30</td>
|
|
<td>7.26</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>12.00</td>
|
|
<td>7.30</td>
|
|
<td>7.23</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>10.00</td>
|
|
<td>7.39</td>
|
|
<td>7.27</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>8.57</td>
|
|
<td>7.50</td>
|
|
<td>7.31</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>7.50</td>
|
|
<td>7.49</td>
|
|
<td>7.25</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>5.00</td>
|
|
<td>7.50</td>
|
|
<td>7.24</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>5.71</td>
|
|
<td>7.51</td>
|
|
<td>7.21</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>0.00</td>
|
|
<td>7.52</td>
|
|
<td>7.18</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>0.00</td>
|
|
<td>7.50</td>
|
|
<td>7.10</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="4">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="4">NOTES: Omits cessations with a medical diary category missing, which accounted for 33.9 percent of child <abbr class="spell">SSI</abbr> recipients in 2003. By 2017 that share had declined to 15.0 percent.
|
|
<div class="newNote">2008 model, representing low cessation pattern, uses the 2008 cessation cohort as the base year; 2017 model, representing stable cessation pattern, uses the 2017 cessation cohort as the base year.</div>
|
|
<div class="newNote">a. The scale for this plot is wider because the number of children from this group with payments ceased is very small (partially because <abbr class="spell">SSA</abbr> typically does not conduct <abbr class="spell">CDR</abbr>s in such cases; see Chart 11). This, in turn, leads to noisier estimates for this group.</div>
|
|
</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>Chart 13 shows the net reduction in the child <abbr class="spell">SSI</abbr> caseload attributable to <abbr class="spell">CDR</abbr>s. The red line shows the actual net reduction, and the light blue and dark blue lines respectively show the predicted net reductions using the 2008 (low cessations) and 2017 (stable cessations) models. The net contribution to the caseload from <abbr class="spell">CDR</abbr>s depends heavily on the selected model, although with consistent <abbr class="spell">CDR</abbr> volumes, it would follow a stable pattern. Under a low cessation model, there would be few cessations and thus few returns. Under a stable cessation model, there would be many more cessations—roughly 25,000 to 30,000 per year. Both models offer substantially less fluctuation than the actual pattern. One reason the 2017 model leads to a smaller net caseload reduction than the actual net reduction is that many children would have had their payments ceased earlier, leading to a lower caseload by 2017. The negative numbers indicate that <abbr class="spell">CDR</abbr>s on net contribute to a reduction in the caseload; there are always more children whose payments have ceased than children who returned to <abbr class="spell">SSI</abbr> following a previous cessation.</p>
|
|
<div class="svgChart chart700" id="chart13"> <img src="v84n4p1-chart13.svg" role="img" alt="Chart 13. Line chart with tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 13. </span>Predicted and actual net reduction in child <abbr class="spell">SSI</abbr> caseload attributable to <abbr class="spell">CDR</abbr> volume, <span class="nobr">2003–2021</span> (in thousands)</caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="3" style="width:12em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year</th>
|
|
<th scope="col">Actual</th>
|
|
<th scope="col">Predicted, 2008 model</th>
|
|
<th scope="col">Predicted, 2017 model</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>-19.03</td>
|
|
<td>-1.19</td>
|
|
<td>-20.20</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>-16.47</td>
|
|
<td>-1.26</td>
|
|
<td>-20.84</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>-11.81</td>
|
|
<td>-1.33</td>
|
|
<td>-21.41</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>-5.16</td>
|
|
<td>-1.39</td>
|
|
<td>-21.85</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>-2.51</td>
|
|
<td>-1.48</td>
|
|
<td>-22.58</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>-1.21</td>
|
|
<td>-1.58</td>
|
|
<td>-23.37</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>-1.53</td>
|
|
<td>-1.71</td>
|
|
<td>-24.53</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>-2.26</td>
|
|
<td>-1.83</td>
|
|
<td>-25.93</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>-5.30</td>
|
|
<td>-1.97</td>
|
|
<td>-27.52</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>-13.43</td>
|
|
<td>-2.07</td>
|
|
<td>-28.49</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>-11.71</td>
|
|
<td>-2.15</td>
|
|
<td>-29.09</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>-21.95</td>
|
|
<td>-2.21</td>
|
|
<td>-29.26</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>-41.53</td>
|
|
<td>-2.20</td>
|
|
<td>-28.45</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>-47.88</td>
|
|
<td>-2.14</td>
|
|
<td>-27.53</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>-40.51</td>
|
|
<td>-2.05</td>
|
|
<td>-26.51</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>-41.34</td>
|
|
<td>-1.95</td>
|
|
<td>-25.53</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>-34.49</td>
|
|
<td>-1.85</td>
|
|
<td>-24.53</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>-21.09</td>
|
|
<td>-1.81</td>
|
|
<td>-24.21</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>-19.68</td>
|
|
<td>-1.80</td>
|
|
<td>-23.99</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="4">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="4">NOTES: Net reduction is measured as the number of <abbr class="spell">CDR</abbr> cessations minus the number of <abbr class="spell">SSI</abbr> program returns among children with a previous <abbr class="spell">CDR</abbr> cessation.
