Using the Medicare buy-in program to estimate the effect of Medicaid on SSI participation

This article assesses the importance of receiving supplemental health insurance on participation in Supplemental Security Income (SSI) for the elderly. The implementation of the Qualified Medicare Beneficiary (QMB) program offered a substitute for Medicaid, and expanded health insurance eligibility to a higher income level. Using a sample of elderly respondents aged 66 to 75, I find that the QMB program reduced SSI participation. More than half of the QMB participants were previously covered by SSI and Medicaid. The calculations suggest that the QMB program was not as expensive as it might first appear because of reductions in SSI expenditure.     

Supplemental Security Income Among Older Immigrants From Central and South America: The Impact of Welfare Reform

This article explores the impact of federal welfare policy changes on older immigrants born in Central and South America. Using data from the 1990 and 2000 U.S. Census 5% Public-Use Microdata Samples, the study examines (1) the change in Supplemental Security Income (SSI) uptake rate after welfare reform for noncitizens from Latin America, naturalized Latin Americans, and U.S.-born Hispanics and (2) how much of the change can be attributed to a change in behavior rather than to a change in eligibility rates. Findings show that the decline in SSI receipt after welfare reform was greater for Latin American noncitizens compared to naturalized citizens and Hispanic U.S.-born citizens. Decomposition analyses show that among eligible elderly noncitizens, the decline in recipiency rate was due mostly to a change in behavior rather than a change in eligibility. This pattern is not found for U.S.-born and naturalized citizens, where changes were mostly due to a decline in the proportion of persons eligible for SSI. This suggests that as a result of legislative changes, older immigrants may not be applying for benefits for which they may be legally entitled. Policy implications are discussed.     

Social Security and SSI as safety nets for the elderly poor

Partial privatization of Social Security is being considered as an integral part of the future Social Security program for American retirees. Because privatization creates uncertainty about the amount of retirement income that future retirees may expect to receive, the issue of a safety net is critical. This article presents the findings from an empirical study that investigated the degree to which the current Social Security and Supplemental Security Income (SSI) programs provide a safety net, separately and in combination, to the elderly poor. The major findings were that the Social Security program not only increases the income statuses of both posttransfer and pretransfer poor elderly people considerably, but that the program also significantly equalizes the distribution of income among them. In addition, the SSI program supplements the Social Security program in establishing an even greater safety net, especially for posttransfer poor elderly people. On the other hand, Social Security benefits make the income disparity among races greater between both posttransfer and pretransfer poor elderly people. Implications for policy are discussed.     

Enacting the Millennium Development Goals: Political Technologies of Calculation and the Counter-calculation of Poverty in Namibia

Abstract

This paper advances that the Millennium Development Goals (MDGs) act as a governmentality that brings with them assemblages of international and national policies and practices of poverty reduction. These assemblages are characterized by neoliberal rationalities that shape relationships and practices with and of the poor themselves by repositioning and deploying the values and norms of the market as the principal means for the establishment of development aid partnerships. Such rationalities, we argue, are exercised through political technologies that make visible and operable certain governing schemes such as calculative practices. Drawing on extensive interview, policy, programme, and archival documents, the paper advances the argument that the MDGs and the national development plan for Namibia, Vision 2030, shape ideas of poverty reduction through political technologies of calculation and via multi-scale partnership arrangements. These technologies emerge from diverse elements, subsume the shaping of social and political spaces, and have diverse effects on the lives of the poor. Our analysis also highlights an approach to poverty reduction in Namibia, that of BIG, a Basic Income Grant scheme. We view BIG as a potential counter-calculation of poverty, and counter-partnership to poverty reduction efforts, which can develop into a more socially just and sustainable means to reduce poverty and lead to an overturn of contemporary neoliberal assemblages of poverty reduction.     

Medicaid Funding for Assisted Living Care: A Five-State Examination

Medicaid waiver programs financing assisted living care are examined in five states to gain insights about program implementation, accomplishments, and challenges. Documents, augmented with stakeholder interviews, are used to describe income eligibility, options for supplementing payments to facilities, risk adjustment payment levels, and participation. Needs determination and waiver-based payments are in place. Eligibility and funding levels are complicated by room and board allocations that are linked to the federal benefit rate for Supplemental Security Income. Provider participation may be diminishing. Many recipients have to accept shared occupancy as program payments are insufficient for single units.     

