Rethinking Disability Policy: The Role of Income, Health Care, Rehabilitation, and Related Services in Fostering Independence

Article excerpt

The Disability Policy Panel of the National Academy of Social Insurance recently issued its Preliminary Status Report as a way to invite public comment on its work to date, and, in particular, to invite suggestions for specific policy proposals for the Panel's consideration in the remaining 14 months of its work. The Social Security Bulletin is publishing the "Overview" section from the report to help the Panel widen the audience of possible respondents. If you wish to comment, please use the address at the end of this note.

The Panel was convened by the Academy in March 1993 in response to a request from Chairman Dan Rostenkowski of the House Committee on Ways and Means, and Chairman Andy Jacobs, Jr., of its Social Security Subcommittee. They asked the Academy to conduct a comprehensive review of disability income policy with a particular emphasis on ways to enable persons with disabilities to remain in or return to the work force as well as to better serve those who are denied benefits but do not find work. In its first year, the Panel engaged in fact finding and information gathering with regard to disability policy and the broad economic, social, and political environment in which that policy operates. The initial findings of that review are included in the Preliminary Status Report.

The National Academy of Social Insurance is a nonprofit, nonpartisan organization whose mission is to promote research and education concerning Social Security, unemployment insurance, workers' compensation, the appropriate role of government in protecting individuals from the costs of personal health care services, and challenges and opportunities facing the world of social insurance. Panel members were selected for their recognized expertise and with consideration for the balance of disciplines appropriate for this project: their names are listed on the page to the right.

THE PANEL'S PERSPECTIVE

Section I of the Preliminary Status Report presents the Panel's perspective on disability policy. The Panel believes: That the primary goal of disability policy is the integration of persons with disabilities into mainstream society; that "disability" is not just an attribute of individuals, but instead represents the interaction between individuals--who may have physical or mental impairments--and the environment in which they live; that there is great diversity among persons with disabilities in terms of their abilities, capacities, needs, and limitations; that the goals of economic self-sufficiency for persons with disabilities are not inconsistent with income security goals of disability income programs; and that integration of and support for persons with disabilities are important to the productive capacity of the Nation and require coordinated responses of the private to sector as well as Federal, State, and local governments.

PRELIMINARY FINDINGS

In the final section of its report, the Panel outlines the topics of its future work and describes its current findings on three issues that have repeatedly been raised as problems by persons with disabilities and other experts the Panel has consulted. These issues are health care and disability income policy, the importance of adequate resources to administer the Social Security Disability Insurance (DI) and the Supplemental Security Income (SSI) disability programs, and the importance of long-term research.

HEALTH CARE AND DISABILITY INCOME POLICY

Health care is important to all Americans. It is particularly important for persons with disabilities because they often have special health care needs, many are at risk of very high health care costs, and they often cannot gain adequate coverage in the private insurance market. The Panel has heard directly from individuals with disabilities that the fear of losing health care and related services is, for many, the major barrier that keeps them from maximizing their earning capacity. Many recipients of DI and SSI disability benefits have said that the risk of losing Medicare or Medicaid coverage that is linked to their cash benefits is a far greater work disincentive than is the loss of cash to benefits. …