2016 Annual Report of the SSI Program

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B. Numbers of SSI Program Recipients
This section presents projections of the numbers of persons receiving federally administered SSI payments by category and age group.1
1. Recipient Categories
The SSI recipient categories of: (1) aged; or (2) blind or disabled identify the criteria under which the recipient established eligibility for SSI payments, in addition to meeting other SSI eligibility requirements. The following paragraphs discuss the recipient categories in more detail.
Aged recipients establish their eligibility for SSI payment by meeting the age-65 -or-older requirement2 and other SSI eligibility requirements. In December 2015, 1.2 million aged individuals received federally administered SSI payments.
Blind or disabled recipients establish their eligibility for SSI payments by meeting the definition of blindness or disability and the applicable income and resource limits as well as any other SSI eligibility requirements. In December 2015, there were 7.2 million blind or disabled recipients of federally administered SSI payments. These recipients can fall into two subcategories based on age: blind or disabled adults (age 18 or older) and blind or disabled children (under age 18).
Blind or disabled adults meet the definition of blindness or disability for individuals age 18 or older and SSI income and resource limits. Students age 18 to 21 must meet the adult definition of disability; they differ from other adults only in that they qualify for a special student earned income exclusion. When blind or disabled adult recipients reach age 65, we generally continue to classify them as blind or disabled adults (rather than aged). In December 2015, 5.9 million blind or disabled individuals age 18 or older received federally administered SSI payments, including 996 thousand disabled or blind recipients age 65 or older.
Blind or disabled children meet the definition of blindness or disability for individuals under age 18 in addition to other SSI eligibility requirements. These children are subject to parent-to-child deeming until they reach the age of 18. At age 18 these individuals continue to be eligible for SSI if they meet the definition of blindness or disability for individuals age 18 or older as well as other eligibility criteria. We reclassify those who continue to be eligible after attainment of age 18 as blind or disabled adults. In December 2015, 1.3 million blind or disabled individuals under age 18 received federally administered SSI payments.
2. Applications and New Recipients
Figure IV.B1 presents historical and projected numbers of persons applying for SSI payments at SSA field offices by calendar year3. Following a 4-year period in the mid-2000s when applications remained fairly level at 2.1 million per year, applications started increasing in 2008, largely due to the severe economic recession that began at the end of 2007 and continued into 2009. The level of applications, which continued to increase through 2010, decreased only slightly in 2011 as the economy recovered slowly but decreased at a faster rate from 2012 through 2014 as the economic recovery continued. In 2015, the number of applications decreased slightly from 2014, and we are projecting that applications in 2016 will continue to decrease from 2015 levels. In 2017, we project that applications will increase slightly to 2.0 million and remain roughly at that level in 2018, and then level off at about 2.1 million per year thereafter.
The projected ultimate growth pattern of the applications incorporates continued refinement in our projection methodology designed to make the projections more consistent with the assumptions underlying the OASDI Trustees Report. Those projected applications reflect: (1) the expectation that the portion of the population that meets SSI income and resource requirements will decline over time as the CPI, and therefore the SSI Federal benefit rate, is projected to grow at a slower rate than average wages and income generally; and (2) the slower growth projected for the portion of the Social Security area population composed of U.S. citizens or legal immigrants as compared to the overall population because SSI recipients must generally come from this portion of the population.
 
 
 
As part of SSA’s adjudication of these applications, we evaluate levels of income and resources available to the applicants as well as other eligibility factors including marital and citizenship status and living arrangements. In addition, well over 90 percent of the SSI applications are for disability payments that require the DDS to evaluate the alleged impairment. Applicants may appeal an unfavorable disability determination through several administrative levels of appeal. If an applicant exhausts all administrative levels of appeal, he or she may appeal to the Federal courts.4
Figure IV.B2 presents historical and projected numbers of persons who start receiving SSI payments as a result of this decision process5. We count individuals as of the first month that they move into SSI payment status. For this reason, we refer to these individuals as “new recipients” rather than “awards.”6 From 2004 to 2007, the numbers of new recipients remained fairly level, roughly consistent with the applications received during this period. Starting in 2008, however, the numbers of new recipients increased substantially. This increase is attributable to: (1) the sharp increase in applications due to the economic downturn; (2) improvements in claims processing; and (3) initiatives to accelerate the processing of cases pending adjudication.
 