|
|
<div class="newNote">2008 model, representing low cessation pattern, uses the 2008 cessation cohort as the base year; 2017 model, representing stable cessation pattern, uses the 2017 cessation cohort as the base year.</div>
|
|
</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>Taken together, the policy simulations suggest that <abbr class="spell">CDR</abbr> cessation patterns play an important role in the overall dynamics of the child <abbr class="spell">SSI</abbr> caseload over time (Chart 14). The actual caseload in 2021 consisted of around 1.04 million child <abbr class="spell">SSI</abbr> recipients, which reflects the varying <abbr class="spell">CDR</abbr> policies during that period. If <abbr class="spell">SSA</abbr> had consistently applied a stable <abbr class="spell">CDR</abbr> cessation policy, the 2021 child <abbr class="spell">SSI</abbr> caseload might have been only 0.92 million. If <abbr class="spell">SSA</abbr> had consistently applied a low cessation policy, the 2021 child <abbr class="spell">SSI</abbr> caseload might have been 1.36 million. Thus, the net child <abbr class="spell">SSI</abbr> caseload difference between a low cessation policy and a stable cessation policy is roughly 400,000.</p>
|
|
<div class="svgChart chart700" id="chart14"> <img src="v84n4p1-chart14.svg" role="img" alt="Chart 14. Line chart with tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 14. </span>Predicted and actual child <abbr class="spell">SSI</abbr> caseload, <span class="nobr">2002–2021</span> (in millions)</caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="3" style="width:12em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year</th>
|
|
<th scope="col">Actual</th>
|
|
<th scope="col">Predicted, 2008 model</th>
|
|
<th scope="col">Predicted, 2017 model</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">2002</th>
|
|
<td>0.915</td>
|
|
<td>0.915</td>
|
|
<td>0.915</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>0.959</td>
|
|
<td>0.977</td>
|
|
<td>0.958</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>0.993</td>
|
|
<td>1.026</td>
|
|
<td>0.988</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>1.036</td>
|
|
<td>1.080</td>
|
|
<td>1.021</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>1.079</td>
|
|
<td>1.126</td>
|
|
<td>1.047</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>1.121</td>
|
|
<td>1.169</td>
|
|
<td>1.069</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>1.154</td>
|
|
<td>1.202</td>
|
|
<td>1.080</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1.200</td>
|
|
<td>1.248</td>
|
|
<td>1.103</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>1.239</td>
|
|
<td>1.287</td>
|
|
<td>1.119</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>1.277</td>
|
|
<td>1.329</td>
|
|
<td>1.134</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>1.312</td>
|
|
<td>1.375</td>
|
|
<td>1.154</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>1.322</td>
|
|
<td>1.394</td>
|
|
<td>1.146</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>1.300</td>
|
|
<td>1.392</td>
|
|
<td>1.117</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>1.267</td>
|
|
<td>1.399</td>
|
|
<td>1.098</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>1.213</td>
|
|
<td>1.390</td>
|
|
<td>1.064</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>1.183</td>
|
|
<td>1.398</td>
|
|
<td>1.047</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>1.148</td>
|
|
<td>1.403</td>
|
|
<td>1.029</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>1.132</td>
|
|
<td>1.420</td>
|
|
<td>1.023</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>1.109</td>
|
|
<td>1.416</td>
|
|
<td>0.996</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>1.038</td>
|
|
<td>1.363</td>
|
|
<td>0.921</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="4">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="4">NOTE: 2008 model, representing low cessation pattern, uses the 2008 cessation cohort as the base year; 2017 model, representing stable cessation pattern, uses the 2017 cessation cohort as the base year.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<p>Although the effect of <abbr class="spell">CDR</abbr> volume in any single year is relatively minor, when cumulated over an extended period, <abbr class="spell">CDR</abbr>s can explain an important share of the change in the child <abbr class="spell">SSI</abbr> caseload. For example, from 2002 through 2013, the number of child <abbr class="spell">SSI</abbr> recipients increased by about 406,000. Comparing the 2017 (stable cessations) and 2008 (low cessations) models' patterns, we estimate that a stable cessation pattern might have netted nearly 250,000 more cessations. Thus, low <abbr class="spell">CDR</abbr> volumes can explain about 60 percent of enrollment growth from 2002 through 2013.<sup><a href="#mn27" id="mt27">27</a></sup> Increased <abbr class="spell">CDR</abbr> volume in the subsequent period, 2013 through 2021, may account for <span class="nobr">two-thirds</span> of that period's program participation decline: The caseload fell by 283,000, while the differential between the stable and low <abbr class="spell">CDR</abbr> cessation models is about 194,000.</p>
|
|
<p>Interestingly, the probability of <abbr class="spell">SSI</abbr> return plays a minimal role in the simulations. For both base year cohorts, if we had not adjusted for program return probability, the estimated value in the final year (which allows for the greatest number of possible returns over time) would be essentially unchanged. For example, the estimated number of <abbr class="spell">SSI</abbr> recipients shown in Chart 14 in 2021 from the low cessation model is 1.363 million; if we had not accounted for the probability of return, the estimated number in 2021 would have been 1.382 million. For the stable cessation model, the estimate would have been only 3,000 recipients lower if we did not adjust for program-return probability.</p>
|
|
