How Did Expansions of Children’s Public Health Insurance Affect Participation in the Supplemental Security Income Program?

DRC Brief Number: 2019-03
Publisher: Washington, DC: Mathematica, Center for Studying Disability Policy
Jun 27, 2019
Authors
Michael Levere, Sean Orzol, Lindsey Leininger, and Nancy Early

Key Findings:

  • We find evidence of substitution between Medicaid and SSI, with the availability of Medicaid to more children reducing the number of youth SSI applications and awards in states without an automatic Medicaid grant with SSI.
  • A 10 percent increase in the share eligible for Medicaid reduced SSI applications by 5 percent and SSI awards by 3 percent.
  • Our results rule out a “welcome mat” effect – that is that expanded access to Medicaid could result in an increase in children’s participation in SSI.

This issue brief highlights findings from a study of the interplay between two important public programs for vulnerable children: Medicaid and the Supplemental Security Income (SSI) program. Medicaid eligibility for children expanded in the late 1990s and early 2000s, primarily due to the creation of the Children’s Health Insurance Program (CHIP). Because people who receive Medicaid or CHIP often access other public supports, these expansions may have affected other social safety net programs, including SSI. We found that on average, expanding Medicaid eligibility did not affect youth SSI applications or awards, though there were differences between states. States where expansions in public health insurance coverage led to a significant decrease in both applications and awards had higher transaction costs associated with entering Medicaid via SSI, which could explain the decrease in SSI participation.