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Event Recap: Disability Policy for the 21st Century

Jun 12, 2019 | Social Security

On Thursday, June 6, the Committee for a Responsible Federal Budget and the McCrery-Pomeroy SSDI Solutions Initiative hosted an event on "Disability Policy for the 21st Century." The event featured a panel of experts and practitioners in disability policy along with discussions and presentations from SSDI Solutions Initiative co-chairs Jim McCrery (R-LA) and Earl Pomeroy (D-ND), Ways and Means Social Security Subcommittee Chairman John Larson (D-CT), and Senate Finance Social Security Subcommittee member Bill Cassidy (R-LA).

You can find a video of the full event here, or below:

The event kicked off with co-chairs Pomeroy and McCrery offering remarks on the successes of the initiative. After the great success and reception of the initiative's first phase, which concluded with the publication of SSDI Solutions: Ideas to Strengthen the Social Security Disability Insurance Program, seven additional papers were commissioned to build upon this body of work. Six of the seven papers have been published thus far, while lawmakers and the Administration consider more of the initiative's ideas for future legislation and administrative action. Pomeroy noted that while the Social Security Disability Insurance (SSDI) is no longer a few years from exhaustion – the Bipartisan Budget Act (BBA) of 2015 reallocated funds from the old-age program to stave off exhaustion, which is now scheduled for depletion in 2052 – we shouldn't let that stop us from testing new ideas to improve the program for people with disabilities, people who pay into the program, and the economy as a whole. Pomeroy mentioned how a few of the initiative's recommendations have already been implemented, but there is still more to be done, especially while the economy is strong. He thanked the authors for their participation in the second phase of the initiative.

McCrery then reflected on the how the initiative has been instrumental in influencing legislative and administrative action on programs for people with disabilities. Apart from several pieces of legislation from both sides of the aisle that include initiative proposals, the BBA itself funded further program integrity measures that were recommended by the co-chairs. McCrery also spoke about the Retaining Employment After Injury and Illness Network (RETAIN), a demonstration project run by the Department of Labor and the Social Security Administration that is based off of the paper by Jennifer Christian, Tom Wickizer, and Kim Burton on developing a Community-Focused Health & Work Service (HWS). Additionally, McCrery mentioned the State of Maine's embrace of the auto-enrollment in private disability insurance proposal offered by David Babbel and Mark Meyer as well as the Department of Labor's clarification that employers across the country could auto-enroll as well. Finally, McCrery touched on how initiative proposals have influenced the last few President's budgets, which have offered both ideas to reform the SSDI program and demonstration projects to test other changes.

The event continued with a panel of disability experts moderated by Committee for a Responsible Federal Budget senior vice president Marc Goldwein and featuring Jamie Wilson of the Office of Management and Budget, Jason Fichtner of Johns Hopkins University (and an initiative author), initiative author David Stapleton, and TJ Sutcliffe of the House Ways and Means Committee, Social Security Subcommittee. The panel started with a discussion about where policymakers should focus on improvements in disability policy. Wilson spoke about the Administration's efforts to improve labor force participation, highlighting several demonstration projects they would like to test in addition to using their existing authority to test RETAIN. Sutcliffe shared that to date, Social Security Subcommittee Chairman John B. Larson has held three hearings: on the importance of Social Security, on potential benefit improvements, and on legislative proposals including his Social Security 2100 Act. Sutcliffe noted that themes at the hearings have included protecting and preserving Social Security benefits, ensuring access to earned benefits, and strengthening the system overall including improving benefits and solvency. Fichtner discussed how he believes we should rethink disability from its current binary "disabled" or "not disabled" function to one that focuses on supporting work and keeping people with disabilities in the labor force. Stapleton highlighted his belief that reforming SSDI has to start with fixing the determination process, which currently fails to acknowledge the nuance and ever-evolving nature of work-limiting disability.

The conversation then turned to the Administration's and Congress's views on disability policy. Wilson explained how much of the Administration's emphasis has been on improving the determination process by updating all of the medical listings for work capacity, improving how medical evidence is submitted and what kinds of physicians can submit evidence, and reducing the hearings and Continuing Disability Review (CDR) backlogs. Sutcliffe further described the work of Chairman Larson and Social Security Subcommittee Democrats to strengthen Social Security, ensure strong customer service for applicants and beneficiaries, reduce the hearings backlogs, strengthen disability determinations at the state level, and make sure there are no new hurdles to accessing benefits.