<p>Finally, Chart 15 shows that the results are mostly not sensitive to the year chosen to represent the stable cessation cohort. When we use 2003 or 2019 as the base year instead of the 2017 cessation cohort, we still find that the child <abbr class="spell">SSI</abbr> caseload would have been substantially smaller, with subsequently smaller declines in the caseload than have been observed. Comparing the estimates with the 2008 low cessation cohort, all three cohorts would still lead us to the conclusion that <abbr class="spell">CDR</abbr> cessation patterns can explain a substantial share of the changes in child <abbr class="spell">SSI</abbr> program participation. With the 2017 base year, <abbr class="spell">CDR</abbr> volume could explain 61 percent of the caseload growth from 2002 through 2013 and 68 percent of the caseload decline from 2014 through 2021. With the 2019 base year, <abbr class="spell">CDR</abbr> volume could explain 57 percent and 62 percent, respectively, and with the 2003 cessation cohort, <abbr class="spell">CDR</abbr> volume could explain 44 percent and 47 percent, respectively.</p>
|
|
<div class="svgChart chart700" id="chart15"> <img src="v84n4p1-chart15.svg" role="img" alt="Chart 15. Line chart with tabular version below.">
|
|
<div class="table altTable"> <a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 15. </span>Predicted and actual child <abbr class="spell">SSI</abbr> caseloads using alternative base year models to represent stable cessation patterns, <span class="nobr">2002–2021</span> (in millions)</caption>
|
|
<colgroup span="1" style="width:6em"></colgroup>
|
|
<colgroup span="4" style="width:12em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Year</th>
|
|
<th scope="col">Actual</th>
|
|
<th scope="col">Predicted, 2003 model</th>
|
|
<th scope="col">Predicted, 2017 model</th>
|
|
<th scope="col">Predicted, 2019 model</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">2002</th>
|
|
<td>0.915</td>
|
|
<td>0.915</td>
|
|
<td>0.915</td>
|
|
<td>0.915</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2003</th>
|
|
<td>0.959</td>
|
|
<td>0.963</td>
|
|
<td>0.958</td>
|
|
<td>0.959</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2004</th>
|
|
<td>0.993</td>
|
|
<td>0.998</td>
|
|
<td>0.988</td>
|
|
<td>0.990</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2005</th>
|
|
<td>1.036</td>
|
|
<td>1.037</td>
|
|
<td>1.021</td>
|
|
<td>1.025</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2006</th>
|
|
<td>1.079</td>
|
|
<td>1.068</td>
|
|
<td>1.047</td>
|
|
<td>1.052</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2007</th>
|
|
<td>1.121</td>
|
|
<td>1.096</td>
|
|
<td>1.069</td>
|
|
<td>1.075</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2008</th>
|
|
<td>1.154</td>
|
|
<td>1.112</td>
|
|
<td>1.080</td>
|
|
<td>1.088</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2009</th>
|
|
<td>1.200</td>
|
|
<td>1.141</td>
|
|
<td>1.103</td>
|
|
<td>1.112</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2010</th>
|
|
<td>1.239</td>
|
|
<td>1.163</td>
|
|
<td>1.119</td>
|
|
<td>1.130</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2011</th>
|
|
<td>1.277</td>
|
|
<td>1.186</td>
|
|
<td>1.134</td>
|
|
<td>1.147</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2012</th>
|
|
<td>1.312</td>
|
|
<td>1.214</td>
|
|
<td>1.154</td>
|
|
<td>1.169</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2013</th>
|
|
<td>1.322</td>
|
|
<td>1.214</td>
|
|
<td>1.146</td>
|
|
<td>1.163</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2014</th>
|
|
<td>1.300</td>
|
|
<td>1.193</td>
|
|
<td>1.117</td>
|
|
<td>1.136</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2015</th>
|
|
<td>1.267</td>
|
|
<td>1.181</td>
|
|
<td>1.098</td>
|
|
<td>1.119</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2016</th>
|
|
<td>1.213</td>
|
|
<td>1.155</td>
|
|
<td>1.064</td>
|
|
<td>1.087</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2017</th>
|
|
<td>1.183</td>
|
|
<td>1.146</td>
|
|
<td>1.047</td>
|
|
<td>1.073</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2018</th>
|
|
<td>1.148</td>
|
|
<td>1.134</td>
|
|
<td>1.029</td>
|
|
<td>1.056</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2019</th>
|
|
<td>1.132</td>
|
|
<td>1.136</td>
|
|
<td>1.023</td>
|
|
<td>1.053</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2020</th>
|
|
<td>1.109</td>
|
|
<td>1.116</td>
|
|
<td>0.996</td>
|
|
<td>1.028</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2021</th>
|
|
<td>1.038</td>
|
|
<td>1.049</td>
|
|
<td>0.921</td>
|
|
<td>0.956</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="5">SOURCE: Authors' calculations using administrative records from <abbr class="spell">SSA</abbr>.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="5">NOTE: 2003, 2017, and 2019 models use the 2003, 2017, and 2019 cessation cohorts as their base years, respectively.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
</div>
|
|
<h2>Conclusion</h2>
|
|
<p>We investigated the role that the increase in the frequency of <abbr class="spell">CDR</abbr>s had on recent changes in the child <abbr class="spell">SSI</abbr> recipient population. We found that cessation rates by children's primary diagnoses and other demographic characteristics were stable, though the ages of children at the time of their <abbr class="spell">CDR</abbr> cessations shifted noticeably around 2010. That finding is not unexpected, as children aged <span class="nobr">11–13</span> were presumably more likely to be overdue for a <abbr class="spell">CDR</abbr> because of a backlog in the earlier period. By contrast, the backlog also would likely contain cases of child <abbr class="spell">SSI</abbr> recipients that would be more consistent across other characteristics. Children who lived in <abbr>ZIP</abbr> Codes with higher levels of socioeconomic deprivation were also more likely to have <abbr class="spell">SSI</abbr> payments ceased by a <abbr class="spell">CDR</abbr>.</p>
|
|
