United States Government Accountability Office

Washington, DC 20548 

December 7, 2009 

The Honorable Herb Kohl 

Chairman 

Special Committee on Aging 

United States Senate 

Subject: Social Security: Options to Protect Benefits for Vulnerable Groups 

When Addressing Program Solvency 

Dear Mr. Chairman: 

For over 70 years, Social Security has been the foundation of retirement income 

for American workers and their families and has been instrumental in reducing 

poverty among the elderly. The Congressional Research Service estimates that if 

Social Security benefits did not exist, an estimated 44 percent of all elderly people 

would be poor today.1

 Still, some people who receive Social Security retirement 

benefits remain vulnerable to poverty in old age. The elderly poverty rate in 2007 

was 9.7 percent. In addition, the long-term financing shortfall currently facing the 

Social Security program is growing and has made reform of the program a priority 

for policy makers. Thus, the nation faces the challenge of improving long-term 

program solvency, while also ensuring benefit adequacy for economically 

vulnerable beneficiaries. Many Social Security reform proposals have suggested 

modifying the system to restore its financial balance by reducing benefits or 

increasing payroll or other taxes, and several also include options to address 

concerns about benefit adequacy for economically vulnerable groups of 

beneficiaries.2

 

 

Economically vulnerable beneficiaries generally have limited income from other 

sources, such as employer-sponsored pension plans or personal savings, and 

therefore depend heavily on their Social Security benefits. Because they have 

limited resources, many of those beneficiaries also receive assistance from other 

programs for low-income individuals, including Supplemental Security Income 

(SSI); Medicaid; and the Supplemental Nutrition Assistance Program (SNAP), 

formerly known as the Food Stamp Program; among others. This report addresses 

the following key questions: (1) What are the options for modifying Social 

Security benefits to address concerns about benefit adequacy and retirement 

 

1

Kathleen Romig, Social Security Reform: Possible Effects on the Elderly Poor and Mitigation 

Options, (Congressional Research Service: 2008). 

2

See the bibliography (enc. III) for a list of proposals that we reviewed. 

GAO-10-101R Social Security 
Page 2 GAO-10-101R Social Security 

 

income security for economically vulnerable groups? and (2) What effects could 

these options have on benefits those groups receive from SSI, Medicaid, and 

SNAP? 

To complete our work, we identified and analyzed options for modifying Social 

Security benefits to address concerns about benefit adequacy for economically 

vulnerable groups of beneficiaries when addressing program solvency. 

Specifically, we focused on groups of beneficiaries who depend on Social Security 

for almost all of their income. Thus, the groups we primarily focused on include 

lifetime low earners, low-income women, and the oldest beneficiaries who are in 

danger of outliving their other resources.3

 To identify options for modifying Social 

Security benefits, we conducted a literature review and interviewed agency 

officials about Social Security reform proposals that included options for 

addressing benefit adequacy. We also interviewed a range of retirement security 

experts who have extensive experience with Social Security reform issues. Those 

agency officials and experts agreed that the options we identified included the 

main approaches for addressing these concerns. In accordance with GAO’s 

criteria for evaluating Social Security reform proposals, we analyzed the options’ 

implications for benefit adequacy, solvency, and program administration.4

However, time constraints did not allow us to undertake the complex analysis 

necessary to develop quantitative estimates of the options’ potential impacts or 

costs, or to assess how they would interact with other elements of Social Security 

reform proposals. Additionally, some details about the options were not always 

clearly specified in the proposals, and we would have had to make a number of 

assumptions to conduct this analysis. We acknowledge that looking at the options 

in isolation presents certain limitations, since different elements of a proposal 

may interact with each other. To determine how the options could affect SSI, 

Medicaid, or SNAP benefits received by vulnerable groups of Social Security 

beneficiaries, we reviewed the eligibility requirements and benefits for each 

program and analyzed whether and how eligibility and benefits would be affected 

by the changes suggested by these options to address benefit adequacy. We did 

not review how reform options would affect Medicare benefits because it is not a 

means-tested program, and thus an increase in Social Security income would not 

affect eligibility for those benefits. See enclosure I for additional details regarding 

our scope and methodology. 

We conducted our work from August 2009 to December 2009 in accordance with 

all sections of GAO’s Quality Assurance Framework that are relevant to our 

3

Although we did not focus specifically on individuals with disabilities, we acknowledge that the 

groups highlighted in this report are likely to include such individuals. However, there are other 

issues associated with the Social Security disability program, and individuals with disabilities face 

different circumstances from other beneficiaries. These issues and circumstances would need to 

be addressed separately. See GAO, Social Security Reform: Issues for Disability and Dependent 

Benefits, GAO-08-26 (Washington, D.C.: Oct. 26, 2007). 

4

GAO, Social Security: Criteria for Evaluating Social Security Reform Proposals, 

GAO/T-HEHS-99-94 (Washington, D.C.: Mar. 25, 1999). 
objectives. The framework requires that we plan and perform the engagement to 

obtain sufficient and appropriate evidence to meet our stated objectives and to 

discuss any limitations in our work. We believe that the information and data 

obtained, and the analysis conducted, provide a reasonable basis for any findings 

and conclusions in this product. 

We briefed your office on October 26, 2009, and this report transmits the results of 

our work. Enclosure V contains a copy of the briefing slides. 

Agency Comments and Our Evaluation 

We obtained written comments on a draft of this report from the Social Security 

Administration (see enc. II). The Social Security Administration agreed with our 

findings. We incorporated technical comments throughout the report, as 

appropriate. 

- - - - - 

As agreed with your office, unless you publicly announce its contents earlier, we 

plan no further distribution of this report until 30 days from the report date. At 

that time, we will then send copies of this report to interested congressional 

committees and the Commissioner of the Social Security Administration. In 

addition, this report will be available at no charge on GAO’s Web site at 

http://www.gao.gov. 

If you or your staff have any questions concerning this report, please contact me 

at (202) 512-7215 or jeszeckc@gao.gov. Contact points for our Offices of 

Congressional Relations and Public Affairs may be found on the last page of this 

report. Key contributors to this report were Barbara Bovbjerg, Director; Michael 

Collins, Assistant Director; Annamarie Lopata, Analyst-in-Charge; Kristen Jones; 

Susan Aschoff; James Bennett, Courtney LaFountain; Joe Applebaum; and Roger 

Thomas. 

Sincerely yours, 

Charles Jeszeck 

Acting Director, Education, Workforce, and 

 Income Security Issues 

Enclosures – 5 

Page 3 GAO-10-101R Social Security 
Enclosure I

Page 4 GAO-10-101R Social Security 

 

Objectives, Scope, and Methodology 

To complete our work, we identified and analyzed options for modifying Social 

Security benefits that address concerns about benefit adequacy and retirement 

income security for economically vulnerable groups. Specifically, we focused on 

groups of beneficiaries who depend on Social Security for almost all of their 

income, that is, lifetime low earners, low-income women, and the oldest 

beneficiaries. We did not focus on other subgroups that may also be economically 

vulnerable—such as foreign-born or immigrant citizens, different racial groups, 

and workers who have lost their pensions—to manage the scope of this project. 

However, some of those individuals are covered by the groups on which we did 

focus. We also acknowledge that the groups highlighted in this report are likely to 

include individuals with disabilities. However, we did not focus specifically on 

these individuals because there are other issues associated with the disability 

program, and individuals with disabilities face different circumstances from other 

beneficiaries, which will need to be addressed separately.5

 

To identify options for modifying Social Security benefits, we conducted a 

literature review and interviewed agency officials about Social Security reform 

proposals that included options for addressing benefit adequacy (see the 

bibliography in enc. III for a list of those proposals). We also interviewed a range 

of retirement security experts who have extensive experience with Social Security 

reform issues. Those experts agreed that the options we identified included the 

main approaches for addressing these concerns. We also reviewed relevant 

federal laws and regulations. In accordance with GAO’s criteria for evaluating 

Social Security reform proposals, we analyzed the options’ implications for 

benefit adequacy, solvency, and program administration. In prior work, GAO has 

outlined the following criteria for evaluating Social Security reform proposals: 

• balancing equity and adequacy in the benefit structure, 

• financing sustainable solvency, and 

• implementing and administering proposed reforms.6

Time constraints did not allow us to undertake the complex analysis necessary to 

develop quantitative estimates of the options’ potential impacts or costs, or assess 

how they would interact with other elements of the Social Security reform 

proposals. Additionally, some details about the options were not always clearly 

specified in the proposals, and we would have had to make a number of 

assumptions to conduct this analysis. We acknowledge that looking at the options 

5

GAO, Social Security Reform: Issues for Disability and Dependent Benefits, GAO-08-26

(Washington, D.C.: Oct. 26, 2007). 