Household Finance and Food Insecurity

Despite repeated expansions of federal food assistance, food insecurity and hunger continue to affect many Americans. While job loss and poverty are among major contributors, theoretical and empirical literature suggest that households’ ability to borrow and save might provide a buffer protecting from food insecurity. Using data from the Panel Study of Income Dynamics, we tested whether liquidity constraint, asset inadequacy, and insolvency risk defined based on financial ratios could predict household food insecurity separately from the effects of income and program participation. Results showed that a household’s liquidity constraint and asset inadequacy were linked with increased risk of food insecurity at all income levels, although the association was strongest among poor households and those with incomes slightly above the federal food assistance eligibility threshold. Unlike indications from qualitative literature, financial constraint appeared to be an exogenous determinant of household food insecurity. Implications for financial practitioners and policymakers are discussed.     

The economic safety net for low-income families with children

Following the passage of welfare reform in the mid-1990s and the end of entitlement benefits under Temporary Assistance for Needy Families, the U.S. economic safety net has become increasingly individualized. In fact, it is no longer clear whether low-income families tend to rely on particular types of public benefits, or whether there are characteristics that differentiate benefit “packaging”.This study examines the combinations of various income sources comprising economic safety nets for low-income families participating in the Fragile Families and Child Wellbeing Study. The income sources we explore include earnings, child support, Temporary Assistance for Needy Families (TANF), Supplemental Nutritional Assistance Program (SNAP) benefits, childcare subsidies, unemployment insurance (UI) benefits, Supplemental Security Income (SSI), the Earned Income Tax Credit (EITC), housing subsidies, and Medicaid. We use cluster analysis to determine the most common patterns of income and benefit sources, and identify four distinct clusters of income and benefits that are associated with different family demographic characteristics. The findings from this investigation may be useful to social service programs as they attempt to identify relevant safety net resources for economically struggling families, and to policymakers attempting to reconcile requirements associated with programs and benefits that are regularly combined by beneficiaries.     

Challenges Faced by Women with Disabilities Under TANF

SUMMARY

A number of studies report the multiple problems facing women during the welfare reform transition. Within this group is a large number of single mothers struggling with both poverty and chronic health problems or disabilities. Those with these additional challenges might be expected to experience less success in moving out of poverty than those without these health challenges. In this study, we examine the progress of 178 women around the state of Wisconsin who were interviewed repeatedly about their experiences with welfare reform and poverty between 1997 and 2000, when the Wisconsin Works (W-2) program was being implemented. The incidence of health problems is related to level of education, and the type of disability has major impacts on expected outcome. Those with less education are more likely to suffer from health problems, especially mental health issues, depression and post-traumatic stress, which seem to be the most debilitating. These women also had difficulty accessing non-work support, such as Supplement Security Income (SSI), a federal assistance program for disabled persons with little or no income, or assistance from the Department of Vocational Rehabilitation (DVR), a federal and state program of assistance to promote the employment abilities of adults with disabilities.     

Options to liberalize Social Security disabled widow(er)s benefits

Each month, 200,000 widows and 6,000 widowers receive Social Security disabled widow(er)s benefits, each benefit averaging about $550. Among the most economically at-risk Social Security beneficiaries, their benefits are permanently reduced. This paper reviews the legislative history of the disabled widow(er)s benefit, identifying key decisions that gave shape to this benefit. Social Security program data and six years of Current Population Survey data (March Annual Demographic Files, 1995-2000) are used to profile the economic status of current and potential disabled widows. The analysis, including comparison with other widows, provides strong evidence of economic need among disabled widows with, for example, 44% of disabled widow beneficiaries, ages 50-59, having below-poverty incomes compared with 15% of like-aged non-disabled widows. We conclude that serious consideration should be given to extending eligibility to all widow(er)s disabled before the normal retirement age; to providing a benefit equal to 100% of the deceased spouse's private insurance amount (PIA); to eliminating the unnecessarily restrictive seven-year rule; and to protecting beneficiaries from losing their eligibility to Medicaid. Even in the context of today's heated Social Security debate, we suggest that a rare opportunity may exist to garner bipartisan support for meaningful, low-cost improvements, in a benefit that primarily targets women.     