<p>The rate at which children with payments ceased because of a <abbr class="spell">CDR</abbr> returned to the <abbr class="spell">SSI</abbr> program was lower among the <span class="nobr">post-2008</span> cessation cohorts. We were not able to isolate a single cause of that decrease, but two factors are consistent with the observed trends. First, childhood <abbr class="spell">CDR</abbr> volume was not particularly high before 2008. The resulting <abbr class="spell">CDR</abbr> backlog may have included a substantial number of cases involving children with relatively less severe disabilities, who then experienced <span class="nobr">post-2008</span> <abbr class="spell">CDR</abbr> cessations as <abbr class="spell">SSA</abbr> emphasized backlog reduction. Having less severe disabling conditions, these children would be less likely to return to the <abbr class="spell">SSI</abbr> program thereafter.<sup><a href="#mn28" id="mt28">28</a></sup> However, returns to the <abbr class="spell">SSI</abbr> program did not increase as the frequency of <abbr class="spell">CDR</abbr>s subsequently increased. Second, earnings 5 years after cessation were relatively higher for the cohorts whose payments were ceased after 2008 (the postrecession economic recovery may have contributed). Thus, there might have been less of a perceived need for <abbr class="spell">SSI</abbr> payments.<sup><a href="#mn29" id="mt29">29</a></sup> Those two explanations are not mutually exclusive, and more research is needed to confirm whether either is correct or whether other factors explain the trend.<sup><a href="#mn30" id="mt30">30</a></sup></p>
|
|
<p>Our results indicate that <abbr class="spell">CDR</abbr>s can explain a notably large portion of the <abbr class="spell">SSI</abbr> caseload dynamics during the study period. The frequency of <abbr class="spell">CDR</abbr>s can explain about 60 percent of the increase in child <abbr class="spell">SSI</abbr> participation from 2002 through 2013: If <abbr class="spell">CDR</abbr> volume had followed a more stable pattern, the number of child <abbr class="spell">SSI</abbr> recipients would have been substantially lower. In addition, <abbr class="spell">CDR</abbr> frequency can explain <span class="nobr">two-thirds</span> of the decline in program enrollment from 2013 through 2021. Without the increase in <abbr class="spell">CDR</abbr>s that occurred during that period, the caseload would have been roughly unchanged. These findings indicate that <abbr class="spell">CDR</abbr> policies that would have maintained consistent cessation counts over time would have led to a more stable pattern of child <abbr class="spell">SSI</abbr> participation. Expectations about when <abbr class="spell">CDR</abbr>s will be conducted might be especially important for families in planning for the possibility of losing payments. Even though <abbr class="spell">SSA</abbr> conducted <span class="nobr">age-18</span> redeterminations consistently during the study period, few families correctly anticipate the potential payment cessation for their child (Deshpande and Dizon-Ross 2023).</p>
|
|
<p>Given the variation in childhood <abbr class="spell">CDR</abbr> frequency even among the low-volume years, an unanticipated loss in payments would be that much more difficult for families. Deshpande and Dizon-Ross (2023) also showed that families tend not to change their behavior even when they obtain accurate information about the likelihood of payment cessation, which may further complicate matters for them. Still, two large demonstration projects that sought to support young <abbr class="spell">SSI</abbr> recipients as they transition to adulthood, the Youth Transition Demonstration and Promoting Readiness of Minors in <abbr class="spell">SSI</abbr>, found that combining program information on redeterminations with vocational rehabilitation or similar services can enhance the recipient's human capital investment; however, the effect seems to be short-lived (Fraker and others 2014; Patnaik and others 2022). <abbr class="spell">SSA</abbr> already informs all child recipients aged <span class="nobr">14-17</span> about the <span class="nobr">age-18</span> redetermination through an annually mailed brochure noting the high likelihood of losing payments.<sup><a href="#mn31" id="mt31">31</a></sup> Including additional information about childhood <abbr class="spell">CDR</abbr>s in the award notification or other program communications could potentially avert any parental expectations that <abbr class="spell">SSI</abbr> eligibility is permanent.</p>
|
|
<p>We found that a substantial fraction of the trends in child <abbr class="spell">SSI</abbr> participation can be attributed to the increase in program integrity funding for <abbr class="spell">CDR</abbr>s from 2014 through 2018. Although the volume of <abbr class="spell">CDR</abbr>s has increased since the early 2000s, the stable rates of cessation across demographic characteristics, even as <abbr class="spell">CDR</abbr> volume varied, indicates that <abbr class="spell">CDR</abbr>s are targeted consistently. The main determinant of who faces a <abbr class="spell">CDR</abbr> is the medical diary category. In its fiscal year 2020 budget request, the agency proposed expanding the number of diary categories from three to four to enable it “to conduct <abbr class="spell">CDR</abbr>s more frequently for those medical impairments that are expected or likely to improve” (<abbr class="spell">SSA</abbr> 2019, 35). Our results suggest that such a change likely would have lowered the number of child <abbr class="spell">SSI</abbr> recipients, extending recent trends in declining program enrollment that continued during the <span class="nobr"><abbr>COVID</abbr>-19</span> pandemic (Levere, Hemmeter, and Wittenburg 2024a).</p>
|
|
<p>Even with consistent targeting, children with ceased payments are not necessarily receiving the supports they need to be self-sufficient. As noted earlier, we found low earnings levels for children whose <abbr class="spell">SSI</abbr> payments were ceased as they transitioned to adulthood, which correlates with poor adult economic outcomes (Patnaik and others 2022; Luecking and Leggett 2009; Fraker and others 2014). Although <abbr class="spell">SSA</abbr> determines that such children's impairments are no longer sufficiently severe to qualify for <abbr class="spell">SSI</abbr>, most of those children still face substantial barriers to full participation in educational settings or the labor force. Because <abbr class="spell">SSI</abbr> eligibility is linked with Medicaid eligibility, cessation of the former means loss of the latter for many children. However, state Medicaid offices typically look for ways to retain a child's Medicaid eligibility, perhaps based on limited incomes. Although there is substantial overlap in <abbr class="spell">SSI</abbr> and Medicaid eligibility (Levere and Wittenburg 2024), additional supports might be necessary for many children to fully participate in society. <abbr class="spell">SSA</abbr> is currently conducting the Beyond Benefits Study,<sup><a href="#mn32" id="mt32">32</a></sup> which examines the supports needed for adults whose <abbr class="spell">SSI</abbr> payments were ceased by a medical <abbr class="spell">CDR</abbr>. <abbr class="spell">SSA</abbr> is also planning a new survey of children that might highlight their potentially unique needs.<sup><a href="#mn33" id="mt33">33</a></sup></p>
