by Ben Adler
It's fashionable on the nation’s mainstream op-ed pages these days to call for eviscerating the social safety net in the name of pragmatic deficit reduction. In a column that was widely derided by liberal economists and pundits, The New York Times’ Bill Keller on Monday urged Baby Boomers to cut their own future Social Security and Medicare benefits.
But a far more pernicious piece—because it's genuinely misleading on matters of fact—appeared the next day in The Washington Post, when Charles Lane claimed that too many disabled Americans are feeding at the public trough. Here's the gist of the argument:
Under the [Americans with Disabilities], employers who refuse to hire or promote the disabled may be liable for money damages in federal court. Social Security Disability Insurance, however, pays people who can show that they are too mentally or physically impaired to remain in the labor force. In short, for many workers, SSDI creates a quasi-right not to work. This paradox is getting expensive.
First, Lane is setting up a false “paradox”—that employers should not discriminate against the disabled and yet we provide for those who cannot work. To state what should be obvious: In a civilized country, people who have disabilities but can work with reasonable accommodation—say, someone confined to a wheelchair due to a spinal injury—should be enabled to do so and protected from discrimination. But some people who are more severely disabled—someone with severe cognitive impairments, for example—simply cannot work.
Moreover, despite the ADA's attempts to crack down on discrimination against the disabled, such discrimination remains rampant, advocates say. That's one major reason why unemployment among Americans with disabilities is at over 60 percent.
That's only the first problem. Lane goes on to complain that too many malingerers are claiming disabilities like backaches and depression. That, combined with rules that make it too easy to qualify, are causing the rolls to swell, he argues. “Applications spike during serious recessions, as laid-off workers turn to SSDI when unemployment benefits run out. Thanks to the Great Recession, applications spiked in 2010 to an all-time high of 2.94 million, before declining slightly last year.”
But there are several explanations for why applications are increasing before one jumps to allege massive fraud. As Charles Martin and Debra Shifrin of the National Organization of Social Security Claimants' Representatives (NOSSCR) wrote just this week in The Hill, the Boomers "are reaching the age where injury, illness, or disease more frequently knocks them out of the workforce."
And as Dean Baker of the Center for Economic and Policy Research pointed out in response to Lane, improvements in health care can increase disability rates, by extending the lives of Americans who previously would have died, without allowing them to return to work. Baker also points out that disability claims may increase during a recession because disabled workers are some of the first to be laid off during a downturn.
But it's Lane's conclusion that's perhaps the most misguided.
“More than 6 percent of the U.S. working-age population is on SSDI,” he writes. “Does that statistic represent laudable social solidarity, a scandalous excess of the welfare state, or a tragic but unavoidable idling of human resources?”
So in Lane's view, it's either good welfare, bad welfare, or unavoidable tragedy. But the correct answer is none of the above. It's too little welfare—specifically, too little health insurance for the working poor.
Here's why: SSDI comes with a health insurance component. After two years on SSDI, you qualify for Medicare, even if you're under 65. So what happens if you're on SSDI but you want to re-enter the workforce? You'll likely lose your health insurance, unless your new employer offers coverage. And even if it does, you may wait up to 90 days from your first day on the job to be covered, or the coverage may be inadequate for your needs. (Since you're disabled, your health insurance needs will be greater than the average person’s.) In most cases you simply cannot afford to go without it, even for a few months.
Ironically, the very medical accommodations that you need to work may be those you will lose if you take a job and no longer receive Medicare. Suppose you need a daily visit from a home health attendant to help you get dressed and out of the house. Employer-based insurance for someone stocking shelves at a supermarket is unlikely to cover that.
Lane comes close to acknowledging this. “For many workers," he writes, "the alternative to a steady SSDI check (and, often, Medicare) would be a minimum-wage job, possibly one without insurance.”
But he never draws the obvious conclusion: If everyone in the country qualified for Medicare—in other words, if we had a single payer universal health insurance system—we would remove this frightening disincentive to move from SSDI back into the workforce. Even a system that covered more people, with better coverage, would help.
To disability advocates, if not to Lane, the real issue is clear.
“I don't think the problem is that it’s too easy to qualify,” says Mark Periello, president of the American Association of People with Disabilities. “The problem is not enough options for folks on the other side to leave the system.”
Ben Adler is a contributing writer for The Nation and federal policy correspondent for Next American City.