Below, I will give an extended overview of some aspects in the evolution of the SSI (Supplemental Security Income) program since 1974 (when it was first implemented) as an example of how the purpose of a support system becomes corrupted over time.
I was working for Michigan Protection and Advocacy Service as the SSI program rolled out in its first years, and saw first-hand just how deep the corruption of the eligibility determination process became. It has only worsened since.
SSI eligibility determination has embraced a purpose of denying eligibility unless there is a political downside. Given the vulnerability of recipients of SSI, this is tantamount to condemning a large number of people with severe disabilities to additional medical problems, debility, and death.
The Supplemental Security Income System
Wikipedia has a decent review of the history and thinking that went into the SSI program, but the article is bloodless. It doesn’t reflect the efforts of the SSI system and advocates in their mutual struggle to (on the one hand) reduce the number of claimants or make it so difficult to get or be on SSI that the claimant despairs and leaves the program, and (on the other) to correct failings of the system, expand eligibility, and due process protections.
- During the early part of the Reagan administration, large numbers of people who were currently eligible for SSI were tossed off the program. In Michigan this amounted to 50-60 thousand individuals. Marsha Katz (the most knowledgeable expert in Michigan at the time) and other advocates created a curriculum which several hundred advocates embraced to more effectively respond to this wholesale attack on the lives of people with severe disabilities. With capable representation in the fair hearing, many people were able to become eligible for benefits again. The cases I had were all individuals with developmental disabilities, whose disability was clear. I think we all became convinced by our experience in these hearings that there was no due process review that resulted in the huge number of denials, but a simple arrogant process of tossing as many people under the bus as the administration could.
- The Statute that defines the purpose and goals of the SSI program is more or less clear about eligibility for the benefit. I may not agree with the definition of eligibility, but it is clear. The procedural framework that is used in initial disability determination and first-reconsideration for disability determination is not the statutory standard. It is a hodge-podge of procedural barriers designed to produce automatic triggers for denial. The result is that roughly twice as many people are denied eligibility as would be the case if the statutory standard was used. This is not simply bureaucratic obfuscation. It has real world consequences. The number of denials begins to result in appeals that create waiting lists as long as 2 years for a hearing that might actually look at eligibility under the statute. There is also an empty and deliberately useless process called an in-office reconsideration step that uses up time but seldom results in a change in the initial eligibility determination result. SSA whines that it needs more money to solve this waiting list “resources” problem when it could easily free up an enormous number of resources by making its initial eligibility standard reflect the statute. It won’t do this. The administrative structure is deliberately framed to deny the maximum politically safe number of people with severe disabilities it can.
- There are a huge number of procedures that are “gotchas” (they seemed to have multiplied during the pandemic) in the decades of the program’s development. It is impossible to mention them all. They are designed to require a level and sophistication of response from people on SSI (who have very severe disabilities, and whose income is WELL below the poverty level) that makes it certain a large number of appeals will simply not be made, and another recipient will “bite the dust”. The one that has been used with the most venomous intent is the overpayment reimbursement requirement. While repayment of overpayments is abstractly reasonable, I would ask you if the following scenario is reasonable (this response is especially spiteful and shows the contempt that SSI has for its recipients)? A person on SSI has a small, part time job whose income is paid out every two weeks. The person dutifully reports the income to SSA each time it is received. Because it is possible for more than two paychecks to be given in a single month, the person may go over a threshold in one month while not actually ever being over the threshold for the year. In SSA ‘s reality this is an overpayment, and SSA must terrorize the recipient with threats to recoup their lost riches. Now, I still wouldn’t think it was fair to cost the person a month of their Medicaid or a month of financial eligibility, but at least that would be transparent. Instead, SSA doesn’t take any responsibility for notifying the person that this situation exists in anything you or I would see as a realistic time frame. There was an extreme example recently, in which SSA demanded the repayment of 2 cents from 15 years ago. SSA never has any responsibility to be transparent, and they exist in a timeless universe where 15 years is the same as no time at all. Advocates have struggled against such procedural evil across decades, but the fight is a loser. The reality is that the SSI bureaucracy pays their employees an enormous amount of money specifically to come up with gotchas. These employees don’t have to struggle because of poverty or lack of health insurance. In the truest sense of the concept, such policies live off the backs of people with severe disabilities, and can’t even claim they are doing this for the “good” of the person with the disability. Instead, their purpose is to implement more and more complex ways of forcing people off benefits without causing political pain to their superiors.
I hope I’ve given the flavor of this ongoing effort to reduce or slow the growth of the number of SSI recipients without creating political problems. In my view, this is corruption in every sense of that word.
Other examples of programs that started out with good intentions and ended up with bad:
- The Spend Down Program under Medicaid
- SSDI waiting periods for financial support and health insurance
- Mental Health Severity Thresholds and the way they are gamed
- And many, many more examples.
Ask an advocate you know for examples from their own experience. They are endless. Corruption is part and parcel of every support system in government as it evolves over time. This corruption is a form of sabotage, the ongoing, step-by-step, corroding of the purpose of the system.
Sabotage exists as a ubiquitous form of corruption in every aspect of the American experience. While I think most people are well aware of financial corruption as a basis of policy in governmental systems, there are less obvious and more common forms. I’m going to do a series of posts on this invisible sabotage of life possibilities next.
Next: The Long-Entangled Insurgency: Part One