|
|
<p>Studies of <abbr class="spell">CDR</abbr> policies and practices should also address potential equity concerns, given that children from high-deprivation areas are more likely than others to have their <abbr class="spell">SSI</abbr> payments ceased. The role of economic, medical, environmental, or social factors in payment cessations is beyond the scope of this study. Illuminating the childhood <abbr class="spell">SSI</abbr> experience will help policymakers understand whether children and families are prepared for <abbr class="spell">CDR</abbr>s, have the necessary resources when undergoing a <abbr class="spell">CDR</abbr>, and can weather a payment cessation.</p>
|
|
<div id="notes">
|
|
<h2>Notes</h2>
|
|
<p> <a href="#mt1" id="mn1">1</a> We use the term “<abbr class="spell">CDR</abbr>s” to refer to ongoing assessments of child <abbr class="spell">SSI</abbr> recipients' medical eligibility, excluding low birth weight <abbr class="spell">CDR</abbr>s (typically conducted at age 1) and <span class="nobr">age-18</span> redeterminations. <abbr class="spell">SSA</abbr> also conducts work <abbr class="spell">CDR</abbr>s for Social Security Disability Insurance beneficiaries, which are not relevant to this analysis.</p>
|
|
<p> <a href="#mt2" id="mn2">2</a> If an <abbr class="spell">SSI</abbr> recipient's payments are ceased once an overdue <abbr class="spell">CDR</abbr> is eventually conducted, the payments received while the <abbr class="spell">CDR</abbr> was overdue are not considered overpayments.</p>
|
|
<p> <a href="#mt3" id="mn3">3</a> In this article, the term “children with ceased payments” refers to children whose payments ceased after a <abbr class="spell">CDR</abbr> and not for non-<abbr class="spell">CDR</abbr> reasons, unless otherwise specified.</p>
|
|
<p> <a href="#mt4" id="mn4">4</a> Reliable comparisons to a broader population are difficult because so many people at those ages are <span class="nobr">full-time</span> students. However, among youths who were working 5 years after <abbr class="spell">SSI</abbr> payments ceased, average annual earnings were about $11,500. By contrast, median weekly earnings for all <abbr>U.S.</abbr> workers aged <span class="nobr">16–24</span> were $734 (Bureau of Labor Statistics 2024), which, assuming 48 weeks of work per year, translates to annual earnings of over $35,000, more than triple the average for children whose payments ceased because of a <abbr class="spell">CDR</abbr>.</p>
|
|
<p> <a href="#mt5" id="mn5">5</a> We also considered using 2003 or 2019 as stable cessation cohorts to assess the relative sensitivity of the estimates compared with using the 2017 cohort. Under either alternative cessation cohort, the percentage of the changes in the child <abbr class="spell">SSI</abbr> caseloads explained by changes in <abbr class="spell">CDR</abbr> volume would decline, but would remain substantial.</p>
|
|
<p> <a href="#mt6" id="mn6">6</a> Some states supplement <abbr class="spell">SSI</abbr> payments. In many states, <abbr class="spell">SSI</abbr> recipients automatically qualify for Medicaid.</p>
|
|
<p> <a href="#mt7" id="mn7">7</a> For more detail on this process, see <a href="https://secure.ssa.gov/apps10/poms.nsf/lnx/0428005030">https://secure.ssa.gov/apps10/poms.nsf/lnx/0428005030</a>.</p>
|
|
<p> <a href="#mt8" id="mn8">8</a> The regulations describing <abbr class="spell">CDR</abbr>s are detailed at <a href="https://secure.ssa.gov/poms.NSF/lnx/0428001020">https://secure.ssa.gov/poms.<abbr class="spell">NSF</abbr>/lnx/0428001020</a>. These <abbr class="spell">CDR</abbr>s differ from mandatory redeterminations conducted at age 18 for all child <abbr class="spell">SSI</abbr> recipients and at age 1 for low birthweight awardees. Those redeterminations consider <abbr class="spell">SSI</abbr> eligibility under medical and nonmedical rules that differ from those of the initial allowance. They are required by law and offer much less variation in frequency.</p>
|
|
<p> <a href="#mt9" id="mn9">9</a> For researchers, these funding variations provide opportunities for comparative analysis. For example, Deshpande (2016a) used the funding changes to estimate the effects of a child's removal from the <abbr class="spell">SSI</abbr> program on parents' subsequent earnings.</p>
|
|
<p><a href="#mt10" id="mn10">10</a> A <abbr class="spell">CDR</abbr> can begin in one year and result in an initial decision in a later year. In turn, an initial decision does not necessarily occur in the same year as the final decision, which may follow an appeal. We use the year of the initial decision to identify the year in which the <abbr class="spell">CDR</abbr> was processed.</p>
|
|
<p><a href="#mt11" id="mn11">11</a> For more details on those outreach efforts, see <a href="/thirdparty/groups/vulnerable-populations.html">https://www.ssa.gov/thirdparty/groups/vulnerable-populations.html</a>.</p>
|
|
<p><a href="#mt12" id="mn12">12</a> We base our analyses on calendar year data.</p>
|
|
<p><a href="#mt13" id="mn13">13</a> Note that this slightly contrasts with our use of the date of initial decision to identify the year a <abbr class="spell">CDR</abbr> was conducted in <a href="#chart1">Chart 1</a>.</p>
|
|