6

GAO, Social Security: Criteria for Evaluating Social Security Reform Proposals, 

GAO/T-HEHS-99-94 (Washington, D.C.: Mar. 25, 1999). See enclosure IV for a list of other GAO 

products related to Social Security. 
Enclosure I

in isolation presents certain limitations, since different elements of a proposal 

may interact with each other. Additionally, GAO has previously suggested that 

policy makers evaluate Social Security reform proposals as packages that strike a 

balance among individual elements of the proposal and the interactions of these 

elements.7

 

To determine how the options could affect other benefits that vulnerable 

beneficiaries receive from Supplemental Security Income (SSI); Medicaid; and the 

Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food 

Stamp Program, we reviewed the eligibility requirements and benefits for each of 

these programs. We analyzed whether and how eligibility and benefits would be 

affected by the changes suggested by the options we analyzed to address Social 

Security benefit adequacy. Also, we used the following current year eligibility 

criteria for each program: calendar year 2009 criteria apply for SSI and Medicaid, 

and fiscal year 2010 criteria apply for SNAP. We did not assess how Social 

Security reform options would affect Medicare benefits because Medicare is not a 

means-tested program. 

To identify the number of Social Security beneficiaries age 65 and older living in 

households for which Social Security income makes up a large fraction of 

household income and to identify the numbers of people participating in various 

combinations of Social Security, SSI, Medicaid, SNAP, and Medicare, we used 

data from the Current Population Survey, 2008 Annual Social and Economic 

Supplement (ASEC). The ASEC sample includes approximately 206,000 

observations on people and approximately 76,000 observations on households. 

People in the sample are members of the civilian noninstitutional population 

living in housing units and members of the armed forces living in either civilian 

housing on a military base or in a household not on a military base. Survey 

questions include inquiries about a respondent’s age; gender; receipt of income 

from various sources, including Social Security and SSI; amount of income 

received from those sources; reasons for receiving Social Security benefits; 

Medicaid coverage; Medicare coverage; and household receipt of SNAP benefits. 

The 2008 ASEC sums a person’s income from each source to calculate total 

personal income, sums each household member’s income from each source to 

calculate total household income from that source, and sums the total personal 

income of each household member to calculate total household income. Total 

household income is used to identify the household’s place in the national income 

distribution. Questions about age and gender refer to the time of the survey. 

Questions about program participation and income refer to the year 2007. 

For the purpose of identifying Social Security recipients age 65 and older who live 

in households that depend on Social Security for the majority of their income, we 

included all people age 65 and older who indicated receiving Social Security 

income for any reason. For the purpose of identifying which recipients of SSI, 

 

7

GAO, Social Security: Evaluating Reform Proposals, GAO/AIMD/HEHS-00-29 (Washington, D.C.: 

Nov. 4, 1999).

Page 5 GAO-10-101R Social Security 
Enclosure I

Medicaid, SNAP, and Medicare benefits could be affected by changes in Social 

Security retired worker, spousal, or survivor benefits, we included only those 

respondents who reported being a retired worker, spouse, or survivor as at least 

one reason for receiving Social Security benefits. 

ASEC data include person and household weights so that analysis of the sample 

will represent the U.S. population of noninstitutionalized civilians living in 

housing units and armed forces members living in either civilian housing on a 

military base or in a household not on a military base. We used these weights in all 

of our calculations. 

We assessed the reliability of ASEC data by (1) reviewing related documentation 

of the data and (2) performing electronic testing of key data elements. We 

determined that the data were sufficiently reliable for the purposes of our report. 

Page 6 GAO-10-101R Social Security 
Enclosure II

Page 7 GAO-10-101R Social Security 

Comments from the Social Security Administration 
Enclosure III

Bibliography 

Belt, Bradley, editor. “The 21st Century Retirement Security Plan: the National 

Commission on Retirement Policy Final Report.” Washington, D.C.: Center for 

Strategic and International Studies. March 1999. 

Biggs, Andrew G. “Enhancing Social Security Benefits for Low Earners: Effects of 

Reducing Eligibility Requirements for Social Security Retirement Benefits.” 

National Academy of Social Insurance. November 14, 2008. 

Burkhauser, Richard V., and Timothy M. Smeeding. “Social Security Reform: A 

Budget Neutral Approach to Reducing Older Women’s Disproportionate Risk of 

Poverty.” Syracuse University, Maxwell School of Citizenship and Public Affairs, 

Center for Policy Research Policy Brief No. 2/1994, 1994. 

Diamond, Peter, and Peter Orszag. Saving Social Security: A Balanced 

Approach. Washington, D.C.: The Brookings Institution Press. 2004. 

Dilley, Patricia E. “Restoring Old Age Income Security for Low Wage Single 

Women.” National Academy of Social Insurance. Undated. 

Entmacher, Joan. “Strengthening Social Security Benefits for Widow(er)s: The 

75% Combined Worker Benefit Alternative.” National Academy of Social 

Insurance. November 2008. 

Favreault, Melissa M. “A New Minimum Benefit for Low Lifetime Earners.” 

National Academy of Social Insurance. November 2008. 

Fierst, Edith U., and Nancy Duff Campbell, editors. Earnings Sharing in Social 

Security: A Model for Reform. Report of the Technical Committee on Earnings 

Sharing. Center for Women Policy Studies. 1988. 

Fitzpatrick, Christina Smith, Catherine Hill, and Leslie Muller. “Increasing Social 

Security Benefits for Women and Men with Long Careers and Low Earnings.” 

National Women’s Law Center. June 2003. 

Hartmann, Heidi, Catherine Hill, and Lisa Witter. “Strengthening Social Security 

for Women.” Paper presented at the Institute for Women’s Policy Research and 

the National Council on Women’s Organizations’ Task Force on Women and 

Security Working Conference on Women and Security. 2000. 

Herd, Pamela. “Crediting care in Social Security: A Proposal for an Income Tested 

Care Supplement.” National Academy of Social Insurance. Undated. 

Herd, Pamela, Timothy Smeeding, and Madonna Harrington Meyer. “A Targeted 

Minimum Benefit Plan (MBP): A New Proposal to Reduce Poverty Among the 

Elderly.” Undated. 

Page 8 GAO-10-101R Social Security 
Enclosure III

Liebman, Jeffrey, Maya McGuineas, and Andrew Samwick. “Nonpartisan Social 

Security Reform Plan.” New America Foundation. 2005. 

President’s Commission to Strengthen Social Security. Strengthening Social 

Security and Creating Personal Wealth for All Americans: Report of the 

President's Commission. Washington, D.C.: December 21, 2001. 

Smeeding, Timothy M., and R. Kent Weaver. “The Senior Income Guarantee (SIG): 

A New Proposal to Reduce Poverty Among the Elderly.” Center for Retirement 

Research at Boston College. December 2002. 

Sullivan, Laura, Tatjana Meschede, and Thomas M. Shapiro. “Enhancing Social 

Security for Low-Income Workers: Coordinating an Enhanced Minimum Benefit 

with Social Safety Net Provisions for Seniors.” National Academy of Social 

Insurance. November 2008. 

Turner, John A. “Longevity Insurance: Strengthening Social Security at Advanced 

Ages.” National Academy of Social Insurance. November 2008. 

White-Means, Shelly I., and Rose M. Rubin. “Retirement Security for Family Elder 

Caregivers with Labor Force Employment.” National Academy of Social 

Insurance. November 14, 2008. 

Page 9 GAO-10-101R Social Security 
Enclosure IV

Page 10 GAO-10-101R Social Security 

Related GAO Products 

Social Security Reform: Issues for Disability and Dependent Benefits. 

GAO-08-26. Washington, D.C.: October 26, 2007. 

Retirement Security: Women Face Challenges in Ensuring Financial Security 

in Retirement. GAO-08-105. Washington, D.C.: October 11, 2007. 

Social Security Reform: Implications of Different Indexing Choices. 

GAO-06-804. Washington, D.C.: September 14, 2006. 

Options for Social Security Reform. GAO-05-649R. Washington, D.C.: May 6, 2005. 

Social Security Reform: Answers to Key Questions. GAO-05-193SP. Washington, 

D.C.: May 2005. 

Social Security: Program’s Role in Helping Ensure Income Adequacy. 

GAO-02-62. Washington, D.C.: November 30, 2001. 

Social Security: Evaluating Reform Proposals. GAO/AIMD/HEHS-00-29. 

Washington, D.C.: November 4, 1999. 

Social Security: Criteria for Evaluating Social Security Reform Proposals. 

GAO/T-HEHS- 99-94. Washington, D.C.: March 25, 1999. 

(130946) 
Enclosure V 

GAO-10-101R Social Security Page 1

U.S. Senate Special Committee on Aging 10/26/2009

The Benefit Formula 

To determine benefits, a worker’s 

Average Indexed Monthly Earnings 

(AIME) are calculated based on the 

highest 35 years’ earnings on which 

they paid Social Security taxes. 

Social Security limits the amount of 

earnings that are taxed in a given 

year—$106,800 in 2009. The same 

annual limit applies when benefits 

are calculated, which effectively 

caps the benefit amount. 

The formula adjusts these lifetime 

earnings by indexing them to 

changes in average wages to 

account for the fact that earnings 

across all workers grow over time. 

Then the benefit formula replaces 

90 percent of AIME up to a certain 

dollar threshold ($744 in 2009), 32 

percent of AIME above that 

threshold and below a second 

threshold ($745-$4,483), and 15 

percent of AIME above the second 

threshold ($4,484, up to a cap). 