 

The numbers of new recipients declined slightly in 2011 and more sharply in 2012 through 2014, similar to the change in applications, with a slight decrease in 2015. We project the total number of new recipients in 2016 to remain at roughly the same level as experienced in 2015, consistent with the level of projected applications in 2016 and reflecting the assumed reduction in the backlog of cases pending adjudication. Over the longer term, we project the number of new recipients to level off and remain roughly level throughout the projection period, despite the growing legal resident population. This leveling off reflects the effect of the fixed-dollar value of certain SSI program parameters on the potential growth in the SSI-eligible population. For example, the countable resource limit for SSI eligibility is not adjusted for inflation, so it will continue to lose value over time. As a result, we expect fewer people to meet the eligibility requirements for the SSI program because they will have excess countable resources.
3. Terminations
Some persons receiving SSI payments in a year will stop receiving payments during the year because of death or the loss of SSI eligibility. SSA uses two primary tools to assess continuing eligibility: (1) a nonmedical redetermination; and (2) a medical continuing disability review (CDR).7 In a redetermination, we reexamine the recipient's nonmedical factors of eligibility, including income and resources. In a medical CDR, we determine whether the recipient continues to meet the Social Security Act's definition of disability. For example, disabled children, upon attainment of age 18, lose eligibility if they do not qualify for payments under the disabled adult eligibility criteria. We refer to the net reduction in the number of SSI recipients in current-payment status during a period as the number of SSI terminations for that period.
For purposes of presentation in the following figures, as well as the tables presented at the end of this section, we use the general label “terminations” to refer to the total of: (1) deaths while in current-payment status during the period; plus (2) the number of persons during the period moving out of payment status into suspended status less those returning to payment status from suspended status. Figure IV.B3 presents historical and projected numbers of total terminations by calendar year8. The overall total number of terminations of federally administered recipients in 2015 decreased by about 1 percent from 2014. This decrease in total terminations differs by reason for termination. Terminations due to death increased by roughly 2 percent in 2015, reflecting the gradual aging of the recipient population, while the number of terminations for all other reasons decreased by about 3 percent in 2015. This decrease in terminations for all reasons other than death is primarily attributable to a decrease in the number of new SSI recipients concurrently eligible for OASDI disability benefits who received SSI payments only temporarily during the 5-month Social Security Disability Insurance waiting period.
Projected terminations reflect the assumption that over the next few years increased Congressional appropriations will allow SSA to expand resources for processing medical CDRs. This increase in appropriations will result in higher levels of SSI terminations other than death.
4. Recipients in Current Payment Status
 
Combining the number of persons coming on the SSI payment rolls during a year with the number of those already receiving payments at the end of the previous year, and subtracting the number leaving the rolls during the year, yields the number of persons receiving federally administered SSI payments at the end of the year. Figure IV.B4 presents the number of individuals receiving Federal SSI payments, who comprise the great majority of federally administered recipients.9
 
The number of SSI recipients receiving Federal payments increased rapidly in the early 1990s due to the growth in the numbers of disabled adults and children. The  growth  in  the  numbers  of  children  receiving  SSI  resulted  in large part  from  the  Supreme  Court decision in the case of Sullivan v. Zebley, 110 S. Ct. 885 (1990), which greatly expanded the criteria used for determining disability  for  children. The growth in   the numbers of  disabled adults  is  a more  complicated phenomenon. Extensive research conducted under contract to SSA and the Department of Health and Human Services suggested that this growth was the result of a combination of factors including: (1) demographic trends; (2) a downturn in the economy in the late 1980s and early 1990s; (3) long-term structural changes in the economy; and (4) changes in other support programs (in particular, the reduction or elimination of general assistance programs in certain States).10,11 The 1996 welfare reform legislation, the economic downturn in the early 2000s, and the recent economic recession that began late in 2007 have contributed to the more recent changes in program participation.
As figure IV.B4 illustrates, the implementation of Public Law 104-121 and Public Law 104-193 resulted in a decline in the Federal recipient population from 1996 to 1997. From the end of 1997 through the end of 2000, the Federal SSI recipient population grew at an annual rate of less than 1 percent. From the end of 2000 to the end of 2008, the Federal SSI recipient population grew an average of 1.7 percent per year. From the end of 2008 to the end of 2012, the Federal recipient population grew an average of 2.7 percent per year due largely to the economic recession and the slow recovery from that economic downturn. In 2013, the Federal SSI recipient growth slowed to 1.3 percent, with much smaller growth in 2014. The Federal SSI recipient population decreased slightly in 2015, by roughly 0.2 percent relative to 2014, reflecting the lower numbers of applications and new recipients and the increased number of medical CDRs conducted in recent years. As the economy continues to recover, we project the numbers of Federal SSI recipients to grow more slowly at an average rate of less than 1 percent per year for the remainder of the 25-year projection period.
In order to place this projected growth in the context of overall population growth, figure IV.B5 presents Federal SSI prevalence rates by age group, defined as SSI recipients with Federal payments in current-payment status as percentages of selected Social Security area population totals.12 We calculated the age group percentages using the corresponding population age group totals. We computed the ratios for the separate recipient categories—total blind or disabled and total aged—as percentages of differing base populations, the total Social Security area population and the 65 and older Social Security population, respectively. As a result of this method of calculation, the percentage for the total SSI recipient population is not the arithmetic sum of the percentages for the respective recipient categories.
 