<p><a href="#mt14" id="mn14">14</a> These characteristics include measures of educational attainment (the percentage of the population with less than 9 years of education and the percentage with a high school diploma or more), employment status (the percentage employed in a white-collar job [management, business, science, and arts occupations] and the percentage unemployed), housing characteristics (the percentage who are homeowners, the percentage with more than one person per room in the household, as well as standardized measures of the median monthly mortgage, median gross rent, and median home value), income and poverty characteristics (a standardized measure of median family income, the ratio of people with income of less than $15,000 to people with income greater than $75,000, the family poverty rate, and the percentage of people with earnings of less than 150 percent of the federal poverty limit), and several other characteristics (the percentage of the population who are single parents with children under age 18, the percentage with no motor vehicle, the percentage with no telephone, and the percentage of occupied housing units without complete plumbing).</p>
|
|
<p><a href="#mt15" id="mn15">15</a> For example, the percentage of child <abbr class="spell">SSI</abbr> recipients with intellectual disabilities decreased from 27 percent in 2003 to 11 percent in 2017, while the percentage of child <abbr class="spell">SSI</abbr> recipients with autism spectrum disorders increased from 6 percent in 2003 to 16 percent in 2017 (not shown).</p>
|
|
<p><a href="#mt16" id="mn16">16</a> Although 14,052 cases from the backlog were processed in 2017, they constituted only 6.7 percent of the 208,500 <abbr class="spell">CDR</abbr>s conducted that year (<abbr class="spell">SSA</abbr> 2023b). Because a small backlog remained through 2018, 2019 is the first year that represents a typical year with zero backlog. However, the available data cannot identify any potential <abbr class="spell">SSI</abbr> program returns that occurred more than 3 years thereafter, so we selected the 2017 cohort.</p>
|
|
<p><a href="#mt17" id="mn17">17</a> For children who stopped receiving <abbr class="spell">SSI</abbr> payments for non-<abbr class="spell">CDR</abbr> reasons during the year, we set the probability equal to 0.</p>
|
|
<p><a href="#mt18" id="mn18">18</a> Because we assumed a uniform probability of return in each year, multiplying the likelihood of return at any point in the 5 subsequent years by <span class="nobr">one-fifth</span> gave us the likelihood of returning in each year. That assumption did not match the data exactly, and it likely led to an overestimate of the likelihood of children returning to <abbr class="spell">SSI</abbr> after experiencing a <abbr class="spell">CDR</abbr> cessation (because we extend the uniform probability to apply in years after the first 5 years, whereas most program returns happen in the first couple of postcessation years). For example, Hemmeter and Bailey (2015) found that nearly 10 percent of children with payments ceased by a <abbr class="spell">CDR</abbr> return to <abbr class="spell">SSI</abbr> within 10 years (conditional on not first reaching age 18), with <span class="nobr">two-thirds</span> of those returns happening within 5 years of <abbr class="spell">CDR</abbr> cessation. However, the uniform probability of return assumption is necessary to make the math behind the simulation tractable. As a result, our simulation likely <i>overestimated</i> returns to the program, meaning we <i>underestimated</i> the role <abbr class="spell">CDR</abbr>s play in caseload dynamics.</p>
|
|
<p><a href="#mt19" id="mn19">19</a> For example, from 2003 through 2004, child <abbr class="spell">SSI</abbr> participation increased by 33,748. The net change from <abbr class="spell">CDR</abbr>s in 2004 was −16,474: 17,113 children had payments ceased in 2004, while 639 children whose payments had ceased in 2003 or 2004 returned. Our <span class="nobr">base-year-2017</span> model predicted that in 2004, the net change from <abbr class="spell">CDR</abbr>s would have been −20,836. Thus, if we replaced the actual net reduction with the model-based net reduction, we would have seen an additional decline of 4,362 child recipients (−20,836 minus −16,474), or the caseload would have grown by only 29,386 (33,748 minus 4,362). We then calculated a new number for the caseload for 2004 and reiterated the process for each subsequent year.</p>
|
|
<p><a href="#mt20" id="mn20">20</a> Nonbenchmarked figures—that is, the simple shares of children whose payments ceased because of a <abbr class="spell">CDR</abbr> for each characteristic—are available from the authors on request.</p>
|
|
<p><a href="#mt21" id="mn21">21</a> <a href="#chart7">Chart 7</a> shows the four most prevalent diagnosis codes among children with mental disorders and the four most prevalent nonmental diagnoses in 2017. It does not include children with mental disorders that fall into the categories of childhood and adolescent disorders not elsewhere classified; depressive, bipolar, and related disorders; neurocognitive disorders; and schizophrenia spectrum and other psychotic disorders. Statistics for all primary diagnosis codes, age at entry, duration of <abbr class="spell">SSI</abbr> payment receipt, and adjudication level of initial award (initial allowance, reconsideration, administrative law judge, or other) are available on request.</p>
|
|
<p><a href="#mt22" id="mn22">22</a> Other mental disorders include anxiety and obsessive-compulsive disorders, personality disorder, trauma- and stress-related disorders, and attention-deficit hyperactivity disorder.</p>
|
|
<p><a href="#mt23" id="mn23">23</a> Developmental disorders include learning disorders, speech and language impairments, and developmental disorders in infants and toddlers. Autism spectrum disorder is treated as a separate category from developmental disorders.</p>
|
|
<p><a href="#mt24" id="mn24">24</a> Socioeconomic deprivation is estimated for all cessation years using <span class="nobr">2015–2019</span> American Community Survey data. Thus, <a href="#chart8">Chart 8</a>'s socioeconomic deprivation values may differ somewhat from actual values, especially in the earlier years.</p>
|
|
<p><a href="#mt25" id="mn25">25</a> Because enrollments in the Social Security Disability Insurance program after a child <abbr class="spell">CDR</abbr> cessation are extremely rare, we omit them from our statistics.</p>
|
|
