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Reforming Supplemental Security Income to Better Serve Children with Disabilities

Reforming Supplemental Security Income to Better Serve Children with Disabilities

Additional Material:

The Supplemental Security Income (SSI) program is the largest cash assistance program for low-income Americans. The program was created to serve the low-income elderly and disabled Americans who cannot support themselves. Policy changes in the 1990s expanded the program’s eligibility criteria and caused child participation in the program to grow to historically high levels, with more than one million children currently enrolled in the program. One of the main reasons for providing SSI to children was to increase the chances low-income, disabled children would achieve self-sufficiency in adulthood. However, the evidence indicates SSI is undermining workforce connections and failing America’s most vulnerable children.


Key Findings:

  • Policy changes expanding the eligibility criteria for SSI drove rapid growth in child participation during the past several decades. Since the program began, child participation has increased 16-fold, climbing from 70,900 children on SSI in 1974 to 1.1 million as of 2020.

  • Today, a majority of children qualify for the program based on mental health disorders rather than physical or intellectual disabilities. Mental health disorders account for 80 percent of the child SSI caseload growth between 1987 and 2020. The most prevalent mental health disorders rely on more subjective diagnosis criteria, such as attention deficit hyperactivity disorder, speech and language delays, and autism.

  • SSI fails to help able-bodied children transition to the workforce in adulthood. Most youth on SSI at age 18 continue onto the adult SSI program. Only about half of youth who were removed from the program at age 18 because they are considered able to work are employed after leaving the program. These youth are poorly-prepared for the labor force, and earn only an average of $4,400 annually post SSI enrollment.

  • SSI undermines workforce connections for the parents of children in the program. SSI eligibility does not consider how the child’s health care needs affect able-bodied parents’ ability to work. By providing a maximum per-child benefit of up to $841 per month with no work requirement, many SSI-parents choose to reduce work hours or not work at all. This incentive likely reduces material well-being for the parent and the child.

  • SSI for children is duplicative—one of approximately 90 programs targeted to low-income households including children with disabilities. Medicaid, Temporary Assistance for Needy Families (TANF), the Supplemental Nutrition Assistance Program (SNAP), school meal programs, housing assistance, and many other means-tested programs provide resources and services to low-income families. Special education grants and other government programs fund services specifically for children with disabilities.  

  • Reforms are needed to improve SSI’s poor outcomes for children with disabilities. Policymakers should consider phasing out the SSI child program and transitioning limited resources to programs that more effectively serve low-income families with disabled children. Other reforms could include targeting SSI to children with the most serious disabilities, converting SSI from a direct cash assistance program to a flexible spending account (FSA) that can be used for the child’s needs, encouraging work preparation for youth on SSI, and increasing the frequency of continuing disability reviews to determine whether a child still qualifies for SSI. 

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