The prevalence rate for all Federal SSI recipients declined from 1975 through the early 1980s. In 1983, this percentage started increasing and continued to increase through 1996. The prevalence rate then declined in 1997, due to the implementation of Public Law 104-121 and Public Law 104-193, but leveled out over the next few years through 2004. It has increased slightly over the period 2005 through 2013, and experienced slight decreases in each of 2014 and 2015. We expect the prevalence rate to decline gradually throughout the projection period.
Figure IV.B6 presents prevalence rates for the two eligibility categories - blind and disabled and aged - as well as for the SSI program as a whole. It also shows these rates on an age-sex-adjusted basis, adjusted to the age-sex distribution of the Social Security area population for the year 2000. Adjusting these rates in this manner is useful when comparing rates over a long period of time because the age-sex-adjusted rates control for the effects that a changing age-sex distribution in the population can have on prevalence rates over time. That adjustment, however, obviously does not account for the change over time of other factors that may affect the percentage of the Social Security area population that is SSI eligible.
 
Figure IV.B6 shows that the age-sex adjustment does not fundamentally change the overall pattern of the prevalence rates. The total SSI prevalence rate on an age-sex adjusted basis is higher before 2000 and lower after 2000 than the gross prevalence rate due to the changing age distribution of the total population. The adjustment generally results in a more noticeable effect for the aged, especially in the early years of the SSI program, because the prevalence rate for ages 75 and older was much higher than for ages 65 to 74.
The eligibility categories of Federal SSI recipients follow significantly different growth patterns in relation to their respective population totals. The overall aged prevalence rate has declined steadily throughout the historical period. We project that it will continue to decline gradually throughout the projection period. In contrast, except for decreases in the late 1990s due to the eligibility redeterminations and CDRs mandated by Public Law 104-193, the prevalence rate for blind or disabled children increased steadily through 2013, with the increase being quite steep in the early 1990s. The prevalence rate for child recipients decreased slightly in 2014 and 2015. The total blind or disabled prevalence rate (as a percentage of the total population at all ages) remained fairly level until the early 1980s, when it started increasing and then continued to increase through 1996. The blind or disabled prevalence rate declined slightly in the late 1990s due to the effects of welfare reform legislation but resumed its upward trend in 2000. That upward trend continued through 2013, but experienced slight decreases in each of 2014 and 2015. We estimate that the overall prevalence rate for blind or disabled recipients will gradually decline throughout the projection period due to: (1) the SSI-eligible population growing more slowly than the overall population, (2) a smaller proportion of the population becoming new recipients than during the recent economic slowdown; (3) the changing age distribution in the population; and (4) our assumption that SSA will receive the resources authorized to process medical CDR and nonmedical redetermination workloads in the Bipartisan Budget Act of 2015.13
The total number of federally administered SSI recipients includes recipients only receiving a federally administered State supplement, as well as those receiving a Federal payment. Table IV.B8 presents historical and projected numbers of individuals who receive only a federally administered State supplement. Table IV.B9 displays the combined numbers of persons receiving either a Federal SSI payment or a federally administered State supplement. This is the total number of SSI recipients, which follows largely the same patterns of growth as the number of recipients receiving a Federal payment.
 
Table IV.B1.—SSI Federally Administered Applications,a Calendar Years 1974‑2040

a
Based on data reported in the Integrated Workload Management System (formerly known as the District Office Workload Report).

b
“All” column estimated by the Office of Research, Evaluation, and Statistics using a 10-percent sample and published in the SSI Annual Statistical Report.

c
Includes conversions from State programs and applications received in 1973.

d
Fewer than 500.

Note: Totals do not necessarily equal the sums of rounded components. We estimate the historical split among age groups on a calendar year of age basis.
 
Calendar year  a
1974 c

a
Represents period in which first payment was made, not date of first eligibility for payments.

b
Historical totals estimated based on 1-percent or 10-percent sample data.

c
Totals for 1974 include recipients converted from previous State programs as well as new recipients to the SSI program during 1974.

d
Fewer than 500.

Note: Totals do not necessarily equal the sums of rounded components. We estimate the historical split among age groups on a calendar year of age basis.
 
Table IV.B3.—SSI Federally Administered Terminations Due to Deatha, Calendar Years 1974‑2040 
Totals  b