<p><a href="#mt26" id="mn26">26</a> The declining share of children with ceased payments who return to <abbr class="spell">SSI</abbr> can explain some of the differences between our findings and those in Hemmeter and Bailey (2015). Averaging across the 1998 through 2006 cessation cohorts (the groups that Hemmeter and Bailey observed for at least 5 years), the analogous <abbr class="spell">SSI</abbr> return rates were 2.6 percent, 6.6 percent, and 9.3 percent, which are similar to our current findings for the earliest cessation cohorts.</p>
|
|
<p><a href="#mt27" id="mn27">27</a> The difference between the two models represents our best estimate of the share of caseload change that can be explained by differential cessation patterns. Our study period in fact included periods of somewhat more frequent and somewhat less frequent cessations. By comparing two model-based estimates, we can isolate the differential net reduction in the caseload resulting from <abbr class="spell">CDR</abbr> volume. From 2002 through 2013, the caseload pattern mimicked the “low cessation” projection, having very few cessations. From 2014 through 2021, the caseload pattern mimicked the “stable cessation” projection, having relatively more cessations.</p>
|
|
<p><a href="#mt28" id="mn28">28</a> Anecdotal feedback obtained during two <abbr class="spell">SSI</abbr> demonstration projects suggest that child recipients and their families had not expected their <abbr class="spell">CDR</abbr>s and perceived that establishing eligibility was getting harder to do (Fraker and others 2014; Patnaik and others 2022). These factors might have discouraged them from reapplying.</p>
|
|
<p><a href="#mt29" id="mn29">29</a> In the late 2010s, <abbr class="spell">SSA</abbr> began sending annual notices to all <abbr class="spell">SSI</abbr> recipients aged <span class="nobr">14–17</span> alerting them about the <span class="nobr">age-18</span> redetermination, which might have better prepared them for payment cessation.</p>
|
|
<p><a href="#mt30" id="mn30">30</a> Another potential factor, external to <abbr class="spell">SSI</abbr>, is the overall decline in child poverty. From 2013 through 2022, the number of children in poverty dropped by almost 4.5 million children, or from 22 percent to 16 percent of the child population (Annie E. Casey Foundation 2024).</p>
|
|
<p><a href="#mt31" id="mn31">31</a> This brochure is available at <a href="/pubs/EN-05-11005.pdf">https://www.ssa.gov/pubs/<abbr class="spell">EN</abbr>-05-11005.pdf</a>.</p>
|
|
<p><a href="#mt32" id="mn32">32</a> For details, see <a href="/disabilityresearch/bbs.htm">https://www.ssa.gov/disabilityresearch/bbs.htm</a>.</p>
|
|
<p><a href="#mt33" id="mn33">33</a> That will be <abbr class="spell">SSA</abbr>'s first survey on young <abbr class="spell">SSI</abbr> recipients since it conducted the National Survey of <abbr class="spell">SSI</abbr> Children and Families from July 2001 through July 2002 (Ireys and others 2004).</p>
|
|
</div>
|
|
<div id="references">
|
|
<h2>References</h2>
|
|
<p>Annie E. Casey Foundation. 2024. “Children in Poverty in United States.” <a href="https://datacenter.aecf.org/data/tables/43-children-in-poverty">https://www.datacenter.aecf.org/data/tables/43-children-in-poverty</a>.</p>
|
|
<p>Bureau of Labor Statistics. 2024. “Median Weekly Earnings of <span class="nobr">Full-Time</span> Workers Were $1,145 in the Fourth Quarter of 2023.” <abbr>TED</abbr>: The Economics Daily. <a href="https://www.bls.gov/opub/ted/2024/median-weekly-earnings-of-full-time-workers-were-1145-in-the-fourth-quarter-of-2023.htm">https://www.bls.gov/opub/ted/2024/median-weekly-earnings-of-full-time-workers-were-1145-in-the-fourth-quarter-of-2023.htm</a>.</p>
|
|
<p>Deshpande, Manasi. 2016a. “The Effect of Disability Payments on Household Earnings and Income: Evidence from the <abbr class="spell">SSI</abbr> Children's Program.” <i>Review of Economics and Statistics</i> 98(4): <span class="nobr">638–654.</span></p>
|
|
<p>———. 2016b. “Does Welfare Inhibit Success? The <span class="nobr">Long-Term</span> Effects of Removing Low-Income Youth from the Disability Rolls.” <i>American Economic Review</i> 106(11): <span class="nobr">3300–3330.</span></p>
|
|
<p>Deshpande, Manasi, and Rebecca Dizon-Ross. 2023. “The (Lack of) Anticipatory Effects of the Social Safety Net on Human Capital Investment.” <i>American Economic Review</i> 113 (12): <span class="nobr">3129–3172.</span></p>
|
|
<p>Deshpande, Manasi, and Michael Mueller-Smith. 2022. “Does Welfare Prevent Crime? The Criminal Justice Outcomes of Youth Removed from <abbr class="spell">SSI</abbr>.” <i>The Quarterly Journal of Economics</i> 137(4): <span class="nobr">2263–2307.</span></p>
|
|
<p>Fraker, Thomas, Arif Mamun, Todd Honeycutt, Allison Thompkins, and Erin Jacobs Valentine. 2014. <i>Final Report on the Youth Transition Demonstration Evaluation.</i> Washington, <abbr class="spell">DC</abbr>: Mathematica Policy Research.</p>
|
|
<p>Hemmeter, Jeffrey, and Michelle Stegman Bailey. 2015. “Childhood Continuing Disability Reviews and <span class="nobr">Age-18</span> Redeterminations for Supplemental Security Income Recipients: Outcomes and Subsequent Program Participation.” Research and Statistics Note <abbr title="Number">No.</abbr> <span class="nobr">2015-03.</span> Washington, <abbr class="spell">DC</abbr>: <abbr class="spell">SSA</abbr>. <a href="/policy/docs/rsnotes/rsn2015-03.html">https://www.ssa.gov/policy/docs/rsnotes/rsn2015-03.html</a>.</p>
|
|
<p>Hemmeter, Jeffrey, Jacqueline Kauff, and David Wittenburg. 2009. “Changing Circumstances: Experiences of Child <abbr class="spell">SSI</abbr> Recipients Before and After Their <span class="nobr">Age-18</span> Redetermination for Adult Benefits.” <i>Journal of Vocational Rehabilitation</i> 30(3): <span class="nobr">201–221.</span></p>
|
|
<p>Hemmeter, Jeffrey, Michael Levere, Pragya Singh, and David C. Wittenburg. 2021. “Changing Stays? Duration of Supplemental Security Income Participation by First-Time Child Awardees and the Role of Continuing Disability Reviews.” <i>Social Security Bulletin</i> 81(2): <span class="nobr">17–41.</span> <a href="/policy/docs/ssb/v81n2/v81n2p17.html">https://www.ssa.gov/policy/docs/ssb/v81n2/v81n2p17.html</a>.</p>
|
|