The benefit formula replaces a 

larger share of earnings for lower 

earners than for higher earners. It 

also makes other adjustments to 

reflect various other provisions, 

such as those that relate to early or 

delayed retirement, type of 

beneficiary, and maximum family 

benefit amounts. 

Covered Employment 

Covered employment refers to jobs 

where workers pay Social Security 

taxes on earnings received. About 

96 percent of workers are in 

covered employment; the vast 

majority of the rest are state and 

local government employees, or 

federal government employees 

hired before 1984, who do not pay 

Social Security taxes. 

For more information, contact Charles Jeszeck 

at (202) 512-7215 or jeszeckc@gao.gov.

Background: The Social Security Program 

Title II of the Social Security Act, as amended, establishes the Old-Age, 

Survivors, and Disability Insurance (OASDI) program, which is generally 

known as Social Security.1

Social Security benefits are paid to workers who meet requirements for 

time worked in “covered employment.”2

 Typically, workers must amass a 

total of 40 “credits” to qualify, although the requirements are different if a 

worker becomes disabled or dies. Workers and their dependents generally 

become eligible to collect benefits when the worker reaches age 62, 

becomes disabled, or dies. Spouses and divorced spouses of eligible 

workers may also be eligible at age 62 but can become eligible at younger 

ages if disabled, widowed, or caring for eligible children. A spouse can be 

entitled to a spousal benefit, based on the other spouse’s earnings record, 

equal to one-half the retired worker’s benefit. If a spouse is eligible for a 

retired worker benefit based on his or her own earnings, the spouse 

receives his or her benefit and, if the spousal benefit amount is higher, the 

difference between the two amounts. 

Social Security benefits are designed to partially replace earnings when a 

worker retires, becomes disabled, or dies. To help ensure that 

beneficiaries have adequate incomes, Social Security’s benefit formula is 

designed to be progressive, that is, to provide disproportionately larger 

benefits, as a percentage of earnings, to lower earners than to higher 

earners. In addition, once payments have begun, they are adjusted 

annually to reflect price inflation. 

Social Security’s Long-term Financial Challenges 

The Social Security program is currently facing long-term financial 

challenges. According to Social Security’s Board of Trustees, the 

program’s annual surpluses of tax income over expenditures are expected 

to turn to cash flow deficits beginning in 2016.3

 In addition, all of the 

accumulated Treasury obligations held by the trust funds are expected to 

be exhausted by 2037. Once exhausted, annual program revenue will be 

sufficient only to pay about 76 percent of promised benefits, according to 

the Social Security trustees’ 2009 intermediate assumptions. 

The shortfall stems primarily from the fact that people are living longer 

and labor force growth has slowed. The projected long-term insolvency of 

the program necessitates reform to restore its long-term viability. Such 

reform requires that either Social Security receives additional income 

(revenue increases), reduces costs (benefit reductions), or undertakes 

some combination of the two. 

 

1

42 U.S.C. § 401 et seq. 

2

Note that net income from self-employment also counts toward covered employment. 

3

The Board of Trustees, Federal Old-Age and Survivors Insurance and Federal Disability 

Insurance Trust Funds, The 2009 Annual Report of the Board of Trustees of the Federal 

Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds (May 

2009). 
Enclosure V 

GAO-10-101R Social Security Page 2

U.S. Senate Special Committee on Aging 10/26/2009

Social Security’s Long-term Financial Challenges (cont.)

In 2005, GAO analyzed several options for Social Security reform using its 

criteria for evaluating Social Security reform proposals.4

 That analysis 

considered options to restore long-term solvency and support other 

aspects of the program, including benefit adequacy. 

GAO has outlined the following criteria for evaluating Social Security 

reform proposals: 

• balancing equity and adequacy in the benefit structure, 

• financing sustainable solvency, and 

• implementing and administering proposed reforms.5

GAO’s prior work also noted that reform proposals should be evaluated as 

packages that strike a balance among the individual elements of a 

proposal and the interactions among those elements, and that the overall 

evaluation of any particular reform proposal depends on the weight 

individual policy makers place on each of the above criteria. 

 

4

GAO, Options for Social Security Reform, GAO-05-649R (Washington, D.C.: May 6, 2005). 

 

5

GAO, Social Security: Criteria for Evaluating Social Security Reform Proposals, 

GAO/T-HEHS-99-94 (Washington, D.C.: Mar. 25, 1999). 
Enclosure V 

GAO-10-101R Social Security Page 3

U.S. Senate Special Committee on Aging 10/26/2009

Background: Social Security 

and Economically Vulnerable Groups 

The Vulnerable Groups 

Lifetime low earners are highly 

reliant on Social Security benefits, 

since they are likely to have lower 

personal savings and are less likely 

to receive pensions. In addition, 

their Social Security benefits are 

relatively modest because they are 

based on lower earnings and the 

work histories of many lifetime low 

earners include years out of the 

labor force. 

Low-income women generally 

have less retirement income than 

men, largely because they spend 

fewer years in the labor force; more 

often work part-time; and have 

lower earnings, on average. In 

addition, because women tend to 

live longer than men, they are more 

likely to experience widowhood, 

and Social Security benefits are 

reduced at the household level 

upon the death of a spouse. 

Oldest beneficiaries, those age 80 

and older, risk outliving their other 

sources of income and becoming 

increasingly reliant on Social 

Security in retirement. They are 

also less likely than younger 

beneficiaries to be able to work to 

supplement their income. 

Source: GAO (images). 

Social Security has been instrumental in reducing poverty among the 

elderly. From 1959 to 2007, the poverty rate for people age 65 and over 

decreased from about 35 percent to 9.7 percent, according to U.S. Census 

Bureau estimates. Although Social Security is not meant to be the sole 

source of income for retirees, in 2007 approximately one-quarter of 

beneficiaries age 65 and older lived in households that relied on it for at 

least 90 percent of household income (see fig. 1). Among beneficiaries age 

65 and older who rely on Social Security for 90 percent or more of their 

income: 

• 97.3 percent are in the bottom two quintiles of national income 

distribution,6

• 65.6 percent are women, and 

• 36.1 percent are age 80 and older. 

Many of these beneficiaries fall into more than one group, for example, 

low-income women age 80 and older. The impact of benefit reductions 

made to restore solvency of the Social Security program could be felt 

acutely by these beneficiaries. 

Figure 1: Percentage of Income from Social Security Benefits for Beneficiaries, 

Age 65 or Older, 2007 

Note: Social Security benefits include Social Security pensions, survivors’ benefits, and permanent 

disability insurance payments. 

To address concerns about benefit adequacy for these vulnerable groups, 

several Social Security reform proposals include options that would 

maintain or increase their benefits. The options generally target lifetime 

low earners; low-income women; and the oldest beneficiaries, that is, 

those age 80 and older, who are at risk of outliving their other resources. 

 

6

We use the bottom two quintiles of the national income distribution as a proxy for Social 

Security beneficiaries age 65 and older who are also lifetime low earners because of the 

difficulty in identifying lifetime low earners directly. About 88 percent of all beneficiaries 

in these quintiles rely on Social Security for 90 percent or more of their income. 
Enclosure V 

GAO-10-101R Social Security Page 4

U.S. Senate Special Committee on Aging 10/26/2009

Background: Other Programs 

SSI and Medicaid 

In most states, Supplemental 

Security Income (SSI) is a pathway 

to Medicaid eligibility: SSI 

recipients are automatically eligible 

for full benefits. However, 11 states 

have elected to use more restrictive 

eligibility criteria: Connecticut, 

Hawaii, Illinois, Indiana, Minnesota, 

Missouri, New Hampshire, North 

Dakota, Ohio, Oklahoma, and 

Virginia. Under section 1902(f) of 

the Social Security Act, states are 

allowed to use their 1972 state 

assistance eligibility rules in 

determining Medicaid eligibility for 

elderly recipients, rather than SSI 

eligibility. (Pub. L. No. 92-603, 86 

Stat. 1381.) 

Vulnerable groups may also receive benefits from other programs, 

including SSI, Medicaid, and the Supplemental Nutrition Assistance 

Program (SNAP). 

Supplemental Security Income 

SSI is a means-tested program administered by the Social Security 

Administration (SSA) that provides a basic monthly income guarantee to 

eligible individuals age 65 or older and persons with disabilities.7

 In 2009, 

SSI provides up to $674 per month for individuals and $1,011 per month 

for couples. For those age 65 and older, eligibility is based primarily on a 

household’s income and assets, including Social Security retirement 

benefits, which are considered unearned income. Under the SSI benefit 

structure, the first $20 of earned or unearned income is not counted, or 

disregarded.8

 After the first $20, every additional $1 of unearned income 

results in $1 reduction in benefits. To be eligible for SSI, an individual’s 

total earned and unearned income, after disregards, cannot exceed $674.9

In most states, SSI recipients are automatically eligible for Medicaid and 

SNAP benefits. 