Family Financial Management and Individual Deprivation

A core assumption in conventional poverty measurement is that household members share equally in total household income. This paper focuses on heterosexual couple households and asks to what extent male and female partners may derive different benefits from total couple resources. Drawing on the 2010 Irish Survey on Income and Living Conditions module, we examined the couple financial regime, by which we mean which partners received income, whether the income was from work, the extent to which income was contributed for the benefit of other household members and responsibility for decision-making. We explored whether the couple’s financial regime was associated with different living standard outcomes for the partners. Among the findings was the beneficial impact of having income from work and of shared responsibility for decision-making. The paper concludes by pointing to some implications for our understanding of power and bargaining in couples.     

Devil is in the details: Using logic models to investigate program process

Theory-based logic models are commonly developed as part of requirements for grant funding. As a tool to communicate complex social programs, theory based logic models are an effective visual communication. However, after initial development, theory based logic models are often abandoned and remain in their initial form despite changes in the program process. This paper examines the potential benefits of committing time and resources to revising the initial theory driven logic model and developing detailed logic models that describe key activities to accurately reflect the program and assist in effective program management. The authors use a funded special education teacher preparation program to exemplify the utility of drill down logic models. The paper concludes with lessons learned from the iterative revision process and suggests how the process can lead to more flexible and calibrated program management.     

No claim, no pain. Measuring the non-take-up of social assistance using register data

The main objectives of social assistance benefits, including poverty alleviation and labor-market or social reintegration, can be seriously compromised if support is difficult to access. While recent studies point to high non-take-up rates, existing evidence does not make full use of the information recorded by benefit agencies. Most studies have to rely on interview-based data, with misreporting and measurement errors affecting the variables needed to establish both benefit receipt and benefit entitlement. In this paper, we exploit a unique combination of Finnish administrative data and eligibility simulations based on the tax-benefit calculator of the Finnish authorities, carefully investigating the measurement issues that remain. We find rates of non-take-up that are both substantial and robust: 40 to 50% of those eligible do not claim. Using repeated cross-section estimations for years 1996?C2003, we identify a set of stable determinants of claiming behavior and suggest that changes in behavior could drive the observed downward trend in take-up rates during the post-recession period. We discuss the poverty implications of our results.     

Can ‘refundable’ state Earned Income Tax Credits explain child poverty in the American states?

This study estimates the effect of ‘refundable’ state Earned Income Tax Credits (EITCs) on child poverty from 1994 through 2003. Research results indicate that a refundable state EITC is associated with reductions in child poverty, holding all other variables constant. For example, states with refundable state EITCs have observed a 40% greater reduction in child poverty rates compared to states without refundable state EITCs. This study also discusses policy implications for implementing the ‘refundable’ state EITC.     

How Means-Tested Transfer Programs Respond to Household Earned-Income Increases: Policy and Practice

We use data from the 2008 Survey of Income and Program Participation to estimate how four means-tested transfer programs respond to household earned-income increases. In general, the programs respond as we would expect based on the program laws and regulations, with some important exceptions, including that benefits received under some programs take much longer to fully adjust to earned-income increases than we would expect. We explore the reasons for these departures from our expectations and discuss the implications for policymakers’ efforts to balance the programs’ goals of poverty alleviation, cost effectiveness, and work promotion.     

Poverty persistence among the elderly in the transition from work to retirement

On the basis of matched Income Tax/Census data, the majority of the elderly poor in Belgium appear to be persistently poor. The question arises as to why this might be so. To the extent that individual characteristics such as abilities or tastes persist over time, these may also be the reason that individuals persist in poverty over time. In that case, one expects that once individual characteristics are controlled for, duration dependence in poverty becomes spurious. The alternative possibility is that the poverty experience itself has a causal impact on future poverty. This may be because of work disincentives, lack of investment in human capital and/or loss of motivation during the period of job search. The reasons for dependence in poverty are of interest for developing effective poverty-reducing policies. The estimation of a multiple-spell hazard model of transitions in and out of poverty, that allows for unobserved heterogeneity and a significant initial condition problem, supports the suggestion of true duration dependence in poverty. In Belgium the elderly unemployed are exempted from job search and lack any training or counselling from government agencies, while workers above 50 are given strong financial incentives to leave the labour market as soon as possible through different kinds of early retirement schemes.     