<p>Ireys, Henry, Daniel Kasprzyk, Ama Takyi, and Jennifer Gillcrist. 2004. <i>Estimating the Size and Characteristics of the <abbr class="spell">SSI</abbr> Child Population: A Comparison Between the <abbr class="spell">NSCF</abbr> and Three National Surveys</i>. Washington, <abbr class="spell">DC</abbr>: Mathematica.</p>
|
|
<p>Levere, Michael. 2021. “The Labor Market Consequences of Receiving Disability Benefits During Childhood.” <i>Journal of Human Resources</i> 56(3): <span class="nobr">850–877.</span></p>
|
|
<p>Levere, Michael, Jeffrey Hemmeter, and David Wittenburg. 2024a. “The Local Declines in Child <abbr class="spell">SSI</abbr> Applications and Awards During <abbr>COVID</abbr>.” <i>Journal of Disability Policy Studies</i>: <span class="nobr">1–11.</span></p>
|
|
<p>———. 2024b. “The Importance of Schools in Driving Children's Applications for Disability Benefits.” <i>Journal of Public Economics</i> 239: 105239.</p>
|
|
<p>Levere, Michael, and David Wittenburg. 2024. “How Many Medicaid Recipients Might Be Eligible for <abbr class="spell">SSI</abbr>?” Working Paper <abbr title="Number">No.</abbr> <span class="nobr">2023-20.</span> Chestnut Hill, <abbr title="Massachusetts">MA</abbr>: Center for Retirement Research at Boston College.</p>
|
|
<p>Levere, Michael, David C. Wittenburg, and Jeffrey Hemmeter. 2022. “What Is the Relationship Between Socioeconomic Deprivation and Child Supplemental Security Income Participation?” <i>Social Security Bulletin</i> 82(2): <span class="nobr">1–20.</span> <a href="/policy/docs/ssb/v82n2/v82n2p1.html">https://www.ssa.gov/policy/docs/ssb/v82n2/v82n2p1.html</a>.</p>
|
|
<p>Luecking, Richard G., and Karen Leggett. 2009. “Supporting Families to Support Work Experience.” In <i>The Way to Work: How to Facilitate Work Experiences for Youth in Transition,</i> edited by Richard G. Luecking <span class="nobr">(83–98).</span> Baltimore, <abbr title="Maryland">MD</abbr>: Paul H. Brookes Publishing <abbr title="Company">Co.</abbr></p>
|
|
<p>National Academies of Sciences, Engineering, and Medicine. 2015. <i>Mental Disorders and Disabilities Among Low-Income Children</i>. Washington, <abbr class="spell">DC</abbr>: National Academies Press.</p>
|
|
<p>Patnaik, Ankita, Stacy Dale, Monica Farid, Amal Harrati, Anna Hill, Todd Honeycutt, Karen Katz, Gina Livermore, Isabel Musse, Liz Potamites, and Purvi Sevak. 2022. <i>Promoting Readiness of Minors in Supplemental Security Income (<abbr>PROMISE</abbr>): Youth and Family Outcomes Five Years After Enrollment.</i> Washington, <abbr class="spell">DC</abbr>: Mathematica Policy Research.</p>
|
|
<p>Schmidt, Lucie, and Purvi Sevak. 2017. “Child Participation in Supplemental Security Income: Cross- and Within-State Determinants of Caseload Growth.” <i>Journal of Disability Policy Studies</i> 28(3): <span class="nobr">131–140.</span></p>
|
|
<p>Singh, Gopal K. 2003. “Area Deprivation and Widening Inequalities in <abbr class="spell">US</abbr> Mortality, <span class="nobr">1969–1998.</span>” <i>American Journal of Public Health</i> 93(7): <span class="nobr">1137–1143.</span></p>
|
|
<p>[<abbr class="spell">SSA</abbr>] Social Security Administration. 2018. “Social Security Administration (<abbr class="spell">SSA</abbr>) Annual Data for Periodic Continuing Disability Reviews (<abbr class="spell">CDR</abbr>) Processed and Backlog: Periodic <abbr class="spell">CDR</abbr> Cases—Backlog Dataset.” <a href="/open/data/Periodic-Continuing-Disability-Reviews.html">https://www.ssa.gov/open/data/Periodic-Continuing-Disability-Reviews.html</a>.</p>
|
|
<p>———. 2019. <i><abbr title="Fiscal Year">FY</abbr> 2020 Congressional Justification</i>. Baltimore, <abbr title="Maryland">MD</abbr>: <abbr class="spell">SSA</abbr>. <a href="/budget/assets/materials/2020/2020BO_1.pdf">https://www.ssa.gov/budget/assets/materials/2020/2020BO_1.pdf</a>.</p>
|
|
<p>———. 2023a. <i>2023 Annual Report of the Supplemental Security Income Program</i>. Baltimore, <abbr title="Maryland">MD</abbr>: <abbr class="spell">SSA</abbr>. <a href="/OACT/ssir/SSI23/index.html">https://www.ssa.gov/OACT/ssir/SSI23/index.html</a>.</p>
|
|
<p>———. 2023b. “Social Security Administration (<abbr class="spell">SSA</abbr>) Annual Data for Periodic Continuing Disability Reviews (<abbr class="spell">CDR</abbr>) Processed and Backlog: Periodic <abbr class="spell">CDR</abbr> Cases—Processed Dataset.” <a href="/open/data/Periodic-Continuing-Disability-Reviews.html">https://www.ssa.gov/open/data/Periodic-Continuing-Disability-Reviews.html</a>.</p>
|
|
<p>———. 2023c. <i><abbr class="spell">SSI</abbr> Annual Statistical Report, 2022.</i> <abbr class="spell">SSA</abbr> Publication <abbr title="Number">No.</abbr> <span class="nobr">13-11827.</span> Washington, <abbr class="spell">DC</abbr>: <abbr class="spell">SSA</abbr>. <a href="/policy/docs/statcomps/ssi_asr/2022/index.html">https://www.ssa.gov/policy/docs/statcomps/ssi_asr/2022/index.html</a>.</p>
|
|
<p>———. 2024. <i>Annual Statistical Supplement to the Social Security Bulletin, 2024.</i> <abbr class="spell">SSA</abbr> Publication <abbr title="Number">No.</abbr> <span class="nobr">13-11700.</span> Washington, <abbr class="spell">DC</abbr>: <abbr class="spell">SSA</abbr>. <a href="/policy/docs/statcomps/supplement/2024/index.html">https://www.ssa.gov/policy/docs/statcomps/supplement/2024/index.html</a>.</p>
|
|
</div>
|
|
</div>
|
|
</article>
|
|
<footer><div id="footer">
|
|
<div class="important-info"><h4>Important Information:</h4>
|
|
<ul><li><a href="/agency/">About Us</a></li>
|
|
<li><a href="/accessibility/">Accessibility</a></li>
|
|
<li><a href="/foia/">FOIA</a></li>
|
|
<li><a href="/open/">Open Government</a></li>
|
|
<li><a href="/agency/glossary/">Glossary</a></li>
|
|
<li><a href="/privacy/">Privacy</a></li>
|
|
<li><a href="https://oig.ssa.gov/report/">Report Fraud, Waste or Abuse</a></li>
|
|
<li><a href="/agency/websitepolicies.html">Website Policies</a></li></ul>
|
|
</div>
|
|
<p class="align-center margin-top">This website is produced and published at U.S. taxpayer expense.</p>
|
|
</div></footer>
|
|
<!-- SSA INTERNET BODY SCRIPTS -->
|
|
<script src="/policy/js/rspa.doc.js"></script>
|
|
<script src="/policy/js/rspa-shared.js"></script>
|
|
<script src="/framework/js/ssa.internet.body.js"></script>
|
|
</body></html> |