Fewer in state filing for U.S. disability aid

Senator links 19% decline to Medicaid private option

Fewer low-income children and adults are filing for federal disability benefits in Arkansas this year, according to the state's Social Security disability determination agency.

Physically or mentally disabled people up to age 64 who have little or no Social Security trust funds are eligible for Supplemental Security Income, SSI. Those approved for the federal program, which is funded through general tax revenue, are automatically enrolled in Medicaid.

The 19 percent drop -- from 17,497 first-time SSI applications to 14,160 applications from Oct. 1 to Tuesday -- is the largest seen by the agency since 2006.

State Sen. Jonathan Dismang, R-Searcy, linked the decline in initial applications to the state's expanded Medicaid coverage under the private option.

Dismang, who is in line to be Senate president pro tempore in 2015, helped engineer the private option, which allows Arkansas to use federal money available under the Patient Protection and Affordable Care Act to buy coverage on the insurance exchange for those made newly eligible for Medicaid by the expansion.

"That's a significant drop," said Arthur Boutiette, director of the state's Social Security determination agency.

But the private option may not be the full picture, said Boutiette, whose office works together with a federal one to decide which Arkansans are eligible for federal disability payments and how much they get.

"For the percentage of the people who file for SSI who are looking for health coverage, it may be easier to get it through the private option," he said. "But a lot of people filing for disability are doing it because they can't work. They need a monthly paycheck to drive their car and pay for their kids."

According to the most recent year-to-date review of a period beginning Oct. 1, Arkansas' Social Security Disability Agency received 37,580 total initial filings, compared with 42,056 in the same period a year ago, an overall reduction of 11 percent.

For children, the agency received 25 percent fewer SSI applications, or 7,082 compared with 9,396. For adults, it received 13 percent fewer SSI applications, or 7,077 compared with 8,097.

The remainder of recipients are served through the Title II program for those who have Social Security funds built up. Initial Title II filings reduced slightly, from 11,617 filings to 11,441.

A spokesman for the regional Social Security office in Dallas -- which covers Arkansas, Louisiana, New Mexico, Oklahoma, Texas and Navajo nations in parts of Arizona and Utah -- said SSI filings across the nation have been largely stable and the Arkansas trend doesn't hold true elsewhere.

The next annual report for the states will be available in January.

Arkansas leads the nation with the biggest drop in uninsured adult residents this year, and is now tied with New Hampshire as 22nd in the country in the percentage of adults who have reported having insurance, according to a recent Gallup Inc. survey.

Gov. Mike Beebe, the state Department of Human Services and other state officials credit that result to the private option. Sign-ups started Oct. 1 for coverage that began in January.

A total of 192,210 Arkansans were approved for Medicaid coverage by Aug. 1., according to the Department of Human Services.

Since more people have access to health insurance through the Medicaid expansion, which extended eligibility to adults with incomes of up to 138 percent of the poverty level, fewer are filing for SSI in order to receive coverage, Dismang said.

"There is going to have to be an academic to get in there and dig through the numbers, but I think we're seeing a lot of positive movement," Dismang said.

"We are taking away the incentive for people to claim disability and instead providing them with a ladder so that they are able to improve the lives of their families to a point that they no longer need the assistance."

In addition to extending coverage to more Arkansans, fewer SSI enrollments could also save the state money, Dismang said.

A 2013 Arkansas Democrat-Gazette analysis showed that SSI payments made up 51 percent of growth in the state's $5 billion Medicaid expenses, accounting for $500 million of the $985 million increase in state Medicaid spending.

The federal government funds a monthly payment for SSI recipients. For those recipients' health coverage, the federal government picks up 70 percent of the cost of Medicaid, and the state is required to provide the remaining 30 percent.

While the private option could contribute to the decline in initial SSI applications, Boutiette said, it's also important to consider the economy. Generally, when the economy is doing better, fewer people file for SSI, as well as the reverse, he said.

To move forward, the state Department of Human Services is planning to conduct a full review of the SSI data, spokesman Amy Webb said. That review would be conducted by the state's Medicaid office.

"Back when we first began discussing the private option, we thought that if people get insurance elsewhere, they may not file for SSI," Webb said. "From our perspective, it is possible that the private option may have some influence in the decline in SSI applications ... we have no evidence to the contrary."

A section on 08/20/2014

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