Health Status and Health Insurance

Cohort Changes in the Retirement Resources of Older Women

This article uses different sources of United States data to focus on the retirement resources of women aged 55–64 in 2004, 1994, and 1984. Notable changes have occurred with women's pathways into retirement resulting from increased education and lifetime work experience. There appear marked cohort differences in potential retirement outcomes.

Disability Benefit Coverage and Program Interactions in the Working-Age Population

It is widely known that about three-fourths of the working-age population is insured for Disability Insurance (DI), but the substantial role played by the Supplemental Security Income (SSI) program in providing disability benefit coverage is not well understood. Using data from the 1996 panel of the Survey of Income and Program Participation (SIPP) we find that over one-third (36 percent) of the working-age population is covered by SSI in the event of a severe disability. Three important implications follow: (1) SSI increases the overall coverage of the working-age population; (2) SSI enhances the bundle of cash benefits available to disabled individuals; and (3) interactions with other public programs—most notably the SSI path to Medicaid coverage—also enhance the safety net. Ignoring these implications could lead to inaccurate inferences in analytic studies.

Characteristics of Noninstitutionalized DI and SSI Program Participants

A Profile of Children with Disabilities Receiving SSI: Highlights from the National Survey of SSI Children and Families

This article, based on interviews from the National Survey of SSI Children and Families conducted between July 2001 and June 2002, presents a profile of children under the age of 18 who were receiving support from the Supplemental Security Income program. The topics highlighted provide information of SSI children with disabilities and their families not available from administrative records, including demographic characteristics, income and assets, perceived health and disabilities, and health care utilization. While virtually every child in the SSI program is covered by some form of health insurance, primarily Medicaid, the data indicate substantial heterogeneity on other variables. This is true on many different dimensions, such as the perceived severity of the child's disabling conditions, health care utilization and service needs, the presence of other family members with disabilities, family demographics, and access to non-SSI sources of incomes.

An Overview of the National Survey of SSI Children and Families and Related Products

During the first three decades of the Supplemental Security Income (SSI) program, the number of children receiving SSI because of a disability increased from 70,000 in 1974 to about 1 million at the end of 2005. With over 8,500 interviews completed between July 2001 and June 2002, the National Survey of SSI Children and Families (NSCF) is the first nationally representative survey since 1978 of noninstitutionalized children and young adults who were receiving SSI during the survey period or had formerly received SSI. The article discusses the objectives of the survey, its methodology and implementation, content of the questionnaire, a randomized response-incentive experiment, and related products including the release of a public-use data file.

The Erosion of Retiree Health Benefits and Retirement Behavior: Implications for the Disability Insurance Program

The number of companies offering health benefits to early retirees is declining, although reductions in the percentage of early retirees covered by health insurance have been only slight to date. In general, workers who will be covered by health insurance are more likely than other workers to retire before the age of 65, when they become eligible for Medicare. What effect that will have on claims under the Disability Insurance program is not yet clear.

Early Retirees Under Social Security: Health Status and Economic Resources

Policies that would reduce or eliminate Social Security benefits for early retirees could have adverse consequences for older workers in poor health. This article documents the health and financial circumstances of beneficiaries aged 62–64. It examines the extent to which poor health limits work among early retirees and assesses the extent to which curtailment of early retirement benefits might lead to increases in the Disability Insurance program rolls.

Noncash Income, Equivalence Scales, and the Measurement of Economic Well-Being

The economic well-being of subgroups of the population usually is measured by comparing resources and needs. The measure of resources often includes noncash income. Equivalence scales are used to adjust for differential needs. Little attention, however, has been paid to the desirability of consistency between the specifications of the resources and the equivalence scales in these comparisons. This exploratory paper suggests that a lack of consistency between the definitions used on the income and the needs sides can be important for the assessment of the economic well-being of subgroups when some types of noncash income are included in the definition of income. The measured economic status of the aged in the United States when Medicare noncash income is included in the definition of income is used as an example of this consistency problem. Some previous estimates have used equivalence scales that probably understated the relative needs of the aged by omitting needs associated with Medicare. The measured economic well-being of the aged relative to that of other age groups could be overestimated substantially as a result of this consistency problem. The basic problem is not confined to the treatment of Medicare or to the United States, but is much broader in nature.

Statistical Methods for the Estimation of Costs in the Medicare Waiting Period for Social Security Disabled Worker Beneficiaries

This paper presents the statistical methods used to estimate Medicare costs in the waiting period that were presented in text tables 2–3 of Bye and Riley (1989). The first part describes the development of Medicare utilization equations for each Social Security Disability Insurance (DI) program status group. The second part describes how these equations were used to predict expected costs per month and how the monthly estimates were aggregated to yield estimates of costs in the full 2-year waiting period and in the second year only. Finally, there is a brief discussion of the accuracy of the predictions.