Income Mobility and the Earned Income Tax Credit

Households who work full-time at minimum wage jobs earn more than the phasein range of the Earned Income Tax Credit (EITC). This means that the EITC mainly acts as a negative income tax. However, most families are eligible to receive the EITC for a relatively short time. Seventy-four percent of new EITC families will lose their eligibility in two years or less. Sixty-one percent of families already on the EITC will lose their eligibility in three years or less. EITC families are much more mobile than AFDC families. The main reason that families gain or lose EITC eligibility is changes in earnings.     

Assessment of multidimensional poverty and effectiveness of microfinance-driven government and NGO projects in the rural Bangladesh

This paper has developed a multidimensional model usable in assessing economic, social, political and cultural dimensions of poverty by utilizing primary data collected from 78 villages in Bangladesh using a participatory approach. Employing the developed model, a comparative analysis has been performed between microfinance-driven government (GO) and NGO (non-government organization) projects to explore their relative effectiveness in enhancing wellbeing of the poor in rural Bangladesh. It is observed that GO agencies are more effective in enhancing ‘economic wellbeing’ of the poor, whereas NGOs are contributing more in the ‘social’ aspects of wellbeing. Findings also revealed that, as whole, GO agencies perform 42% better than NGOs in improving living standards of the rural poor which contradicts with the existing literature of poverty reduction projects in developing countries.     

Medicaid State Plan personal care services: trends in programs and policies

Policymakers face mounting pressures from consumer demand and the 1999 Olmstead Supreme Court decision to extend formal (paid) programs that deliver personal care to the elderly, chronically ill, and disabled. Despite this, very little is known about the largest program that delivers personal care: the Medicaid State Plan personal care services (PCS) optional benefit. This paper presents the latest available national program (participant and expenditure) trend data (1999-2002) on the Medicaid PCS benefit and findings from a national survey of eligibility and cost control policies in use on the program. The program trends show that, over the study period, the number of states providing the Medicaid PCS benefit grew by four (from 26 to 30), and national program participation, adjusted for population growth, increased by 27%. However, inflation-adjusted program expenditures per participant declined by 3% between 1999 and 2002. Findings from the policy survey reveal that between 1999 and 2002 there was a marked decline in the range of services provided, and by 2004, almost half the programs operated a cap on the hours of services provided.     

How would cash transfers improve child welfare in Viet Nam?

This paper was aimed to estimate how cash transfer to children could help increase access to education and health services as well as to reduce their poverty. To pursue these objectives, we first applied fixed-effect regression models with a panel data from Vietnam Household Living Standard Survey (VHLSS) in 2010 and 2012, and then used the predicted results to simulate how welfare indicators would have been changed if children were provided benefits at different levels. We found that cash transfers would have a positive effect on school enrolment and poverty. However, cash transfers would have no significant effects on both impatient admissions and outpatient visits as well as out-of-pocket spending on health care, but a significant effect on the probability of having health insurance. From these findings, we proposed some policy recommendations such as promoting cash transfer program for more vulnerable groups of children would provide opportunities for them to further reduce poverty and increase access to education and health. More importantly, the research emphasized that quality of services to be provided along with cash transfers should also be guaranteed, so as to make sure that the current benefits will be fully translated into socio-economic development of Viet Nam.     

Improving School Achievement and Inter‐group Relations for Children Placed at Risk: the Roots and Wings program

Roots and Wings is a comprehensive elementary‐school program designed to ensure that all children achieve world class standards in reading, writing and language arts, mathematics, science, history and geography; and can apply their knowledge to solve real‐world problems. Critical to these goals is increasing the achievement of students placed at‐risk as a consequence of poverty, disabilities, language problems, or other factors. Roots and Wings extensively employs cooperative learning to promote student motivation, socialization, appreciation of diversity, and academic achievement. Although cooperative learning offers a variety of potential benefits, it can be challenging to use for teachers and students more accustomed to traditional methods. This paper presents research in inner‐city elementary schools using the Roots and Wings design and identifies several factors that facilitate the change process and quality of cooperative classroom activities.