Medicaid 

Medicaid is a joint federal-state means-tested program that finances 

health care coverage for certain categories of low-income individuals, 

including those age 65 and older.10 States have discretion to establish 

eligibility requirements within broad federal guidelines, thus, an 

individual’s eligibility depends on where he or she lives. 

The program offers health care coverage to the low-income elderly. Full 

Medicaid benefits include services that Medicare does not cover, such as 

hearing, dental, vision, and long-term care as well as assistance with 

Medicare premiums and cost-sharing; other beneficiaries’ coverage only 

includes assistance with Medicare premiums, cost-sharing, or both. 

States may provide Medicaid coverage to elderly individuals through 

eligibility pathways defined by a mix of state and federal criteria. Income 

limits are also used to determine eligibility under many of these pathways 

and are more stringent for full coverage than partial coverage. For 

example, in 2008, 35 states and the District of Columbia offered Medicaid 

coverage to those designated as “medically needy.” The medically needy 

population incurs medical expenses such that their incomes, less those 

expenses, become low enough to qualify for Medicaid. 

 

7

42 U.S.C. § 1381 note. 

8

There is also an earned income exclusion where $65 of earned income and one-half of any 

earnings above $65 are excluded. 

9

An asset limit of $2,000 also applies where individuals above that level are generally 

ineligible. 

1042 U.S.C. § 1901 et seq. 
Enclosure V 

GAO-10-101R Social Security Page 5

U.S. Senate Special Committee on Aging 10/26/2009

Supplemental Nutrition Assistance Program 

SNAP, formerly known as the Food Stamp Program, is a means-tested 

food assistance program designed to help low-income households with 

food purchases.11 Eligibility is based primarily on a household’s income 

and assets. Benefit amounts depend on the number of people living in a 

household. Households with an elderly person must meet net income 

limits, whereas other households must meet net and gross income limits.12

For example, an elderly person living alone may receive a SNAP monthly 

benefit of up to $200 if his or her net income, including Social Security 

retirement benefits, does not exceed $903 per month after certain 

deductions. In most states, households in which all members are receiving 

SSI are automatically eligible for SNAP based on income and do not have 

to meet a separate income or asset test. 

 

117 U.S.C. § 2013. 

12Gross income refers to a household’s total countable income, before any deductions have 

been made. Net income refers to gross income minus allowable deductions. Allowable 

deductions include a standard deduction based on household size, 20 percent of earned 

income, and certain medical expenses. 
Enclosure V 

GAO-10-101R Social Security Page 6

U.S. Senate Special Committee on Aging 10/26/2009

Reform Options Have Been Proposed to 

Address Benefit Adequacy but also Affect 

Program Solvency and Administration 

Options 

• Guaranteeing a Minimum 

Benefit (p. 7) 

• Reducing Work 

Requirements for Eligibility

(p. 9) 

• Supplementing Benefits 

for Low-income Single 

Workers (p. 11) 

• Adopting Earnings Sharing

(p. 12) 

• Reducing the Marriage 

Duration Required for 

Spousal Benefits (p. 14) 

• Providing Caregiver Credits

(p. 15) 

• Increasing Survivor Benefits

(p. 16) 

• Providing Longevity 

Insurance (p. 17) 

Various Social Security reform proposals include options intended to 

address concerns about benefit adequacy for vulnerable groups (see enc. 

III). 

Our analysis focused on benefit adequacy implications for lifetime low 

earners, low-income women, and the oldest beneficiaries as well as on 

solvency and program administration. In certain cases, an option targeting 

one group may also address concerns about other groups because of 

overlap in the population of vulnerable beneficiaries. For example, while 

the minimum benefit option specifically targets lifetime low earners, lowincome women and beneficiaries over age 80 will make up part of the 

target population. 

Adequacy: Retirement security experts and agency officials had mixed 

views about the potential effectiveness of these options. While experts 

told us that several of these options could help address concerns about 

benefit adequacy, agency officials said they may not have the expected 

effects because of the complex rules governing Social Security benefits. 

An option’s design will play an important role in determining its 

effectiveness. 

Solvency: Because these options increase benefits, they have cost 

implications that affect the solvency of the Social Security system. The 

cost of a given option will depend on the number of people affected by it 

and the amount of the benefit increase. Additionally, cost will be affected 

by interactions with other elements of an overall Social Security reform 

proposal. Key factors that influence cost are described for each of the 

options. 

Administration: Implications for program administration vary among the 

options. Retirement security experts and agency officials said that some 

options could be fairly easy to administer, while others could be very 

complex. However, even the less complex options would create 

additional work for SSA, such as monitoring eligibility for additional 

benefits. Also, options that increase the number of people eligible for 

benefits would add to SSA’s administrative workload. 
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Option: Guaranteeing a Minimum Benefit

Targeted Group 

The guaranteed minimum benefit 

option targets lifetime low earners, 

a vulnerable group that relies 

heavily on Social Security benefits 

for their retirement income. 

What Happens Now 

Benefits are generally calculated on 

the basis of a worker’s average 

indexed monthly earnings during 

the 35 years in which they were the 

highest. While the benefit structure 

is progressive, a lifetime minimumor low-wage worker would still 

have correspondingly low benefits. 

The current benefit formula does 

not distinguish between low 

average wages caused by low 

lifetime earnings or low average 

wages caused by years of 

unemployment. 

What This Option Would Do 

Guaranteeing a minimum benefit by increasing Social Security retirement 

benefits for those who have worked in low-wage jobs throughout their 

careers addresses concerns about benefit adequacy. A “special minimum 

benefit” provision intended to increase benefit adequacy for low-earning 

steady workers was enacted in 1972.13 However, because its eligibility 

threshold has not kept pace with wage growth, few people still qualify for 

the benefit. A number of Social Security reform proposals include a new 

minimum benefit option. The amount and structure of the benefit varies 

among proposals, but most minimum benefit options are designed to 

address benefit adequacy by providing a retirement benefit equal to some 

multiple of the federal poverty line, with the multiple based on years 

worked in covered employment. For example, one option would provide a 

minimum benefit equal to 120 percent of the poverty line for a minimumwage earner who had worked for 30 years. Another option would provide 

a minimum benefit equal to 100 percent of the poverty line for a 30-year 

worker and 111 percent of the poverty line for a 40-year worker.14 

Source: GAO.

Implications 

Adequacy: The guaranteed minimum benefit option targets lifetime low 

earners, a vulnerable group that relies heavily on Social Security benefits 

for its retirement income. Retirement security experts said that this 

option targets a broader group of beneficiaries than proposals that focus 

on specific subgroups of low earners. SSA officials said that, depending 

on how this option is designed, it could work well, but it is difficult to 

target lifetime low earners effectively. For example, some officials and 

experts said that requiring a long work history is problematic because low 

earners often have recurring periods of unemployment and cannot satisfy 

such a requirement. Thus, the target population may not be reached if a 

lifetime of work is required to earn the benefit. However, other experts 

said that if a lifetime of work is not required, some people outside the 

target population would also benefit. For example, higher-wage workers 

who worked for a short period of time may also receive benefits. 

Solvency: Cost implications of this option depend on the number of work 

years required for eligibility, since that requirement will directly influence 

the number of people who would qualify for benefit increases. A shorter 

work requirement will result in more people being eligible, and thus costs 

 

13The “special minimum benefit” provision was added by the Social Security Amendments 

of 1972, 42 U.S.C. § 415(a)(1)(c)(i). 

14Other options would provide benefits ranging from 75 percent of the federal poverty line 

for those meeting the standard Social Security eligibility requirements (about 10 years of 

covered employment) up to 125 percent of the poverty line for a 30-year worker. 
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Implications (cont.)

will be higher. Additionally, most of the options we reviewed set the 

benefit amount at some multiple of the poverty line.15 The multiple used 

can have a significant impact on cost. For example, a guaranteed 

minimum benefit equal to 75 percent of the 2009 federal poverty 

guidelines would be $677 per month, whereas a benefit equal to 125 

percent of the guidelines would be $1,128 per month.16

Administration: For the most part, experts and SSA officials did not 

raise concerns about implementing and administering a minimum benefit 

option, although one expert said that policy makers would have to 

consider how to phase it into the Social Security system. 

 

15How the initial benefit level increases for beneficiaries newly eligible in succeeding years 

would also influence costs. For example, over time, indexing the benefit to wages would 

be more costly than indexing to prices. 

16This is a GAO calculation based on the 2009 federal poverty guideline of $902.50 per 

month for a single-person home in all states, except Alaska and Hawaii, and the District of 

Columbia. 
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Option: Reducing Work Requirements 

for Eligibility 

Targeted Group What This Option Would Do 

Reducing the work requirements for Social Security retirement benefit 

eligibility enables people who have shorter earnings histories to receive 

benefits. While some people who do not have 40 credits are still eligible 

for benefits based on the earnings of an eligible spouse, others do not 

qualify for any benefits. For example, a small number of unmarried 

individuals fail to qualify for benefits due to short earnings records. A 

reduced work requirement would allow people with shorter earnings 

records, potentially as short as a single credit of covered employment 

depending on how it is designed, to receive benefits. Benefit amounts 

would be calculated under the existing formula, which uses the worker’s 

average indexed monthly earnings during the 35 years in which he or she 

earned the most, even if there were no earnings from covered 

employment during some of those years. 

