NB22-09: Structural Barriers to Receipt of Income Support and Health Insurance among Adults with Disabilities by Race and Ethnicity

Little is known about racial and ethnic differences in SSDI applications and enrollment. Knowing more about race and ethnicity of applicants and enrollees is important for many reasons, not least of which is that both applications and enrollment have contracted in recent years, and such changes may adversely affect workers differently by race and ethnicity. For example, trends over time towards lower enrollment by Black or Hispanic populations could indicate that Social Security Disability Insurance is not fulfilling its value for those groups. In this research, we will characterize how declining disability awards affect awardees by race and ethnicity and start to understand structural barriers that generate differences in health and economic well-being by race and ethnicity in a project spanning two years.
In year one, we will draw on two decades of Medicare enrollment data – a universe of SSDI beneficiaries receiving Medicare due to disability – to understand changes in the composition of SSDI beneficiaries by race and ethnicity. We will also examine changes in health within race and ethnicity groups, for example comparing trends in the health characteristics of Black and White SSDI beneficiaries newly eligible for Medicare. Finally, we will validate algorithms used in Medicare enrollment files for SSDI beneficiaries, to be used in year two.
In year two, we propose to apply algorithms like those used in Medicare data to identify beneficiary race and ethnicity in administrative data at SSA, where race and ethnicity data have typically been incomplete. This information will be used to identify structural barriers to entry to the program – e.g., bias in examiners or ALJs, in any proposed algorithms designed to standardize eligibility determination, and in the impact of office closings or more stringent eligibility determination guidance. Our deliverables for year one will include a manuscript with our findings as well as a summary data set and computer code for SSA and other researchers with information about SSDI beneficiaries by race and ethnicity.