Date: May 7, 1995
HOUSE COMMlTTEE ON WAYS AND MEANS
MARKUP OF WELFARE REFORM PROPOSAL
On March 3, 1995, the House Ways and Means Committee completed action on Supplemental Security Income (SSI) provisions in a comprehens ive welfare reform proposal based on the "Personal Responsibility Act" (H.R. 4)--the welfare reform bill contai ned in the House Republican Contract with America. The proposal is expected to reach the House floor in late March. (The Committee voted on conceptual language, not statutory bill language . However, under House rules, the proposal cannot be taken up by the full House until the proposal is drafted in statutory bill language.) As passed by the Committee, the proposal includes the following SSI provisions:
RESTRICTING WELFARE FOR NONCITIZENS
- Provides generally that noncitizen aliens would be ineligible for 35 Federal welfare
programs, including SSI , Med icaid, Food Stamps, and housing benefits after the date of
enactment with the following exceptions:
- aliens admitted to the United States (U .S.) under section 207 of the Immigration and Nationality Act would remain eligible for Federal welfare programs during their first 5 years in the U.S;
- legal permanent residents over 75 years of age who have been in the U.S . for 5 years or more would also remain eligible for Federal welfare programs; and
- other noncitizens who are currently eligible for benefits would remain eligible for 1 year after date of enactment.
- Provides that noncitizens would remain el igible for the earned income tax credit, 13 education and job training programs, and emergency medical services and immunizations.
- Requires each Federal agency that administers a program from which noncitizens are to be disqual ified to provide general notification to the public and program recipients of the eligibility changes.
- Requires State agencies administering the AFDC progr ams to provide to the INS the names and addresses of illegal al iens with children who are citizens of the U.S.
- Provides that sponsorship agreements, by which family members and others agree to help noncitizens who would otherwise qualify for welfare, would be made legally binding and would apply until the immigrant becomes a citizen. The agreements are not now legally binding and last for either 3 or 5 years.
- Grants States the option to follow the Federal classification of U.S. citizens and aliens in determining eligibility for any State, local, or municipal means-tested public assistance program.
SUPPLEMENTAL SECURITY INCOME REFORMS
Eliminate SSI Benefits to Drug Abusers and Alcoholics (DA&A)
- Prohibits SSI eligibility, including cash SSI benefits and Medicaid coverage, to those individuals whose DA&A is a contributing factor material to his or her disability if he or she cannot qualify based on another disabling condition. Provides that $100 million of the savings realized from denying cash SSI payments and Medicaid coverage to individuals disabled by DA&A will be targeted annually to drug treatment and drug abuse research.
General Restrictions On Eligibility for Cash and Other New Benefits for Certain Children
- Repeals the "comparable severity" test and eliminates "individualized functional assessments" in determining disability in children. Eligibility for cash benefits or newly authorized medical services will be based solely on meeting or equalling the current Listings of Impairments.
- Provides that children may be eligible for cash SSI payments in one of three
- Children who are currently (defined as during the month prior to the first month for which this provision takes effect) receiving cash SSI disability payments will continue to be eligible for cash SSI payments if they have an impairment(s) which meets or equals the level of sever ity of an impairment specified in the Listing of Impairments.
- Children who file new claims for SSI disability benefits may only receive cash payments if they have an impairment(s) which meets or equals the level of severity of an impairment specified in the Listing of Impairments and is either in a hospital, skilled nursing facility, residential treatment facility, or intermediate care facility for the mentally retarded or otherwise would be placed in such a facility if the child were not receiving personal assistance nessitated by the impairment.
- Currently eligible children who are overseas as dependents of a member of the U.S. Armed Forces , but who would be eligible for block grant services if they were in the U.S., shall continue to be eligible for cash payments so long as they are outside the United States.
- Provides for the reinstatement to eligibility for SSI cash benefits under the grandfathered provision (i.e ., meets or equals the Listing of Impairments) following a per iod of suspended el igibility due to excess income and/or resources.
- Requires the Commissioner to notify, within one month of enactment, all individuals whose eligibility for SSI benefits would be terminated under these proposals.
Continuing Disability Reviews (CDRs)
- Requires CDRs at least once every 3 years for children with disabilities who have non-permanent impairments.
- Requires CDRs for low birth weight children when SSI payments have been made for 12 months.
- Requires the Commissioner to issue regulations necessary to implement the provisions that apply to 551 benefits for children within 3 months of enactment.
- o Requires the Commissioner to review the Listing of Impairments annually and recommend to Congress any necessary revisions.
- Requires the Commission on Childhood Disability to examine the childhood mental listings to ensure that the criteria in these listings are appropriate to ensure that SSI eligibility is limited to serious disabilities for which Federal assistance is necessary to improve the child's condition or quality of life.
Block Grants for Children with Disabilities
- Requires the Commissioner to make block grants for children with disabilities to States that apply for them for FY 1997 or thereafter pursuant to statutory and regulatory requ irements. The purpose of such grants would be to provide authorized medical and non-medical services, other than cash benefits, to children who are determined to be physically or mentally impaired under the medical listings.
- Allows States to decide which services may be provided to qualified children using block grant funds by selecting from a list of authorized medical and non-medical services specified by the Commissioner of Social Security. The final list would be issued by the Commissioner no later than January 1, 1996. Requires that the Commissioner ensure that serv ices on the list are designed to meet the unique needs of qualifying children that ar ise from their physical and mental impairments.
- The amount of the block grant allotment for each State for a fiscal year would be the
- The difference between the total number of qualifying children in the State and the number of qualifying children in the State who were eligible for SSI cash benefits, and
- an amount equal to 75 percent of the mean average of the respective annual totals of cash benefits paid to each qualifying child who received an SSI cash benefit.
- Allows States to designate an already existing State entity to administer the childhood block grant, if the State determines appropriate.
Medicaid Coverage Under Block Grants
- Provides that children who are eligible solely for medical serv ices through the block grant but do not rece ive coverage under Medicaid because they live in one of the twelve 209(b) States will be elig ible for cash SSI benefits until October 1, 1996, when medical services through the block grant become available.
- Requires that any child who meets or equals the medical listing criter ia, currently or in the future. will receive Medicaid, whether or not they are receiving block grant services at a given time, except those children who would not be eligible for Medicaid under the current eligibility criteria.
Other SSI Changes
Provides that SSI-eligible children who are in a medical facility and whose care is being paid for through private insurance would be eligible for a benefit of up to $30 a month.
- Provides that, in the case of parents who disposed of theirs or their child's assets (or a guard ian who disposed of his ward's asset) within 36 months of the child's application for SSI benefits. the child' s eligibility for benefits will be delayed for a number of months equal to the uncompensated value of the divested resource divided by the SSI Federal benefit rate.
- Eliminates the maintenance of effort requirement ("passalong") on States with regard to their State supplementary payment programs.
Provisions Regarding Other Programs
- Provides that the value of the authorized services offered through the block grant shall not be taken into account in determining eligibility for, or the amount of, benefits or services under any Federal or federally-assisted program. Authorized services provided under the block grant are considered to be SSI benefits for purposes of Medicaid coverage. An individual who would be eligible for block grant services but lives in a State in which such services are not available is considered an SSI recipient for purposes of Medicaid coverage.
- Provides for the establishment of block grants for Puerto Rico, the U.S. Virgin Islands,
Guam, and American Samoa for the establishment of adult assistance programs for the
aged, blind and disabled in those jurisdictions. Funding would be set by the Secretary
of HHS based on 1994 funding levels of adult assistance programs operating in these