Source: GAO.

Reducing the Social Security work 

requirement is an option that 

targets workers with low lifetime 

earnings due to short work 

histories, as opposed to those with 

long histories of low earnings. 

What Happens Now 

Under current law, workers must 

accrue 40 credits—about 10 years 

of earnings—in covered 

employment to be eligible for Social 

Security retirement benefits. 

Implications 

Adequacy: Reducing the Social Security work requirement is an option 

that targets workers with low lifetime earnings due to short work 

histories, as opposed to those with long histories of low earnings. Agency 

officials told us there are many people who fall just short of the 40 credits 

requirement because they have intermittent work histories. However, 

officials also said many of those people may already be eligible for 

spousal benefits, resulting in few people benefiting from this option. 

Other retirement security experts expressed similar opinions about the 

limited number of people who would be helped by reduced work 

requirements. In addition, agency officials and experts said benefits based 

on such short work histories are likely to be very low and questioned the 

effectiveness of this option in addressing benefit adequacy. A Social 

Security reform proposal that includes this option simulated its potential 

effect and found similar limitations.17 This option could also expand 

eligibility to those who receive benefits from a pension for work in 

noncovered employment for state and local governments, but an offset, 

such as the Windfall Elimination Provision18 with some modifications, 

could be applied to those benefits.19

 

17Andrew G. Biggs, “Enhancing Social Security benefits for low earners: Effects of reducing 

eligibility requirements for Social Security retirement benefits,” National Academy of 

Social Insurance (Nov. 14, 2008). 

1842 U.S.C. § 415(a)(7). 

19The Windfall Elimination Provision is an existing Social Security provision that reduces 

Social Security benefits for those who also receive pensions from employment that is not 

covered by Social Security. Noncovered workers do not pay Social Security taxes on their 

noncovered earnings. This provision is intended to treat such beneficiaries in a manner 

that parallels treatment of beneficiaries who paid Social Security taxes on all of their 

lifetime earnings. 
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Implications (cont.)

Solvency: Because this option increases the number of people receiving 

benefits, it has cost implications for Social Security’s solvency. The 

number of credits required will directly influence the number of people 

who would be newly eligible for benefits. A shorter work requirement will 

result in more people being eligible. However, because few people are 

actually expected to receive benefits under this option, and those who do 

are expected to receive modest benefits, the impact of a reduced work 

requirement on program solvency is unlikely to be very large. 

Administration: Because few people are expected to gain eligibility 

under this option, the impact on SSA’s workload is likely to be small. 
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Option: Supplementing Benefits 

for Low-income Single Workers 

Targeted Group What This Option Would Do 

Supplementing benefits for low-income single workers by adjusting the 

formula used to calculate Social Security retirement benefits addresses 

concerns about benefit adequacy for that group. In one proposal, the first 

threshold in the benefit formula would be adjusted or supplemented so 

that it increased by one-half, from $744 to $1,116 in 2009, for eligible 

beneficiaries. The benefit amount would be capped to prevent eligible 

workers from receiving higher benefits than those who just miss 

qualifying for the supplement. 

Source: GAO.

The benefit supplement option 

targets low-income women who 

never married or were not married 

long enough to qualify for spousal 

benefits. 

What Happens Now 

In 2009, the formula replaces 90 

percent of the first $744 of a 

worker’s AIME, 32 percent of the 

AIME between $745 and $4,483, and 

15 percent of the AIME above 

$4,483, up to a cap. 

Calculating the AIME 

A worker’s AIME is calculated 

based on a worker’s highest 35 

years’ earnings, after earnings have 

been indexed for wage growth over 

time. 

To be eligible for the supplement, a worker’s AIME must be lower than a 

multiple of the existing formula’s first threshold, such as 150 percent or 

300 percent. For example, if the multiple were set at 300 percent, a 

worker whose AIME was less than $2,232 (3 x $744) in 2009 would qualify. 

To receive the supplement, a worker must have at least 30 years of 

covered employment and the worker cannot be eligible for spousal 

benefits, nor can anyone else claim spousal benefits based on that 

worker’s earnings record. 

Implications 

Adequacy: The benefit supplement option targets lifetime low earners, 

generally women, who never married or were not married long enough to 

qualify for spousal benefits. Low-income single and divorced women are 

expected to benefit most from this option. While some retirement experts 

we interviewed were supportive of this option because it focused on the 

needs of low-income women, others questioned the rationale for basing 

eligibility on marital status and said either that eligibility for the 

supplement should be expanded to a broader group of beneficiaries or 

that the needs of low-income single women could be addressed through 

another option, such as a guaranteed minimum benefit. 

Solvency: Because a benefit supplement for low-income single workers 

increases benefits, it has cost implications for Social Security’s solvency. 

The extent to which this option affects solvency will depend largely on 

the number of people who would be eligible for it. A key factor that 

directly influences the number of eligible beneficiaries is the multiple that 

would be applied to a worker’s AIME, ranging from 150 percent to 300 

percent. Another factor that could influence cost is the way “single” is 

defined for purposes of determining eligibility.20

 

Administration: Agency officials and retirement security experts told us 

that determining an individual’s single status could be administratively 

complex because people’s marital statuses change over time and could 

change after an initial determination is made, for example, from single to 

married. 

 

20One proposal that includes this option defines marital status at the time when a person 

first applies for Social Security retirement benefits and includes a provision to address 

changes in status after that time. See Patricia E. Dilley, “Restoring Old Age Income 

Security for Low Wage Single Workers,” National Academy of Social Insurance (Undated). 
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Option: Adopting Earnings Sharing 

Targeted Group What This Option Would Do 

Earnings sharing combines married individuals’ annual earnings and 

evenly divides them between the two spouses for each year of marriage 

when calculating individuals’ Social Security retirement benefits. Each 

spouse accrues an individual benefit, even if only one of them worked. An 

earnings sharing approach is often proposed as an alternative to existing 

spousal and survivor benefits. For example, under earnings sharing, 

divorced spouses whose marriages lasted less than 10 years would be 

entitled to the individual benefits accrued during the marriage. This 

option is also seen as a way to equalize benefits received by dual-earner 

married couples with those of single-earner couples. Currently, a singleearner couple receives higher total benefits than a dual-earner couple 

with the same total lifetime earnings. Under earnings sharing, the total 

benefit amount a single-earner couple receives would be the same as the 

amount received by a dual-earner couple who makes the same total 

income, rather than 150 percent of the worker’s benefit. 

Source: GAO.

Earnings sharing targets divorced 

spouses, generally women, whose 

marriages were too short to qualify 

them for spouse or survivor 

benefits and whose incomes while 

married were lower than their 

spouses. 

What Happens Now 

Under the current system, a spouse 

who has not worked or who has 

low earnings can be entitled to a 

benefit equal to as much as one-half 

of the retired worker’s full benefit. 

The total benefit received by the 

couple would be 150 percent of the 

worker’s benefit. 

If the spouse is divorced, he or she 

can still get benefits based on a 

retired worker’s earnings record if 

the marriage lasted at least 10 

years, and the spouse is unmarried 

and at least 62 years old. 

Implications 

Adequacy: Earnings sharing targets divorced spouses, generally women, 

whose marriages were too short to qualify them for spouse or survivor 

benefits and whose incomes while married were lower than their spouses’ 

incomes. Retirement security experts and agency officials said earnings 

sharing could increase benefits for divorced women. Proponents of this 

option also focus on it as a means to improve equity between singleearner and dual-earner married couples. However, other experts said this 

option would not do much to improve benefits for economically 

vulnerable beneficiaries, in part, because it is not well targeted. For 

example, SSA’s simulations found that earnings sharing would decrease 

benefits for the majority of future retirees, although benefits for some 

would increase.21 Specifically, benefits would decrease for about 50 

percent of divorced women and increase for about 40 percent of divorced 

women. Benefits would also increase for over one-third of married 

individuals, but decrease for the vast majority of widow(er)s. 

Solvency: Because earnings sharing would increase benefits for some but 

decrease them for others, its net impact on Social Security’s solvency is 

unclear. Its cost would depend on the relative numbers of people whose 

benefits increase or decrease and the amounts of those changes. In 

addition, cost will be affected by future demographic trends regarding 

marriage, workforce participation, and related variables. 

 

21Benefit reductions would be more widespread for married individuals in single-earner 

couples, and benefit increases would be more prevalent for those in dual-earner couples. 

See Iams, et al., “Earnings Sharing in Social Security: Projected Impacts of Alternative 

Proposals Using the Mint Model,” Social Security Bulletin, vol. 69, no. 1 (2009). 
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Implications (cont.)

Administration: The extent to which this option increases SSA’s 

workload depends on the number of newly eligible people who would 

receive benefits, which will be influenced by future trends in marriage and 

workforce participation. Some additional administrative effort and cost 

would also be required to transition from the current system’s spousal 

benefit to an earnings sharing approach, in part because of the need to 

verify marriage and divorce data. 
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Option: Reducing the Marriage Duration 

Required for Spousal Benefits 

Targeted Group What This Option Would Do 

Reducing the number of years a marriage must have lasted for a divorced 

person to receive spousal benefits addresses benefit adequacy by 

increasing the number of people who are eligible to receive Social 

Security spousal benefits. Proponents of this option note that reducing 

the marriage requirement from 10 to 7 years would reflect current trends 

for shorter marriages.22 One Social Security proposal suggests that 

reducing the required marriage duration could be combined with a 

minimum work requirement for the divorced spouse. Combining at least 7 

years of marriage with a minimum of 3 years of work would mimic the 

standard 10-year work requirement for Social Security retirement 

benefits. 

Source: GAO.

Reducing the marriage duration 

required for spousal benefits is an 

option that targets divorced 

spouses, generally women, whose 

marriages were too short to qualify 

them for benefits. 

What Happens Now 

Currently, a divorced spouse can 

receive benefits based on a retired 

worker’s earnings record if the 

marriage lasted at least 10 years, 

and the spouse is unmarried and at 

least 62 years old. 

Implications 

Adequacy: Reducing the marriage duration required for spousal benefits 

is an option that targets divorced spouses, generally women, whose 

marriages were too short to qualify them for benefits. One retirement 

security expert said that this option would be an improvement over the 

current 10-year requirement and other experts and agency officials said it 

would help address benefit adequacy for women. However, experts also 

said they do not expect this option to effectively target economically 

vulnerable groups. This option would not benefit women who were never 

married but could benefit higher-income women who are not 

economically vulnerable. 

Solvency: The extent to which this option affects solvency depends on 

how many people would become eligible with a shorter marriage 

requirement.23 Increased eligibility will depend on the way the option is 

designed. For example, not including a corresponding work requirement 

would increase costs more because people who have no work history 

would also be eligible. In addition, cost will be affected by future 

demographic trends regarding marriage. 

Administration: The extent to which this option increases SSA’s 

workload depends on the number of newly eligible people who would 

receive spousal benefits, which will be influenced by future trends in 

marriage and workforce participation. 

 

22According to the Census Bureau, the median duration of first marriages that ended in 

divorce was 8 years in 2001. 

 

23In prior work, GAO found that very few people would be newly eligible for benefits if the 

marriage duration were reduced to 7 years. See GAO, Retirement Security: Women Face 

Challenges in Ensuring Financial Security in Retirement, GAO-08-105 (Washington, 

D.C.: Oct. 11, 2007). 
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Option: Providing Caregiver Credits 

Targeted Group What This Option Would Do 

Providing caregiver credits increases benefits for those who spend time 

out of the workforce to care for dependent children or elderly relatives. 

Time spent out of covered employment as a caregiver may reduce 

benefits for workers, and others may not work enough to earn the 

required 40 credits to be eligible for benefits. Source: GAO.

Caregiver credits seek to improve 

benefit adequacy for workers, 

primarily women, who have shorter 

earnings records because they 

spent time providing care for 

children or elderly relatives and do 

not qualify for spousal benefits. 

What Happens Now 

Under the current system, Social 

Security eligibility and benefit 

amounts depend on the amount of 

time a worker spends in covered 

employment. 

A caregiver credit option can be designed in different ways. One design 

allows a specified amount of caregiving time, such as 3 or 4 years, to count 

as covered employment, and assigns a wage to that time. For example, an 

average wage for all workers could be assigned or a wage linked to an 

individual beneficiary’s prior earnings could be used. Another design 

excludes a limited number of caregiving years from the benefit calculation 

so that instead of averaging earnings over 35 years, earnings are averaged 

over fewer years. A final design supplements caregivers’ retired worker 

benefits directly, regardless of whether they took time out of the workforce 

for caregiving. For example, an income-tested supplement could be given to 

increase retired worker benefits by 75 percent for those who have one child 

and 80 percent for those with two or more children. Both parents of a child 

would be eligible for this supplement, as long as the total household income 

did not exceed 125 percent of the federal poverty line.24

Implications 

Adequacy: Caregiver credits seek to improve benefit adequacy for 

workers, primarily women, who have shorter earnings records because 

they spent time providing care for children or elderly relatives and do not 

qualify for spousal benefits because they never married or were not 

married long enough to qualify for them. Retirement security experts said 

this option recognizes the societal value of caregiving, but experts also 

said that, for various reasons, it may not reach its target population. For 

example, low-income people are less likely to be able to take time off 

from work. Therefore, people who have relatively higher incomes may 

benefit more from the creation of caregiver credits. 

Solvency: Because caregiver credits increase benefits they have cost 

implications for Social Security’s solvency. The extent to which this 

option affects solvency depends largely on who would be eligible to 

receive the credit: one or both parents, all caregivers, or just those who 

have low incomes. Extending eligibility to a greater number of people will 

increase costs. In addition, the number of years that credits may be 

received and the wage assigned to those years will impact costs. 

Administration: Retirement security experts and SSA officials told us 

that caregiver credits would be complex to administer. A key issue is how 

to verify that care was provided to a qualifying person. Experts said a 

birth certificate could be used to document child care, but elder care 

would be more burdensome to document. Measuring time off and 

verifying that caregiving actually occurred would also be difficult. 

 

24The credit would remain income tested if the parents are living apart. 
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Option: Increasing Survivor Benefits 

Targeted Group What This Option Would Do 

Increasing benefits for surviving spouses, often widowed women, by 

providing a Social Security retirement benefit equal to 75 percent of the 

combined amount the couple received addresses concerns about benefit 

adequacy. The current benefit structure decreases household income 

upon widowhood by one-third if the couple’s benefits had been based on 

one spouse’s work history and up to 50 percent if both spouses had been 

receiving retired worker benefits. Increasing survivor benefits would 

lessen the magnitude of this change. 

Source: GAO.

Increasing survivor benefits is an 

option that targets widowed 

women, although widowed men 

could also benefit. 

What Happens Now 

Currently, a surviving spouse at full 

retirement age or older typically 

receives 100 percent of the 

worker’s basic benefit amount. This 

is roughly equal to one-half to twothirds of the couple’s total benefits. 

The Widow(er)’s Limit 

The widow(er)’s limit is a provision 

that establishes caps on the benefit 

amounts of widow(er)s whose 

deceased spouses filed for early 

retirement benefits. SSA has 

estimated that one-third of 

widow(er)s receive lower benefits 

because of this provision. 

Implications 

Adequacy: Increasing survivor benefits is an option that targets widowed 

women, although widowed men could also benefit. Retirement security 

experts and agency officials said this option could address benefit 

adequacy for a very vulnerable group and would be an improvement over 

the current system. They also said that this option can be targeted 

specifically toward low-income survivors, for example, by including a cap. 

Experts and agency officials also said this option addresses equity 

concerns by increasing benefits for dual-earner couples. Under the 

current system, dual-earner couples experience a proportionally greater 

decrease in benefits upon the death of a spouse than single-earner 

couples experience. However, as some experts noted, this option would 

not address benefit adequacy for women who do not qualify for spousal or 

survivor benefits. 

Solvency: Increasing survivor benefits will have implications for Social 

Security’s solvency. The extent to which this option increases costs 

depends on how much greater the benefit amount is across all eligible 

survivors. Capping the amount of the increase based on income could 

help moderate costs. Some proposals also combine this option with a 

reduction in spousal benefits to help finance the increase in survivor 

benefits so it is cost neutral or has a very small affect on solvency. 

Administration: Agency officials told us that this option could be 

complex to administer, in part because it uses a “couple’s benefit” as a 

baseline for calculating survivor benefits. Since such a benefit does not 

currently exist in the Social Security system this could be problematic, for 

example, in cases where one of the spouses dies before retiring. In 

addition, officials said there are many complicated rules for survivors 

because of an existing provision, called the widow(er)’s limit, that caps 

benefit amounts for some survivors.25 Benefit increases expected under 

this option could be negated by this provision. 

 

2542 U.S.C. § 402(f)(2); (f)(3) and (q). 
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Option: Providing Longevity Insurance 

Targeted Group What This Option Would Do 

Providing longevity insurance 

targets the oldest Social Security 

beneficiaries. 

What Happens Now 

While Social Security benefits are 

intended to replace lost wages and 

are adjusted annually to reflect 

price inflation, they are not meant 

to be the sole source of retirement 

income. However, the value of 

other income sources, such as 

pensions and annuities, may be 

eroded by inflation over time. 

Providing longevity insurance addresses concerns about benefit adequacy 

by increasing Social Security retirement benefits for beneficiaries who 

reach an advanced age, such as 80 or 85. As people grow older, they risk 

outliving their other resources, become less able to work, and become 

more dependent on Social Security benefits for their income. Longevity 

insurance seeks to reduce the risk that they fall into poverty at older ages 

by increasing their Social Security benefits. 

Source: GAO.

This option could be targeted specifically toward low-income beneficiaries, 

or provided to all those who reach an advanced age. Work history could be 

an additional condition for eligibility. For example, one longevity insurance 

proposal increases benefits for people who have low benefits at age 82 and 

have at least 20 years of covered employment. It would provide a minimum 

benefit equal to 70 percent of the federal poverty line for a 20-year worker 

and increases the benefit for each additional year of work. Another proposal 

increases benefits by 10 percent at age 85 for 30-year workers whose benefits 

are lower than 75 percent of the average benefit all workers receive.26

 

Implications 

Adequacy: Providing longevity insurance targets the oldest Social 

Security beneficiaries. Retirement security experts told us this could be 

an effective option for addressing concerns about benefit adequacy for 

the very old, especially the oldest widows, because women generally live 

longer than men. However, some experts also said that unless this option 

is specifically targeted toward low-income beneficiaries, most of the 

benefits would accrue to higher-income people because they tend to live 

longer. In addition, agency officials said this option could create 

disincentives to save for retirement or incentives to spend down 

resources before beneficiaries become old enough to qualify for the 

longevity increase. By doing so, those whose assets would be too high to 

satisfy the means test could become eligible for the increase. 

Solvency: Providing longevity insurance would increase Social Security 

program costs. Key factors that influence costs include the age at which 

the benefit increases, the amount of the increase, and whether all 

beneficiaries or only low-income ones are eligible to receive the benefit. 

Providing the benefit at an earlier age, for example, at 80 instead of 85, 

would increase costs, as would providing it to all 80 year olds instead of 

only those who are low income. In addition, costs could increase if life 

expectancy continues to increase in the future. 

Administration: This option would not increase the number of 

beneficiaries SSA serves and could use existing information to determine 

eligibility, and retirement security experts and agency officials said that 

this option would be easy to administer. However, one expert said adding 

measures to improve targeting would increase administrative complexity. 

 

26This proposal presents different options for implementing the increase, for example, 

adding the supplement to the cost-of-living adjustment each year. 
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Benefit Adequacy Options Could Reduce Other 

Benefits for Vulnerable Groups, but Approaches 

to Mitigate These Effects Are Available 

Other Programs 

• SSI (p. 19) 

• Medicaid (p. 20) 

• SNAP (p. 21) 

Many Social Security retirement beneficiaries receive benefits from other 

federal programs. Nine percent of Social Security beneficiaries age 65 or 

older, or more than 2.7 million people, also receive SSI, Medicaid, or 

SNAP benefits (see fig. 2).27 Increasing Social Security benefits to address 

concerns about adequacy for vulnerable groups of beneficiaries could 

result in a decline in benefits from these other programs. In fact, some 

beneficiaries could lose eligibility for benefits from the other programs 

altogether. On the other hand, some beneficiaries may not be affected 

because their incomes, even with increased Social Security benefits, 

would stay within the other programs’ eligibility limits. 

Figure 2: Social Security Beneficiaries, Age 65 or Older, in 2007 

Did not receive

SSI, Medicaid,

or SNAP

Received

SSI, Medicaid,

and/or SNAP

9%

91%

Percentage of those beneficiaries who...

SSI

Medicaid

SNAP

0 1 mil. 2 mil.

461,198

2,112,843

988,042

Number of those Social Security

Beneficiaries who also received...

Source: GAO analysis of U.S. Census Bureau data. 

Note: Data refer to Social Security beneficiaries who reported receiving retirement, spousal, or 

survivor benefits. Because beneficiaries may participate in more than one program, the sum of the 

program participation numbers does not equal the number of beneficiaries who received SSI, 

Medicaid, or SNAP. 

 

27For the purposes of our data analysis, we specifically examined Social Security 

beneficiaries who receive retirement, spousal, or survivor benefits. All references to Social 

Security beneficiaries pertain to this group. 
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U.S. Senate Special Committee on Aging 10/26/2009

Other Programs: SSI 

What Is SSI? 

SSI is a means-tested program that 

provides a basic monthly income 

guarantee to eligible individuals age 

65 or older and persons with 

disabilities. 

Table 1: An Example of How SSI 

Eligibility Relates to an Individual’s 

Income 

An increase in Social Security retirement benefits could cause some SSI 

recipients to receive lower SSI benefits, although the total amount from 

both sources could remain constant or even increase. However, some 

recipients would lose SSI eligibility altogether if their income, including 

their enhanced Social Security benefits, exceeded the SSI income 

eligibility standards. Every additional dollar of Social Security benefits, 

beyond the first $20, results in a dollar-for-dollar reduction in SSI benefits. 

This trade-off results in no net loss of benefits from these two sources. 

However, there could be a loss of SSI eligibility if the Social Security 

benefit increase causes earned and unearned income, after disregards, to 

exceed the maximum allowable SSI benefit, or $674 per month in 2009.28

Assuming no other sources of income, an SSI recipient who currently 

receives $693 per month from Social Security alone or both programs 

combined retains SSI eligibility, but an SSI recipient whose Social 

Security benefit exceeds $693 per month loses SSI eligibility (see table 1). 

$694

-20

674

No

 0

$694

$693

-20

673

Yes

 1

$694

Social Security

benefits

Less income

disregard

Total countable

income for SSI

SSI eligible?

SSI benefits

Total income

$620

-20

600

Yes

 74

$694

Source: GAO analysis of SNAP eligibility requirements. 

Losing SSI eligibility also closes one pathway to Medicaid eligibility for 

some individuals, although individuals may be able to keep their Medicaid 

coverage under other rules. Many experts said losing Medicaid eligibility 

is more detrimental to beneficiaries than losing SSI eligibility. Some 

beneficiaries would be harmed rather than helped because the loss of 

Medicaid coverage and the subsequent increase in out-of-pocket health 

care costs could significantly outweigh the Social Security benefit 

increase. Similarly, losing SSI eligibility also eliminates a pathway to 

SNAP eligibility for some households, but these households may still 

qualify for SNAP benefits based on net income. 

There are also reasons why some beneficiaries may prefer Social Security 

benefits to SSI benefits. Several retirement security experts said there 

may be a stigma associated with SSI that deters people from participating 

because it is viewed as welfare, while Social Security is tied to income 

earned through work. In addition, Social Security benefits do not require 

the income and asset testing that SSI benefits do, reducing the application 

burden for beneficiaries. SSA officials said applicants may consider that 

burden a deterrent to applying, especially if their potential SSI benefit is 

small. Because people may choose not to apply for SSI, some experts told 

us that Social Security may more effectively target vulnerable 

populations. 

 

28For couples receiving SSI, this break point would be $1,011. Some states offer 

supplements to the federal SSI payment, which allow those with incomes above the 

federal limits to qualify for SSI. 
Enclosure V 

GAO-10-101R Social Security Page 20

U.S. Senate Special Committee on Aging 10/26/2009

Other Programs: Medicaid 

What Is Medicaid? 

Medicaid is a joint federal-state 

means-tested program that finances 

health care coverage for certain 

low-income individuals, including 

those age 65 and older. 

SSI as a Medicaid “Pathway” 

In 39 states and the District of 

Columbia, SSI recipients 

automatically qualify for Medicaid. 

Figure 3: Social Security 

Beneficiaries, Age 65 or Older, 

Participating in Medicaid, by SSI 

Status, 2007 

Medicaid Benefits May Be Retained 

For some beneficiaries, Medicaid coverage is linked to their receipt of 

SSI, which puts them at risk of losing Medicaid if they lose SSI because 

their Social Security benefits increase. However, those who lose their SSI 

benefits may be able to retain their Medicaid coverage under alternative 

eligibility pathways.29 For example, they may still be eligible to retain 

Medicaid coverage if their income is low enough or if they qualify under 

state rules as “medically needy.” In 2007, about one-fifth of the more than 

2 million Social Security beneficiaries who received Medicaid also 

received SSI benefits, and the other four-fifths were eligible for Medicaid 

under other pathways (see fig. 3). 

Medicaid beneficiaries whose income increases to the level where they 

are no longer eligible for all Medicaid benefits may still qualify for 

assistance with Medicare premiums, cost-sharing, or both. However, 

under these circumstances, certain benefits that may be covered by 

Medicaid, such as dental, vision and long-term care services, would no 

longer be covered.30 The amount of assistance with Medicaid premiums 

and cost-sharing for which beneficiaries may qualify is based on several 

factors, including income levels and states’ policies. For example, states 

are required to provide assistance for Medicare premiums and costsharing to beneficiaries with incomes at or below 100 percent of the 

federal poverty line.31 For individuals with higher incomes, states may vary 

in the amount of premium and cost sharing assistance they provide. 

Received

SSI benefits

432,697

Did not

receive SSI

1,680,147

79.5%

20.5%

Source: GAO analysis of U.S. Census Bureau data.

Medicaid Benefits Could Be Lost Entirely 

In general, because Medicaid eligibility requires beneficiaries to meet 

some sort of income test, an increase in Social Security benefits could 

cause those near these income limits to lose their Medicaid benefits 

entirely. The amount of the increase that would result in a loss of 

Medicaid may vary among states, because they have discretion to set 

income limits and other eligibility criteria. 

Note: Data refer to Social Security 

beneficiaries who reported receiving 

retirement, spousal, or survivor benefits. 

“Medically Needy” 

The medically needy population 

incurs medical expenses such that 

their incomes, less those expenses, 

become low enough to qualify for 

Medicaid. 

While Social Security beneficiaries who lose Medicaid would still have 

Medicare coverage, some beneficiaries could still incur significant out-ofpocket health care expenses.32 Researchers have found that individuals 

who qualify for both Medicare and Medicaid tend to have very low 

incomes and experience serious and costly health conditions, such as 

heart disease. 

 

29Because not all states offer all eligibility pathways, an individual’s options for coverage 

may be affected by where he or she lives. 

30Medicare does not provide coverage for these services. 

31Beneficiaries must also have resources that are at or below an established level to qualify 

for this assistance. 

32In 2007, all Social Security beneficiaries age 65 and older received Medicare benefits. 
Enclosure V 

GAO-10-101R Social Security Page 21

U.S. Senate Special Committee on Aging 10/26/2009

Other Programs: SNAP 

What Is SNAP? 

SNAP, formerly known as the Food 

Stamp Program, is a means-tested 

food assistance program designed 

to help low-income households 

with food purchases. 

Figure 4: Social Security 

Beneficiaries, Age 65 or Older, 

Participating in SNAP, 

An increase in Social Security benefits could cause a loss of SNAP 

eligibility for some beneficiaries. In all states except California, 

households in which all members receive SSI qualify for SNAP without 

meeting an income test.33 If SSI eligibility is lost, beneficiaries may still 

qualify under SNAP’s income eligibility rules. In 2007, about 81 percent of 

Social Security beneficiaries who received SNAP benefits qualified for 

them under the program’s rules, rather than through SSI (see fig. 4). 

SNAP’s eligibility rules are based on higher income limits than those of 

SSI, and SNAP limits vary by household size (see table 2).34 Households 

with an elderly person must meet net income limits but not gross income 

limits to qualify for SNAP. Under current rules, an elderly individual living 

alone whose net monthly income exceeds $903 would not be eligible for 

SNAP benefits.35 Therefore, if an elderly individual whose net monthly 

income is close to the income limit receives a large enough increase in 

Social Security benefits he or she may no longer meet the income test for 

SNAP and lose all SNAP benefits. For example, if Social Security benefits 

are increased by $104 for an individual currently receiving $800, total 

income would increase to $904, and they would lose SNAP eligibility. 

by SSI Status, 2007 

Note: Data refer to Social Security 

beneficiaries who reported receiving 

retirement, spousal, or survivor benefits. 

Received

SSI benefits

191,505

Did not

receive SSI

796,537

80.6%

19.4%

Source: GAO analysis of U.S. Census Bureau data. Table 2: Fiscal Year 2010 SNAP Income Limits for Households with an Elderly 

Member 

Size of

household

Net 

monthly

income

One

$903

Two

$1,215

Three

$1,526

Four

$1,838

Five

$2,150

Six

$2,461

Seven

$2,773

Eight

$3,085

Additional

members

+$312

each

Source: U.S. Department of Agriculture, Food and Nutrition Service.

Note: Households with an elderly person must meet net income limits, whereas other households 

must meet net and gross income limits. Income limits are higher in Alaska and Hawaii. 

 

33California converted SNAP benefits to cash included in state supplementary payments. 

34Households where all members receive Temporary Assistance for Needy Families or, in 

some places, general assistance (benefits for low-income individuals who are not eligible 

for federal assistance) do not need to meet separate income limits to qualify for SNAP. 

35Net income limits are higher in Alaska and Hawaii. In determining net income, 

households in all states are allowed to make certain deductions.
Enclosure V 

GAO-10-101R Social Security Page 22

U.S. Senate Special Committee on Aging 10/26/2009

Other Programs: SNAP 

Calculating SNAP Benefits 

SNAP households are expected to 

be able to allocate 30 percent of 

household income, after 

deductions, to food purchases. The 

household’s net monthly income is 

multiplied by 30 percent when 

calculating SNAP assistance, and 

the SNAP benefit makes up the 

difference between the resulting 

amount and the maximum SNAP 

allotment. 

Table 3: An Example of How SNAP 

Eligibility Relates to an Individual’s 

Income 

Although an increase in Social Security benefits could prompt a reduction 

in SNAP benefits, the total benefits received would increase. SNAP 

benefits are reduced by 30 cents for every additional dollar of Social 

Security, unless the increase becomes large enough to raise total income 

above the SNAP eligibility limit. For example, an individual whose net 

monthly income is $500 could currently qualify for $50 in SNAP benefits 

(see table 3). If the individual’s monthly Social Security income increased 

by $100, raising net monthly income to $600, SNAP benefits would decline 

to $20 per month. However, total monthly income would increase by $70, 

from $550 to $620 per month. 

As with SSI, beneficiaries may prefer to receive benefits through Social 

Security instead of SNAP. Several retirement security experts said there 

may be a stigma associated with SNAP because it is viewed as a welfare 

program, while Social Security is tied to income earned through work. 

Additionally, unlike Social Security, SNAP benefits are subject to income 

and asset tests, which can create a burden for applicants and deter 

participation. Finally, beneficiaries may prefer the flexibility of Social 

Security, a cash benefit, to SNAP benefits, which are provided as grocery 

credits and restricted to food purchases. 

Monthly net income

(A) Maximum monthly

SNAP allotment

(B) Net monthly income

multiplied by 30 percent

SNAP benefits (A-B)

Total income

$500

200

150

50

$550

$600

200

180

20

$620

Source: GAO analysis of SNAP eligibility requirements.
Enclosure V 

GAO-10-101R Social Security Page 23

U.S. Senate Special Committee on Aging 10/26/2009

Steps Could Be Taken to Mitigate 

Potential Benefit Reductions 

The Role of SSI Eligibility

Although many of the approaches 

to mitigate potential benefit 

reductions focus on preventing a 

loss of SSI eligibility, most Social 

Security beneficiaries who receive 

either Medicaid or SNAP do not 

participate in SSI. In 2007, more 

than 2.2 million Social Security 

beneficiaries received Medicaid or 

SNAP benefits, but not SSI benefits. 

Thus, changes to SSI would not 

prevent a loss of Medicaid or SNAP 

benefits for all groups potentially 

affected by options to address 

Social Security benefit adequacy. 

For example, individuals living in 

the 11 states where SSI eligibility is 

not used to determine Medicaid 

eligibility and receive Medicaid 

through a different pathway could 

lose benefits. 

Retirement security experts suggested several ways to mitigate the 

potential loss of benefits from other programs as a result of an increase in 

Social Security benefits for vulnerable groups. Each of these approaches 

would entail trade-offs, including additional costs and administrative 

effort for the affected programs. Depending on the scope and provisions 

of each option when implemented, these approaches could also increase 

states’ Medicaid caseloads and have a significant effect on their budgets. 

• Increasing the SSI general income disregard of $20 would let SSI 

recipients receive more Social Security before losing SSI eligibility. 

• Increasing the maximum allowable SSI benefit would also enable SSI 

recipients to receive more Social Security before losing SSI eligibility. 

• Creating a Social Security exclusion in SSI would allow income from 

Social Security to be disregarded when calculating SSI benefits. 

• Deeming those who qualify for SSI under current rules to be eligible for 

Medicaid would also allow those who would otherwise lose SSI 

eligibility to retain Medicaid coverage. The so-called “Pickle 

Amendment” allows those formerly eligible for SSI to maintain SSI 

eligibility, at a benefit level of zero dollars, for the purpose of receiving 

Medicaid if they become ineligible as a result of Social Security cost-ofliving adjustments.36 A similar approach could be used if beneficiaries 

become ineligible for Medicaid as a result of an increase to Social 

Security benefits for vulnerable groups. 

• Disregarding increased Social Security benefits in determining 

Medicaid eligibility would allow those who would otherwise lose 

Medicaid to retain their coverage. There is some precedent for this 

approach: Individuals who meet certain criteria currently can continue 

to receive Medicaid even if their earned income becomes too high to 

qualify for SSI benefits. However, this existing provision applies only 

to those who need Medicaid to work.37

• Although Medicaid already has other eligibility pathways that are 

income-based and not linked to SSI, breaking the direct link between 

SSI and Medicaid eligibility would prevent a loss of SSI from affecting 

Medicaid benefits. One expert suggested using a program with a 

higher income limit than SSI, such as SNAP, to test income eligibility 

for Medicaid. Other experts said that if the income limit for Medicaid 

were tied to some multiple of the federal poverty line, such as 100 

percent or 133 percent, more Medicaid beneficiaries would retain 

coverage, despite increases in Social Security benefits.

 

36Pub. L. No. 94-566, § 503 codified at 42 U.S.C. § 1396a note. 

3742 U.S.C. § 1382h(b). To qualify, a person must have been eligible for SSI for at least 1 

month, still meet the disability and nondisability requirements, need Medicaid in order to 

work, and have gross earned income that is either below a predetermined state threshold 

or below an individualized threshold.
GAO-10-101R Social Security Page 24

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