NY24-05: Health Insurance Coverage, Household Income, and Poverty Status of Disability Applicants

Abstract/Specific Aims:

Social Security Disability Insurance (SSDI) and Supplemental Security Insurance (SSI) programs are designed to provide a safety net after disability onset. Yet applying for benefits is a lengthy, complex process. Applicants who lack a source of health insurance while they wait may experience deteriorating health and financial insecurity, compounding economic and health disparities.

How do health insurance and financial security change from before disability application to the months and years after application or rejection? Do SSDI and SSI mitigate the trajectory of disadvantage for older working-age adults with disabilities? What role does health insurance play in health and out-of-pocket medical costs? SSDI and SSI applicants are more likely to lack insurance than other working-age adults, but most studies used data from the 1990s; and no studies cover the period since the Affordable Care Act (ACA), and research has rarely focused on older workers with disabilities. Finally, studies have not followed applicants and beneficiaries in the long term.

This study examines the ways in which SSDI and SSI, in concert with programs like Medicare, Medicaid, and the ACA, address the trajectory of cumulative disadvantage faced by many middle-aged and older adults. It will generate recommendations for how SSA can strengthen its programs to better target those most in need of help. Using panel data from the Health and Retirement Study linked to Social Security Administration (SSA) disability records and earnings files, this study will track patterns of health insurance coverage, household income, poverty, out-of-pocket medical expenditures, and health status of SSDI and SSI applicants age 51-64 by race, gender, and region, over the course of disability.