Supplemental security income provides a minimum income to

What Works for Health Strategy

The federal Supplemental Security Income (SSI) program provides monthly payments to people who are blind, disabled, or age 65 or older with limited income and resources who meet eligibility criteria; blind or disabled children may also qualify. Federal benefits can be supplemented with state contributions; benefits vary by state and by recipient. Federal benefit maximums change yearly. In 2018 federal monthly maximums were $750 for an individual and $1,125 for a couple1, with average benefits of $662 for children, $577 for adults, and $447 for elderly beneficiaries2. SSI incentivizes work by disregarding $1 out of every $2 earned over $65 for benefit calculation. Personal assets help determine eligibility; individuals cannot have countable resources above $2,000, and couples are limited to $3,000. Child recipients are assessed at age 18 to determine eligibility under adult standards1. In most states, individuals eligible for SSI are eligible for Medicaid, and in 32 states and Washington DC Medicaid is automatically conferred3.

Expected Beneficial Outcomes (Rated)

• Increased income

Other Potential Beneficial Outcomes

• Reduced poverty

• Improved well-being

• Increased access to care

Evidence of Effectiveness

Increasing Supplemental Security Income (SSI) benefit levels is a suggested strategy to reduce poverty among senior citizens aged 65 and older, and adults and children who are blind or have severe disabilities4. Available analysis indicates SSI brings some recipients and their families above the poverty line5. Benefits raise half of child beneficiaries out of poverty, and bring some of the poorest recipients above 50% of the poverty line6. However, at current benefit levels, SSI may not alleviate material hardship7 or food insecurity for families with children with disabilities8.

Loss of SSI benefits has been shown to increase the likelihood of unmet medical needs9 and hardships such as hunger and homelessness10. A study of child SSI recipients who underwent redetermination in 1998-2006 as they aged out of the program suggests that recipients who lose benefits at age 18 have higher rates of employment at age 24 than those who continue to receive SSI; on average, employment rates are close to those of peers with disabilities but substantially lower than those without disabilities11. However, health outcomes and ability to live independently have not been assessed12. While some youth secure full-time, full-year employment, overall earnings among former recipients average $4,400 annually and income volatility is substantial13. 

Higher SSI benefit rates may decrease disability among the elderly14. Experts suggest many children with mental disorders who may meet eligibility criteria for SSI are not receiving benefits15. Additional evidence is needed to confirm optimal program targeting and benefit amounts for children and adults.

Impact on Disparities

Likely to decrease disparities

Implementation Examples

As of December 2017, over 8 million individuals received Supplemental Security Income (SSI). SSI provides support for 1.1 million US children16, about half of them eligible because of disability due to a mental disorder15. State policies regarding enrollment of children with mental disabilities17, and practices regarding cessation and continuation for children older than 18 vary widely11.

Approximately 4 in 9 SSI recipients receive a state supplement to their federal benefits. Four states do not offer SSI supplements for adults: Arizona, Mississippi, North Dakota, and West Virginia. Eighteen states do not provide a state supplement for children. The federal Social Security Administration implements SSI supplements for eleven states and Washington DC; other states implement their own programs1.

Implementation Resources

SSA-SSI - Social Security Administration (SSA). Understanding Supplemental Security Income SSI.

Footnotes

* Journal subscription may be required for access.

1 SSA-SSI - Social Security Administration (SSA). Understanding Supplemental Security Income SSI.

2 SSA-Snapshot 2018 - Social Security Administration (SSA). Monthly statistical snapshot, June 2018.

3 SSA-Medicaid - Social Security Administration (SSA). Medicaid Information.

4 CBPP-SSI 2014 - Center on Budget and Policy Priorities (CBPP). Introduction to the Supplemental Security Income (SSI) program. Washington, DC: Center on Budget and Policy Priorities (CBPP); 2014.

5 SSA-Stegman Bailey 2015 - Stegman Bailey M, Hemmeter J. Characteristics of noninstitutionalized DI and SSI program participants, 2013 Update. Washington, DC: Social Security Administration (SSA); 2015.

6 CBPP-Romig 2017 - Romig K. SSI: A lifeline for children with disabilities. Washington, DC: Center on Budget and Policy Priorities (CBPP); 2017.

7 Ghosh 2015 - Ghosh S, Parish SL. Deprivation among US children with disabilities who receive Supplemental Security Income. Journal of Disability Policy Studies. 2015;26(3):173-183.

8 Rose-Jacobs 2016* - Rose-Jacobs R, Fiore JG, Ettinger de Cuba S, et al. Children with special health care needs, Supplemental Security Income, and food insecurity. Journal of Developmental & Behavioral Pediatrics. 2016;37(2):140-147.

9 Hemmeter 2011* - Hemmeter J. Health-related unmet needs of Supplemental Security Income youth after the age-18 redetermination. Health Services Research. 2011;46(4):1224-42.

10 Norris 2003a* - Norris J, Scott R, Speiglman R, Green R. Homelessness, hunger and material hardship among those who lost SSI. Contemporary Drug Problems. 2003;30:241-73.

11 Hemmeter 2017* - Hemmeter J, Mann DR, Wittenburg DC. Supplemental Security Income and the transition to adulthood in the United States: State variations in outcomes following the age-18 redetermination. Social Service Review. 2017;91(1):106-133.

12 Mathematica-Levere 2017 - Levere M. The labor market consequences of receiving disability benefits during childhood. Princeton: Mathematica Policy Research (MPR); 2017.

13 Deshpande 2016 - Deshpande M. Does welfare inhibit success? The long-term effects of removing low-income youth from the disability rolls. American Economic Review. 2016;106(11):3300-3330.

14 Herd 2008 - Herd P, Schoeni RF, House JS. Upstream solutions: Does the Supplemental Security Income program reduce disability in the elderly? The Milbank Quarterly. 2008;86(1):5-45.

15 Kelleher 2016* - Kelleher KJ, Stein REK, Hoagwood KE. Supplemental Security Income for children with mental disabilities. Pediatrics. 2016;137(3):e20153342.

16 SSA-SSI 2018 - Social Security Administration (SSA). SSI recipients by state and county, 2017. SSA Publication No. 13-11976. Washington, DC, June 2018.

17 Hoagwood 2017* - Hoagwood KE, Zima BT, Buka SL, Houtrow A, Kelleher KJ. State-to-state variation in SSI enrollment for children with mental disabilities: An administrative and ethical challenge. Psychiatric Services. 2017;68(2):195-198.

Date Last Updated

Aug 7, 2018

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