On improving the disability determinations process, Stapleton explained that eventually his Employment/Eligibility Services (EES) system would replace the current state Disability Determination Services (DDS) by helping to direct applicants towards benefits, employment supports, or quick ineligibility decisions. On implementation, Stapleton argued that the longer timeline for the SSDI trust fund should allow the Administration and Congress to take lessons learned from RETAIN and pilot these changes slowly before ramping them up nationwide to learn about any challenges they may face in doing so. In the same vein, Fichtner spoke about his paper on lessons learned from past demonstration pilots, noting that it is best to start with small changes with input from all stakeholders and as much collaboration as possible. Fichtner stressed the importance of good leadership and the eventual need to scale up successful projects.

The discussion then turned to the Administration's current demonstration projects. Wilson outlined how RETAIN is currently in its pilot phase in eight states; after 18 months, up to five states will receive further grants for full implementation. Additionally, Wilson said that the Administration is working on projects for disabled youth on Supplemental Security Income (SSI) and other proposals for helping potential applicants with substance abuse and mental health treatment, time-limiting benefits, and using vocational rehabilitation (VR) for a broader set of the disability community. Stapleton noted that in recent years, VR has been gaining more prominence for helping broader communities than just the severely impaired; he specifically highlighted a successful approach in the State of Alabama.

Sutcliffe then discussed some of the recent improvements to the representative payee system. She highlighted the Strengthening Protections for Social Security Beneficiaries Act of 2018, which was a bipartisan achievement to improve oversight and simplify the process for helping people with disabilities who need representative payees to get access to them.

Next, audience questions prompted a discussion on what might best explain the drop in the number of SSDI applicants over the last few years. Stapleton thought it was most likely that applications were going back to an equilibrium following a bump during the Great Recession. Sutcliffe emphasized the importance of this question, stated that it is too soon to know what is at play, and noted that Social Security’s actuaries are currently exploring this question in depth and looking at a number of different factors. Fichtner said that he thought it was largely the economy being stronger right now, pulling marginal workers in the labor market. A full discussion of the audience questions can be viewed in the video above.

The panel discussion was followed by a video message from Representative Larson, chairman of the Ways and Means Social Security Subcommittee, who commended the initiative's authors for their work and spoke about his Social Security 2100 Act that would combine the SSDI and old-age trust funds and achieve sustainable financial solvency for Social Security as a whole. You can view the video below:

After the video, McCrery and Pomeroy sat down with Senator Cassidy, a member of the Senate Finance Social Security Subcommittee, for a discussion on disability policy. Asked about how his work as a physician has informed his views on disability, Senator Cassidy explained how he worked in a charity hospital, so he interacted with low-income communities frequently and learned the struggle of cash-flow problems caused by short-term disabilities. As a result, he stated that he would like to explore further how to provide a system of short-term disability income that is separate from the all-or-nothing long-term disability benefits that SSDI provides. On whether we should continue demonstration authority with a strong economy and plenty of time to test changes, Senator Cassidy agreed with extending it, noting that it may be a hot economy now, but it might not stay that way forever so we shouldn't be tempted into a false sense of complacency.

Asked about the BBA 2015, given that the reallocation was meant as a short-term fix and wondering whether we should work on fixing SSDI now, Senator Cassidy explained how the reallocation was essentially a "bailout" of the SSDI program, so now is the time to solve the whole problem rather than delaying further. The conversation then shifted towards the new Social Security Commissioner, Andrew Saul, who is the first Senate-approved commissioner in over a decade. Senator Cassidy expressed his confidence for Saul's ability to help improve SSA as he did with the Thrift Savings Program. The conversation ended on a positive note about Congress's ability to work in a bipartisan fashion, with Senator Cassidy noting that he has around 15 bills with Democratic co-sponsors on other areas like health care that he believes can pass in the Senate. The full interview can be viewed in the video above.

The Committee for a Responsible Federal Budget and the McCrery-Pomeroy SSDI Solutions Initiative are thankful to all those who attended and tuned into the live stream.

Read the papers from the SSDI Solutions Initiative: