Supplemental Security Income: SSA Provides Benefits to Multiple Recipient Households but Needs System Changes to Improve Claims Management
Published: 2016-08-17T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: SSA administers SSI, which provides cash benefits to eligible aged, blind, and disabled individuals with limited financial means. Generally, SSI recipients are eligible to receive up to a maximum benefit amount, though the maximum is lower for married couple recipients. Other households with multiple SSI recipients are not subject to this benefit reduction. GAO was asked to review households that include multiple SSI recipients.
GAO examined what is known about (1) SSI recipients who live in households with other SSI recipients, (2) SSI benefits received by households with multiple SSI recipients, and (3) potential effects of implementing a change in the benefits received by households with multiple SSI recipients. GAO reviewed relevant federal laws, and regulations; analyzed May 2013 SSA administrative data on SSI recipients that was matched with U.S. Census survey data, the most recent matched data available; and interviewed researchers, disability advocates, and SSA officials in headquarters and five field offices selected for geographic dispersion, a higher concentration of multiple SSI recipient households, and overall population density.
section_title: What GAO Found
paragraphs: In May 2013, an estimated 15 percent of the 7.2 million households with blind, aged, and disabled individuals receiving Supplemental Security Income (SSI) cash benefits included more than one SSI recipient, according to GAO's data analysis. Of the estimated 1.1 million households with multiple SSI recipients, most included two recipients (953,000) and at least one adult recipient between ages 18 and 64 (695,000). Most households with multiple recipients did not have any child recipients, though an estimated 190,000 had one child recipient, 111,000 had two, and 30,000 had three or more. Few households reported having married couple recipients (an estimated 90,000). Most multiple recipient households reported that members of one family—those related by birth, marriage, or adoption—lived in the household (an estimated 941,000). GAO was unable to determine the specific relationships of recipients in these households.
The Social Security Administration (SSA) provided households with multiple SSI recipients almost 30 percent, or an estimated $1.2 billion, of the total $4.3 billion paid in SSI benefits in May 2013, according to GAO's data analysis. In that month, multiple recipient households received an estimated average of $1,131 in SSI benefits, compared to $507 for single recipient households. Further, consistent with federal law that applies a lower maximum benefit rate to married couple recipients, GAO's analysis found that households with nonmarried multiple recipients received a higher estimated average monthly benefit payment than married recipient households.
Since the 1990s, several alternative benefit structures for households with multiple SSI recipients have been discussed, but the potential effects of any such change on program costs and recipients are largely unknown. Specifically, reducing the maximum benefit limit for these households would likely decrease benefit costs, according to analyses GAO reviewed; however, the potential effects of such a change on program administrative costs and SSI recipients have not been studied. Further, according to SSA staff, SSA's claims management system lacks the ability to automatically connect and adjust claim records of those living in households with other SSI recipients, as it is structured around providing benefits to individuals. For example, if a mother lives with two of her children who are both SSI recipients, and the mother reports changes to her income, SSA's system does not automatically adjust both children's benefit amounts to account for this change in income. In addition, the system is unable to automatically process claims when two SSI recipients marry or separate, so staff must manually complete forms and calculate benefits outside the claims management system, which is time consuming and error prone, according to staff GAO spoke with in three of five selected field offices. SSA officials said the agency has not assessed the risks associated with the system's limited ability to automatically process claims for multiple recipient households, and has no plans to improve the claims management system to address related issues. According to federal internal control standards, agencies should design their information systems to support the completeness, accuracy, and validity of information needed to achieve objectives. Without assessing risks and making changes to address the issues related to households with multiple SSI recipients, SSA is at increased risk of making improper payments to recipients who live with, marry, or separate from other recipients.
section_title: What GAO Recommends
paragraphs: GAO recommends that SSA assess risks associated with the manual process for adjusting claim records for SSI multiple recipient households, and, as appropriate, take steps to make system improvements. SSA disagreed, based in part on its prior payment and accuracy reviews, but GAO continues to believe an assessment is warranted, as discussed in the report.

section_title: Letter
paragraphs: The Supplemental Security Income (SSI) program, which provides cash  benefits to eligible aged, blind, and disabled individuals with limited  financial means, has significantly expanded over time, both in terms of  federal outlays and the number of program recipients. The Social Security  Administration (SSA) administers the program and paid almost $55 billion  in federally funded SSI benefits to about 8.4 million individual recipients in  fiscal year 2015. Maximum monthly SSI benefits are generally adjusted  annually, and an eligible individual’s income from other sources reduces  the individual’s monthly SSI benefit. Generally, SSI recipients are eligible  to receive up to a maximum benefit amount, though the maximum is  lower for married couple recipients. Other households with more than one  SSI recipient, such as those with multiple child recipients or those with  multiple nonmarried adult recipients, are not subject to this benefit  reduction. This benefit structure differs from other programs for low- income people that generally consider household or family size when  determining benefit amounts.
Since the 1990s, advocacy groups, members of Congress, and SSA  officials have discussed alternative benefit structures for SSI. For  example, some options include eliminating the benefit reduction for  married couple recipients or applying a reduction to all nonmarried  multiple SSI recipient households, and the SSA Office of the Inspector  General has reported that the latter policy change could result in  significant cost savings. To inform consideration of potential changes to  the SSI benefit structure, you asked us to provide information on  households that include multiple SSI recipients.
This report assessed what is known about 1) households that have  multiple SSI recipients, 2) SSI benefits that those households receive,  and 3) the potential effects of implementing a change in the amount of  benefits received by these households on program administration and  other factors.
To address these objectives, we reviewed relevant federal laws,  regulations, program guidance, and key agency documents, including  SSA’s Program Operations Manual System, 2014-2018 Agency  Strategic Plan, SSA Vision 2025: Innovative Organization, and SSA’s  Fiscal Year 2017 Federal Budget Justification. To describe households  with multiple SSI recipients and their benefits, we analyzed SSA  administrative data on SSI recipients and benefits in May 2013, matched  to U.S. Census Bureau survey data on household characteristics in that  month, the most recent matched data available. We assessed the  reliability of these data through interviews with relevant officials and  reviews of relevant documentation and electronic data testing, and we  determined they were sufficiently reliable for our purposes. To gather  information for all of the objectives, we interviewed SSA staff at  headquarters and five field offices regarding the characteristics of multiple  recipient households and SSA’s administration of SSI claims for individual  recipients and multiple recipient households. Field offices were selected  to include offices serving substantial numbers of SSI recipients and to  provide variation in geographic location, and the information provided by  staff from these offices is not generalizable to all field offices nationwide.  To understand how changing the amount of benefits received by multiple  recipient households may potentially affect SSA, we compared the  information SSA staff provided to the agency documents noted above and  to the Standards for Internal Control in the Federal Government as they  relate to both program goals and objectives, as well as the agency’s  processes and procedures for managing SSI claims for this population.
To gather additional information, we also interviewed staff from disability  advocacy organizations and other relevant stakeholder groups, as well as  researchers who have studied the SSI population. Further, we reviewed  relevant studies on the SSI population specifically, and the disabled  population more generally, including studies that addressed disability- related costs and trends in living arrangements, for example. To  understand the potential effects of changing an SSI recipient’s benefits on  other federal benefit programs, we reviewed relevant program laws,  regulations, and other information for three federal programs selected  because they serve large numbers of low-income individuals and  households with SSI recipients may be eligible to receive benefits from  them. For more information about our objectives, scope, and  methodology, see appendix I.
We conducted this performance audit from March 2015 to August 2016 in  accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit to obtain  sufficient, appropriate evidence to provide a reasonable basis for our  findings and conclusions based on our audit objectives. We believe that  the evidence obtained provides a reasonable basis for our findings and  conclusions based on our audit objectives.
subsections: section_title: Background
paragraphs: The SSI program was established in 1972 under Title XVI of the Social  Security Act and provides payments to low-income aged, blind, and  disabled persons—both adults and children—who meet eligibility  requirements. SSA administers the SSI program through more than  1,200 field offices around the country where staff process applications for  benefits, verify financial eligibility, and compute benefit amounts.  Following SSA’s initial review, state disability determination services  offices assess applicants’ medical eligibility for SSI. In order to be eligible  for SSI benefits based on a disability, an individual must have a medically  determinable physical or mental impairment that (1) prevents the  individual from engaging in any substantial gainful activity, and (2) has  lasted or is expected to last at least 1 year or result in death. After a  person is found to be eligible for SSI and begins receiving benefits, SSA  conducts periodic redeterminations of financial eligibility and continuing  disability reviews to ensure that only recipients who remain medically  eligible continue to receive SSI benefits.
subsections: section_title: Determination of Financial Eligibility and Benefits
paragraphs: To be financially eligible for SSI, individuals must meet program income  and resource requirements. Specifically, in 2016, an individual recipient’s  or married couple recipient’s monthly countable income must be less  than the maximum monthly federal SSI benefit rate of $733 per month for  an individual and $1,100 per month for a married couple. Generally, SSI  recipients are eligible to receive up to a maximum benefit rate, with  married couple recipients eligible for a lower maximum benefit rate  approximately equal to 75 percent of the benefit rate for nonmarried  individuals. Further, an individual’s or couple’s countable resources  (such as financial institution accounts) must be $2,000 or less for  individuals and $3,000 or less for married couple recipients in 2016.
Although SSI is a benefit for an individual, SSA generally considers  income of certain other people in the household when determining the  amount of an individual’s SSI benefit to reflect a family member’s  responsibility for certain other family members. For example, a parent’s  or spouse’s income is generally included as part of the income of a child  or spouse, respectively, living in the same household. Therefore, if the  SSI recipient lives with a spouse who does not receive SSI benefits, SSA  considers the income of that spouse when determining the recipient’s SSI  benefit amount, potentially reducing the benefit payment.
Similarly, food and shelter that an individual receives from others, referred  to as in-kind support and maintenance (ISM), is also considered by SSA  when determining an individual’s benefit amount. In situations where the  householder is providing both food and shelter to an individual, SSA  decreases the recipient’s SSI benefit by an amount equal to one-third of  the federal benefit rate to account for ISM. In all other situations in  which an individual is receiving ISM, SSA counts the presumed value of  the food or shelter-related items received by the SSI recipient in-kind  (including such assistance provided by individuals who do not live with  the recipient) as unearned income, unless the recipient demonstrates that  the actual value is less than the presumed value, in which case SSA uses  the actual value. However, the amount that the recipient’s SSI benefit  may be reduced in this manner is limited to an amount equal to one-third  of the applicable benefit rate plus $20.
section_title: Overview of SSA’s Claims Management System
paragraphs: SSA operates two separate, but linked, systems to update and store SSI  recipient information and process benefits: the Supplemental Security  Record (SSR) and Modernized Supplemental Security Income Claims  Systems (MSSICS). Field office staff use SSR to calculate benefits,  including any reductions to benefits from ISM, based on information  retrieved from MSSICS. MSSICS, an online data collection system, is  used by field office staff to collect recipient information. MSSICS houses  data such as whether the individual lives alone, owns a house, has  certain kinds of expenses, and what, if any, financial support the person  receives from others. MSSICS stores information like a paper file. When  SSA staff need to update records, they can open the recipient’s file and  make changes electronically. Overall, SSA’s database systems are 40  years old, and the agency plans to expand their capabilities through a  multiple-year initiative beginning in fiscal year 2017.
section_title: Programs for Low-Income Individuals and Families
paragraphs: We previously reported that SSI is one of over 80 federal programs that  target low-income individuals, families, and communities to help them  meet basic needs or provide other assistance. We reported that  financial and nonfinancial eligibility requirements are established for each  program, with financial requirements generally limiting eligibility to  individuals, families, or households with income and assets below defined  levels. In some circumstances, federal law extends automatic eligibility  for one program for low-income people based on an applicant’s  participation in another program. Such provisions can simplify the  application and eligibility determination process for applicants and reduce  the time program administrators spend verifying applicants’ income and  resources. In most states, SSI recipients are automatically eligible for  Medicaid health insurance and, if they live alone or in households in  which all members receive SSI benefits, are automatically eligible for the  Supplemental Nutrition Assistance Program (SNAP).
Medicaid is a joint federal-state program that finances health insurance  coverage for certain low-income individuals. An estimated 65 million  low-income individuals were covered by Medicaid in fiscal year 2014, and  the Centers for Medicare and Medicaid Services report that enrollment  has been growing under the Patient Protection and Affordable Care Act.  Medicaid allows significant flexibility for states to design and implement  their programs; however, each state Medicaid program, by federal law,  must cover certain categories of individuals and provide a broad array of  benefits. Medicaid benefits are not adjusted based on an eligible  individual’s income level.
SNAP is intended to help low-income households obtain a better diet by  providing benefits to purchase food. SNAP is the largest of 15 domestic  food and nutrition assistance programs overseen by the U.S. Department  of Agriculture’s Food and Nutrition Service. States administer the  program by determining whether households meet the program’s  eligibility requirements, calculating monthly benefits for qualified  households, and issuing benefits to them. A household generally includes  everyone who lives together and purchases and prepares meals  together. An SSI recipient is generally automatically eligible to receive  SNAP benefits, if they live alone or in households in which all members  receive SSI benefits, and an individual’s monthly SSI benefit is counted  as income when determining the individual’s SNAP benefits. In contrast,  for the purposes of SSI benefit determination, the amount of SNAP  benefits an SSI recipient receives is excluded.
Medicaid and SNAP are not the only other federal assistance programs  available to aged, blind, or disabled individuals with limited means. For  example, monthly cash assistance is available to qualifying low-income  families with children through the Temporary Assistance for Needy  Families (TANF) block grant, administered by the U.S. Department of  Health and Human Services (HHS). TANF provides federal funding to  states, which states are required to supplement with their own funds, to  provide cash assistance and a variety of other benefits and services to  meet the needs of low-income families with children. In addition to  eligibility requirements related to the target population, TANF includes  both work requirements and requirements related to time limits on  individuals’ receipt of TANF cash assistance benefits. While there is no  federal prohibition to simultaneous SSI and TANF eligibility, most states  prohibit payment of TANF benefits to SSI recipients, according to HHS. If  an SSI recipient does receive TANF cash assistance benefits, that  person’s benefit is counted dollar for dollar as income during SSI eligibility  and benefit amount determinations.
section_title: Multiple SSI Recipient Households Represented an Estimated 15 Percent of All SSI Households in May 2013
subsections: section_title: Households with Multiple SSI Recipients Represented an Estimated 15 Percent of All Households with SSI Recipients and Typically Included Two Nonmarried Recipients
paragraphs: In May 2013, an estimated 15 percent of all households with SSI  recipients included more than one SSI recipient (1.1 million households),  according to our analysis of matched administrative and survey data.  Specifically, households with married couple recipients represented an  estimated 1.2 percent of all SSI recipient households; while 13.8 percent  of SSI households were comprised of nonmarried multiple recipients (see  fig. 1). Households with nonmarried multiple recipients include  combinations of related or unrelated recipients living together, such as  parents and children, siblings, or roommates. The vast majority of multiple  recipient households reported having a one-family household (an  estimated 86.7 percent or 941,000 households), with “family” defined as a  group of two or more persons related by birth, marriage, or adoption who  reside together. Based on our analysis of households with SSI  recipients, we were unable to detect any changes in the proportions of  one recipient and multiple recipient households, respectively, from 2009  to 2013.
A vast majority of multiple recipient households had two SSI recipients  (see fig. 2). Specifically, an estimated 953,000 of the 1.1 million multiple  recipient households in May 2013 included two recipients, while an  estimated 131,000 households included three or more recipients.
SSI recipients living in multiple recipient households often shared their  households with other individuals who did not receive SSI benefits (non- recipients). Almost two-thirds of multiple recipient households included at  least one non-recipient (see fig. 3) and, as previously noted, most multiple  recipient households reported being members of one family. As such,  multiple recipient households may include a parent and child who both  receive SSI benefits along with another parent who does not receive  benefits, for example.
section_title: Most Multiple Recipient Households Included Adult Recipients Who Did Not Have Any Earned Income
paragraphs: An estimated 695,000 of 1.1 million multiple recipient households  included at least one working-age adult recipient in May 2013 (see fig.  4). The most common recipient groupings in multiple recipient  households were two or more working-age adult recipients or two or more  elderly recipients. It was less common for multiple recipient households to  have multiple generations of SSI recipients present, such as a  combination of working-age adult recipients and child recipients, or  working-age adult and elderly recipients.
Although representatives from some stakeholder groups and staff we  interviewed at all five SSA field offices noted that, in their experience,  multiple recipient households commonly included children, we found that  an estimated 69.5 percent of multiple recipient households in May 2013  had no child recipients present (see fig. 5). For multiple recipient  households with SSI recipient children in May 2013, most included only  one child recipient, and it was rare for these households to have three or  more child recipients.
Although SSA reports that a slightly greater percentage of SSI recipients  were female, according to our analysis, a slightly greater percentage of  SSI recipients in multiple recipient households were male in May 2013.  Specifically, SSA reported that 53.4 percent of all SSI recipients were  female in December 2013, and we found that 54.0 percent of SSI  recipients in multiple recipient households were male in May 2013. This  may be related to the fact that child SSI recipients were twice as likely to  be male, according to SSA, and child recipients made up a slightly  greater proportion of recipients in multiple recipient households than in  the SSI recipient population as a whole, according to our analysis.
The majority of multiple recipient households—an estimated 87.9 percent  of which had two SSI recipients—reported no earned income and some  unearned income in May 2013. Further, the percentage of households  that reported earned income and the average amount of earned income  per household were similar across one recipient and multiple recipient  households (see table 1). In contrast, although the majority of both one  and multiple recipient households reported receiving unearned income,  the average amount of unearned income reported by multiple recipient  households was greater than that reported by one recipient households.
section_title: Recipients’ Living Arrangements May Be Driven by Various Factors
paragraphs: According to staff from SSA headquarters and our selected field offices,  as well as disability rights advocates, and researchers, SSI recipients  may make living arrangement decisions for various reasons. These may  include family relationships and the role of genetics in the development of  similar health conditions among family members. Married couples,  parents and children, and extended families often share households  because they are related. Further, some researchers we spoke with  suggested that shared genetic conditions among parents or siblings could  result in multiple members of the same household having the same  disability, or a disability on the same illness spectrum.
The potential network effect resulting from individuals living in close  proximity and sharing information was another factor cited by groups we  spoke with that may increase the likelihood of SSI recipients living  together. Network effects potentially reduce perceived barriers to applying  for benefits for individuals who may be eligible, and could increase the  prevalence of multiple recipient households. Specifically, SSA field office  staff and representatives of a disability rights advocate group we spoke  with described word-of-mouth communication among potentially eligible  individuals as one way that applicants learn about the SSI program.  According to one researcher we spoke to, some applicants may hear from  others how to navigate the application and appeals process for SSI  benefits, thus increasing their likelihood of applying.
The supportive care that comes from living with others may also  contribute to SSI recipients choosing to live together. According to  disability advocates we spoke to, SSI recipients may group themselves  into a community to increase connectedness, decrease isolation, and  receive supportive care when needed. In addition, one researcher told us  that SSI recipients might also need assistance coordinating care or  arranging appointments, and SSI recipients with different impairments  may fulfill complimentary functions for other household members.
A range of the stakeholders we spoke to, including SSA field office staff,  disability advocates, and researchers, stated that economic factors may  also contribute to the living arrangement decisions of SSI recipients.  Specifically, according to these groups, SSI recipients may choose to live  together in order to pool resources to share rent and other household  expenses such as utilities or food. Additionally, current fair market rent  levels often exceed SSI benefit rates, research shows. For example,  according to one study, the national average fair market rent for one  bedroom rental units was $780 in 2014, and for studio/efficiency rental  units was $674 in 2014, or about 104 percent and 90 percent,  respectively, of the maximum monthly SSI benefit payment in that year.
In addition, SSA headquarters and field office staff, disability rights  advocates, and researchers, with whom we spoke, stated that the  recession may have exacerbated the economic factors that contribute to  living arrangement decisions for SSI recipients. However, one researcher  we spoke with noted that the effects of the recession varied by state.  According to our analysis of matched administrative and survey data, the  rate of multiple SSI recipient households with two families present  decreased from an estimated 26 percent in 2010 to an estimated 10  percent in 2013. This suggests that the 2007 to 2009 recession may  have played a role in the family composition of households, which is  consistent with other research that has found low-income people tend to  combine households during recessions.
Other factors related to the location and features of housing may  influence SSI recipients’ living arrangements, according to the groups  with whom we spoke. In particular, these factors may contribute to a  greater prevalence of multiple SSI recipient households in certain  neighborhoods. For example, location-related factors noted by those we  spoke with included proximity to accessible infrastructure and public  systems such as transportation and schools. In addition, SSI recipients  may need to live in housing units with universal accessibility features  such as no-step entry, single-floor living, lever-style door handles,  accessible electrical controls, and extra-wide doors and hallways.  However, one study found that in 2011 less than 1 percent of U.S. rental  housing units—roughly 365,800 units—included all five of these  accessibility features.
section_title: Multiple Recipient Households Received an Estimated 30 Percent of All SSI Benefits in May 2013
paragraphs: In May 2013, the estimated 15 percent of all SSI households that had  multiple recipients received an estimated 28.6 percent of all SSI benefits,  or approximately $1.2 billion, according to our analysis of matched  administrative and survey data. (See fig. 6.) Because the total amount  of SSI benefits received by a household includes benefits for all recipient  residents, households with multiple recipients received higher monthly  average SSI benefit payments (an estimated $1,131) compared to  households with one recipient (an estimated $507).
Marital status was also associated with different household benefit  amounts. Households with nonmarried multiple recipients received a  higher estimated average monthly benefit payment than married recipient  households (see table 2). This is consistent with federal statute which  stipulates a lower maximum benefit rate for married couple recipients,  and those rates were $1,066 per couple or $533 per recipient in 2013. In  comparison, all other recipients were not subject to this reduction and  were eligible to receive up to $710 in 2013.
Households typically received SSI benefits close to the maximum benefit  for which their recipients were eligible. For example, in May 2013,  monthly benefit amounts for most multiple recipient households were over  $1,000, while monthly benefit amounts for most households with one  recipient were between $500 and $999. (See fig.7) These findings show  a concentration of households received benefits in the range of SSA’s  2013 maximum benefit rates for individuals and married couple  recipients. These data on benefit amounts for households with one or  multiple recipients are also consistent with our finding that an estimated  87.9 percent (953,000) of multiple recipient households had two SSI  recipients in May 2013.
Child SSI recipients received the highest estimated average monthly SSI  benefit amounts, regardless of whether they were the only recipient in a  household or lived in a multiple recipient household (see fig. 8). Elderly  SSI recipients received the lowest estimated average monthly benefit  amounts. According to SSA officials, children receive higher SSI benefit  amounts because they are less likely to have other sources of countable  income that would reduce their benefits. According to SSA’s 2013 SSI  Annual Statistical Supplement and Report, about 28 percent of all SSI  recipients age 17 or younger had some other countable income,  compared to about 43 percent of adults ages 18 to 64, and 69 percent of  recipients age 65 or older. Further, about two-thirds of all child  recipients lived with one parent, and almost half of those parents had no  other countable income.
section_title: The Effects of Changing Benefits for Multiple SSI Recipient Households Are Largely Unknown, and SSA Has Limited Ability to Electronically Manage Claims for Some of These Households
subsections: section_title: Options for Restructuring Benefits for Multiple SSI Recipient Households Have Been Discussed, but the Effects on SSI Program Costs, Households, and Other Programs Are Largely Unknown
paragraphs: Since the 1990s, members of Congress, SSA officials, and some  advocacy groups have discussed alternative benefit structures for  individuals living in multiple recipient households. Based on our interviews  with SSA headquarters and field office staff, researchers, and  representatives of advocacy groups, these previously considered  alternatives generally involved either eliminating the benefit reduction for  married recipients—so married recipients would have the same maximum  benefit rate as individual recipients—or applying a similar reduction to  other multiple recipient households. Although these alternatives have not  been fully studied to determine the effects they may have on SSI  recipients or SSA’s administration of the program, there is some  information available on their potential effects on recipients and the  program.
subsections: section_title: Eliminating the Benefit Reduction for Married SSI Recipients
paragraphs: Eliminating the benefit reduction for married SSI recipients—so they  would have the same maximum benefit rate as individual recipients— would increase benefit equity, simplify administration of the program, and  also likely increase benefit costs, according to SSA staff and other groups  with whom we spoke and research we reviewed. Because married  recipients have a lower maximum benefit rate than nonmarried recipients,  most disability advocates and researchers we spoke with said that  married recipient households are treated inequitably. Further, according  to SSA, the current benefit structure has led to some SSI recipients  reporting a change in their marital status to avoid the benefit reduction.  Specifically, SSA officials in 3 of the 5 selected field offices said that  some SSI recipients, upon learning of the married couple benefit  reduction, shortly thereafter return to the SSA office to tell SSA staff they  have separated and are no longer living together. According to SSI  policy, the benefit reduction no longer applies if the SSI recipients divorce  or no longer live in the same household, for example. Eliminating the  benefit reduction for married SSI recipient households would also simplify  program administration overall, according to SSA headquarters staff,  because there would then be one maximum benefit amount that applies  to all recipients. However, such a change for married recipients would  also likely increase SSI benefit costs. According to a 2003 SSA study,  eliminating the benefit reduction policy for married recipient households  could increase program costs by more than $900 million annually.
section_title: Reducing the Maximum Benefit Rate for Other Households with Multiple SSI Recipients
paragraphs: Other alternative SSI benefit structures that have been considered  focused on reducing the maximum benefit rates for different groups of  nonmarried multiple recipient households. For example, the 1995  National Commission on Childhood Disability suggested reducing the  maximum SSI benefit rate for households with multiple child SSI  recipients. Another alternative described by SSA in 2008 would replace  the policy under which an SSI recipient’s benefits are reduced to account  for any in-kind support and maintenance they receive with a benefit  reduction for all adult recipients living with other adult recipients. The  report noted that administering the in-kind support and maintenance  policy often requires month-to-month, recipient-by-recipient  recomputations based on information that is unverifiable. In addition, we  have previously reported that administering the in-kind support and  maintenance policy has become increasingly complex and is a primary  cause for overpayments. Another suggested alternative included  applying a reduced maximum benefit rate to all households with two or  more SSI recipients, which SSA examined in 2002.
Potential Effects on Benefit and Administrative Costs  If the maximum benefit rate for additional multiple SSI recipient  households was reduced, SSI benefit costs would likely decrease,  according to analyses we reviewed. Although not all of these alternative  benefit structures have been analyzed for cost savings, those that have  provide some information on potential savings. For example, the  Congressional Budget Office estimated a cost savings of approximately  $4.6 billion from fiscal years 2013 through 2022 if the benefit reduction for  households with multiple SSI children suggested by the 1995 National  Commission on Childhood Disability were to be implemented. Further,  SSA’s Office of the Inspector General estimated a cost savings of  approximately $3 billion for calendar year 2011 if the reduced maximum  benefit rate for married SSI recipients was extended to all households  with two or more SSI recipients.
SSA headquarters officials we spoke with reported that savings in benefit  costs resulting from a reduction in the maximum benefit rate for additional  multiple recipient households may be tempered by increases in  administrative costs; however, SSA has no estimates to help determine  any potential effect. SSA staff we spoke with in 3 of the 5 field offices said  changing benefits for some SSI recipients also could result in an increase  in field office workloads. For example, staff from these three field offices  said a change in the maximum benefit rate for some SSI recipients would  result in more recipients visiting their field offices, and some added that  there would be a need for new training for field office staff and outreach to  inform recipients about the change. However, SSA has not previously  assessed how field offices may be affected by changes in SSI policy, and  therefore the full effects of extending the reduced maximum benefit  beyond married SSI recipients on administrative processes and related  program costs are unknown.
Potential Effects on SSI Recipients  Concerning the potential effects on recipients of a reduction in the  maximum benefit rate for multiple recipient households, some of the  groups we spoke with discussed how such a change may affect  recipients’ financial situations, though research on these effects is limited.  The reduced maximum benefit rate for married couple SSI recipients is  based on the expectation that these couples realize economies of scale,  according to previous SSA reports. In other words, married SSI recipients  who live together are able to share certain household expenses, thus  reducing the overall cost of housing and living expenses for each  individual. Consistent with this, some SSA officials and researchers we  spoke with told us that some multiple recipient households economize on  living expenses, such as rent and food. However, disability advocacy  officials from two organizations said that while recipients may share a  living space, there may be certain out-of-pocket expenses that cannot be  shared, such as medication or specific dietary requirements. While a  2006 report from SSA found that medical expenses for the majority of  child SSI recipients were covered by health insurance rather than their  SSI benefits, the extent to which multiple recipient households realize  economies of scale, and for what purposes recipients in these  households use their SSI benefits, have not been studied, according to  SSA officials and several researchers.
A reduction in the maximum benefit rate for multiple recipient households  may lead some SSI recipients to alter their living arrangements, according  to groups with whom we spoke. Although the extent to which a benefit  reduction leads to such changes has not been studied, as mentioned  earlier, SSA field office staff told us that some married SSI recipients  attempt to avoid the benefit reduction by telling SSA staff they have  separated and are no longer living together. If a reduction in the  maximum benefit rate is extended to include other multiple recipient  households, affected SSI recipients may similarly take steps to avoid the  benefit reduction, according to disability advocates, researchers, and SSA  field office staff with whom we spoke. For example, some SSA field office  staff said that families living with multiple SSI children may move their  children to live with relatives to avoid a reduction in SSI benefits.
Potential Effects on Other Federal Programs for Low-Income  Households and Individuals  Because SSI recipients may be eligible to receive benefits from other  federal programs for low-income households and individuals, these  programs may be affected if a reduced maximum SSI benefit rate were to  be extended to additional multiple recipient households, though the  effects would likely vary by program. Federal programs that these  households may also receive benefits from include, for example,  Medicaid, TANF and SNAP. While the effects of changes in other federal  means-tested programs, such as TANF, on SSI have been studied to  some extent, the reverse effect of SSI benefit changes on other federal  programs has not. However, based on our assessment of relevant laws,  regulations, other reports, and data for selected programs, the effects of a  reduced SSI maximum benefit rate on other programs would likely vary  based on each program’s structure and rules and the extent to which SSI  recipients already receive benefits from these other programs.
Medicaid, which many SSI recipients concurrently receive, would likely be  minimally affected by the extension of the reduced maximum benefit rate  to other multiple recipient households, based on our review of relevant  program laws, regulations, other reports, and data. In most states, SSI  recipients are automatically eligible for Medicaid, and many currently  receive Medicaid benefits. For example, according to one SSA study,  approximately 80 percent of individuals ages 18 to 64 received Medicaid  coverage within a year of being deemed eligible for SSI. Therefore, a  reduction in SSI benefits may result in the small proportion of SSI  recipients who are not currently enrolled in Medicaid applying for the  program and receiving coverage. Further, because Medicaid benefits are  adjusted based on eligibility and not on income level, an SSI recipient’s  Medicaid benefits would not be affected by a reduction in their SSI  benefits so long as the recipient remains eligible for SSI.
TANF, which SSI recipients generally do not concurrently receive, would  also likely be minimally affected by a reduction in the maximum benefit  rate for additional multiple SSI recipient households, based on our review  of relevant program laws, regulations, other reports, and recipient data.  Although the federal government sets some requirements for TANF,  states have broad flexibility to design their TANF programs, and most  states do not allow individuals who receive SSI to simultaneously receive  TANF monthly cash assistance benefits, according to the Department of  Health and Human Services. However, other family members, living in  households with SSI recipients, may receive TANF cash assistance  benefits. The Department of Health and Human Services reported that  about 267,000 child-only TANF families had a parent or adult caretaker  who received SSI in fiscal year 2013. In contrast with Medicaid, TANF  benefits are generally adjusted based on a family’s income level, and for  child-only TANF cases, the income and assets of the parent or adult  caretaker is factored in when determining the child’s TANF benefit.  Therefore, TANF cash assistance benefits received by family members  living in a household with multiple SSI recipients may increase if a family  member’s SSI benefit was reduced. However, given that federal funding  for TANF is provided through a block grant to states, the amount of  federal spending on TANF is not adjusted for changes in cash assistance  benefits provided to eligible families.
In comparison with Medicaid and TANF, SNAP is more likely to  experience an increase in program spending if a reduction in the  maximum SSI benefit rate is established for additional multiple recipient  households, based on our review of relevant program laws, regulations,  other reports, and recipient data. Similar to Medicaid, SSI recipients can  be automatically eligible for SNAP. According to a report by USDA, 82  percent of individuals in households with SSI recipients received SNAP  benefits in fiscal year 2013. Further, according to SNAP administrative  data, about 4.5 million households receiving SNAP benefits included at  least one member who also received SSI benefits in fiscal year 2013.  For the group of SSI recipients who do not receive SNAP benefits, a  reduction in SSI benefits may cause them to apply for these benefits. In  addition, because SNAP benefit amounts are adjusted based on  household income, a reduction in SSI benefits would likely increase a  household’s SNAP benefit, unless the SSI recipient’s household already  receives the maximum SNAP benefit amount. According to SNAP  administrative data, the average monthly SNAP benefit received by  households with SSI as a countable income source was $205 in fiscal  year 2013. Further, these data show that 15.4 percent of households  with disabled nonelderly individuals received the maximum SNAP benefit  that year, compared to 40.7 percent of all SNAP households. Although a  reduced maximum SSI benefit rate for additional multiple SSI recipient  households may therefore result in increased federal spending on SNAP,  federal spending may decrease overall. Specifically, due to the way  SNAP benefits are structured, each lost dollar in SSI benefits would  represent less than one additional dollar gained in SNAP benefits.
section_title: SSA Has Limited Ability to Electronically Manage Claims for Multiple Recipient Households
paragraphs: SSA’s claims management system, which is comprised of MSSICS and  the SSR, is not able to automatically update the claim records for  recipients living in multiple recipient households. SSA officials told us  the claims management system was designed to manage the claims of,  and pay benefits to, individual recipients. When SSA conducts periodic  redeterminations of SSI recipient claims, or SSI recipients inform SSA of  changes in their income or living arrangements, field office staff said they  update recipients’ claims to ensure the correct benefits are paid.  However, SSA headquarters and field office staff told us the system does  not have the ability to automatically connect and adjust the claim records  of individuals living in multiple recipient households. Although changes to  one of the SSI recipient’s income or living arrangements in a multiple  recipient household may affect another recipient’s claim in that  household, SSA headquarters officials stated that staff have to go into  each record separately to update each recipient’s benefits. For example,  if a mother lives with two of her children who are both SSI recipients, and  the mother reports a change in her earned income, SSA’s system does  not automatically adjust both children’s benefit amounts to account for the  mother’s change in income. Rather, while the system will add the new  income information into all relevant claims records, staff need to go into  each record separately to process the change. Further, if SSA field office  staff do not go into a claim record to process such a change, the system  does not alert them to do so. Without the ability to automatically connect  and adjust the claim records for individuals living in multiple recipient  households whose benefits are inter-related, SSA is at increased risk for  improper payments because staff may not adjust benefits for all recipients  in a multiple recipient household after a relevant change.
Furthermore, SSA staff reported that processing claims for SSI recipients  who marry another recipient or separate from another recipient are not  possible in the claims management system. Field office staff must  process these claims manually, outside of the claims management  system, according to SSA headquarters officials and staff from 3 of the 5  field offices with whom we spoke. For these claims, they said field office  staff must manually complete forms to gather recipient information,  calculate benefits outside the claims management system, and then enter  the information into the system. Although SSA officials stated SSA  provides training on how to use the forms, staff from 3 of the 5 field  offices with whom we spoke said they rely on more seasoned field office  employees to demonstrate how to properly complete these forms.  Further, staff from 3 of the 5 field offices we spoke with told us that  manually processing these married and separating recipient household  claims are a common part of their daily work. Although an SSA official  told us that improper payments made in married couple claims in fiscal  year 2014 were attributed to recipient errors, staff from 3 of the 5 SSA  field offices with whom we spoke said processing claims outside of the  claims management system is time consuming and error prone. This  issue may be exacerbated in the near term due to the Supreme Court  ruling recognizing the right of same-sex couples to marry, a concern  specifically noted during one of our interviews with field office officials.
SSA has no plans to update its claims management system to address  issues with processing claims for multiple recipient households, including  marrying and separating recipients, although the agency has broadly  committed to improving other areas of its technology infrastructure. SSA  officials told us that they have not conducted any specific assessments of  the effects manual payment processing for multiple recipient household  claims has on claim processing errors or improper payments as part of  their payment accuracy reporting. SSA officials explained there is no  program requirement to have the claims management system connect the  records of individuals living in multiple recipient households, and they do  not plan to make changes to do so. Yet, SSA has previously stated its  commitment to investing in the capacity and modern technologies needed  to update its aging and strained IT infrastructure. Furthermore, in its  2017 budget request, SSA stated its data systems are no longer the best  solution to administer the agency’s programs, and added that it plans to  undertake a larger, multiyear reform effort. According to our  Organizational Transformation: A Framework for Assessing and  Improving Enterprise Architecture, improving an agency’s enterprise  architecture is an essential means to having operations and technology  environments maximize institutional mission performance and  outcomes. Moreover, Standards for Internal Control in the Federal  Government states that agencies should identify and address risks to  achieving their objectives, including significant changes to both external  and internal conditions, as well as design their information systems to  support the completeness, accuracy, and validity of information needed to  achieve objectives. The increased opportunities for improper payments  resulting from the claims management system’s limitations in updating  and processing benefit claims for those living in multiple SSI recipient  households is a risk to SSA’s overall goal of strengthening the integrity of  SSA’s programs. According to staff at 2 of the 5 field offices with whom  we spoke, fully automating the payment process for all claims and  electronically connecting the records for multiple recipient households  would make processing these claims more efficient and lower the number  of improper payments by reducing errors in claims processing.  However, SSA has not assessed the risks these systems limitations pose,  despite its plans to make changes to its data systems. Absent such an  assessment and without upgrades to the claims management system,  SSA is missing an opportunity to improve its day-to-day work processes.  Further, the agency will likely continue to experience related claim  processing errors and improper payments, both under current program  policies, as well as in the event related policy changes are implemented  in the future.
section_title: Conclusions
paragraphs: Although SSI provides cash assistance benefits to individuals, it is not  surprising that some SSI recipients live together due to family  relationships or economic and social factors. Any household with more  than one member may potentially experience economies of scale, and  when the SSI program was created, it included a lower maximum benefit  rate for certain married couple recipients. However, despite the fact that  the majority of households with multiple SSI recipients report including  members of only one family, few report that they include married couple  recipients. This raises questions for some about benefit equity and  disincentives to marriage, as well as the ability of program administrators  to effectively determine a recipient’s marital status. Although the potential  effects of various benefit restructuring options have not been fully studied,  our finding that households with multiple SSI recipients receive almost 30  percent of all SSI benefits suggests that changing the benefit structure for  all or some of these households may have a significant effect on benefit  costs. Further, regardless of whether a change to benefits for households  with multiple recipients is made, there are limitations in SSA’s information  systems with managing claims for SSI recipients who live with other  recipients, which puts the agency at risk. However, absent a risk  assessment, SSA lacks information on the impact current systems  limitations may have on improper payments. The recent Court ruling  recognizing the right of same-sex couples to marry also likely increases  opportunities for improper payments to SSI recipients, because of the  expected increase in the number of claims SSA staff must process  manually due to the system’s constraints in converting claims for  individual recipients to married couple recipients. Despite reported plans  to upgrade SSA’s aging technology systems, SSA currently does not  have plans to address issues related to processing claims for SSI  recipients who live with other recipients, leaving the program at risk for  improper payments. Should Congress choose to revise benefit structure  policy for households with multiple SSI recipients, SSA will be poorly  positioned to implement and administer those changes in the future.
section_title: Recommendation for Executive Action
paragraphs: To ensure the agency has sufficient information about risks to SSI  program integrity when making decisions about efforts to address them,  we recommend that the Commissioner of the Social Security  Administration conduct a risk assessment of the current manual process  for connecting and adjusting claim records of SSI recipients who live in  households with other SSI recipients, and, as appropriate, take steps to  make cost-effective improvements to SSA’s claims management system  to address identified risks.
section_title: Agency Comments and Our Evaluation
paragraphs: We provided a draft of this report to SSA for review and comment. In its  written comments, reproduced in appendix III, SSA disagreed with our  recommendation stating that current SSI program rules do not support  connecting records of unrelated individuals living in multiple recipient  households. SSA also noted that it does not have evidence from its fiscal  year 2014 payment accuracy reviews that manual processing of married  couple multiple recipient household claims led to payment errors. As  such, the agency stated that it could not commit resources to address our  recommendation at this time, but noted if a legislative proposal is put forth  that affects unrelated multiple SSI recipient households, SSA will assess  program policy and systems risks as part of its evaluation and planning.  However, we continue to believe that the manual processing currently  used to connect and adjust claim records of SSI recipients who live in  households with other SSI recipients leaves the agency at risk. SSA has  acknowledged that it has not assessed the extent to which manual  processing leads to payment errors, and the data they provided us on  fiscal year 2014 improper payments to married couple recipients does not  address the full scope of the issues we identified. Specifically, field office  staff reported several instances in which manual processing is used to  connect and adjust claims records for multiple recipient households due  to system limitations, and indicated that these manual adjustments  increase the likelihood of erroneous payments. These manually  processed claims are for households with multiple related recipients  whose SSI benefits are currently inter-related under program rules, such  as multiple child recipients who are siblings or individual recipients who  marry another recipient. Without an assessment of the risks associated  with the manual processing of these claims, SSA is unable to determine if  additional adjustments to its system would be a cost-effective use of its  resources. SSA officials also provided technical comments, which we  incorporated into the final report, as appropriate.
As agreed with your offices, unless you publicly announce the contents of  this report earlier, we plan no further distribution until 30 days from the  report date. At that time, we will send copies to the Commissioner of the  Social Security Administration, appropriate congressional committees,  and other interested parties. In addition, the report is available at no  charge on the GAO website at http://www.gao.gov.
If you or your staff have any questions about this report please contact  me at (202) 512-7215 or bertonid@gao.gov. Contact points for our  Offices of Congressional Relations and Public Affairs may be found on  the last page of this report. GAO staff who made key contributions to this  report are listed in appendix IV.
section_title: Appendix I: Scope and Methodology
paragraphs: To better understand multiple Supplemental Security Income (SSI)  recipient households and the potential effects of implementing a change  in the amount of benefits received by these households on program  administration and other factors, we employed several methods,  including: analysis of matched data from Social Security Administration (SSA)
Supplemental Security Record (SSR) and U.S. Census Bureau  (Bureau) Survey of Income and Program Participation (SIPP)  review of relevant program laws, regulations, and other reports for  other federal programs for low-income individuals and families  interviews with SSA staff.
We conducted this performance audit from March 2015 to August 2016 in  accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit to obtain  sufficient, appropriate evidence to provide a reasonable basis for our  findings and conclusions based on our audit objectives. We believe that  the evidence obtained provides a reasonable basis for our findings and  conclusions based on our audit objectives.
subsections: section_title: Analysis Using Matched SSR and SIPP Data
paragraphs: To respond to our questions, we obtained and analyzed matched data  from the Bureau’s SIPP and SSA’s SSR on the number and  characteristics of SSI recipients living with other SSI recipients, and the  amounts of benefits received by these recipients. We determined SIPP  was the best choice for matching with the SSR after interviewing experts  who had worked with this and other similar data sets. According to these  experts, SIPP was the best choice for our work because it is updated on a  monthly basis, so it is well matched to the SSR data on the SSI program.
subsections: section_title: Analytical Goals and Target Population
paragraphs: To describe the living arrangements of SSI recipients, we needed data on  both the population of SSI recipients and the characteristics of their  households and families. SSA collects detailed data on recipients for the  purpose of administering the SSI program. These data primarily included  variables related to eligibility, benefit amounts, and beneficiary activities  relevant to the program, such as earned and unearned income. SSA does  not collect data on recipients’ living arrangements. This makes  administrative data incomplete for the purpose of describing household  and family composition among recipients.
The Bureau’s program of matching administrative and survey data  provided these data to supplement SSA’s administrative records. The  Bureau matches SSA’s administrative data to SIPP public use files, using  a complex algorithm that we describe in more detail below. The matched  SIPP files provide detailed information on other people living in SSI  recipients’ households, including related family members. Although SIPP  data on SSI benefit receipt and amount are subject to measurement error,  the survey’s data on households, families, and other social demographic  variables were more detailed and reliable than SSA’s administrative  sources. In this sense, the matched data benefit from each data source’s  strength, and produced more reliable data for our purposes.
The target population for our analysis included SSI recipients who do not  live in large group housing environments, such as boarding houses or  dormitories. The SIPP classifies these environments as “group quarters.”  As a result, we analyzed a subpopulation of the matched SIPP  respondents who received SSI benefits, according to the SSR, and who  did not live in group quarters, according to the SIPP. We analyzed this  subpopulation using methods for domain analysis that set analytical  weights to zero for sample units that were out of scope.
section_title: Data
paragraphs: We analyzed two specific series of data from the Bureau and SSA: public- use “core” files from the 2008 SIPP panel and SSR data extracted at  equivalent time periods.
section_title: 2008 SIPP Core Data
paragraphs: The 2008 SIPP is a longitudinal survey of civilian, non-institutionalized  residents of the United States, with final-stage sampling of housing units.  In the first wave, the survey attempted to interview people living in an  initial sample of 52,031 eligible housing units. In subsequent waves, the  survey attempted to re-interview respondents from the first wave, along  with all other people living with them at later waves. The population  covered by the SIPP is generally the same as the population eligible for  SSI. However, the SIPP may exclude certain SSI recipients who live in  institutions such as long-term medical facilities. We believe this coverage  error to be minimal and therefore, we did not make weight adjustments for  this population.
The survey interviewed respondents roughly once every four months.  Respondents provided data about the previous four month “reference”  period, with many variables measured each month within the period. The  Bureau administered the survey using a system of interview rotation  groups, such that in any month, one-quarter of the eligible sample gave  responses. For any month of measurement, data from four rotation  groups, interviewed on different dates, make up a complete sample.
We analyzed data for five unique time periods: May of each year from  2009 through 2013. We chose May as the reference month to align with  the month of the most recent SSR extract in May 2013 (see below). In  each time period, we built a complete sample by selecting rotation groups  and waves that corresponded to the reference month of interest. For  example, a complete sample for the reference month of May 2013  included data from rotation groups 1 from wave 16 and groups 2-4 from  wave 15. Selecting complete sets of rotation groups avoided the need to  adjust weights and maximized the available data. We applied monthly  weights to make generalizeable estimates for the SIPP target population  for each of the five distinct reference months. We did not include  longitudinal data on whether respondents gave responses or were in- scope for all time periods, and instead made five cross-sectional  estimates.
section_title: SSR Extracts
paragraphs: The SSR contains various fields that describe SSI recipients’ participation  in the program. For our purposes, the primary fields of interest include  benefit receipt, benefit amount, marital status, earned income, and  unearned income.
The Bureau maintains a cumulative file of the SSR extracts that it has  received since its record linkage program began. One record in the file  exists for each SIPP respondent who ever matched an SSR extract.  Fields include a subset of SSR fields in SSA’s version of the file, some of  which are measured at multiple times and some only for the date of the  file. We analyzed a May 2013 vintage of this file, which contains monthly  historical data for all variables of interest except marital status.
section_title: Record Linkage
paragraphs: The Bureau has developed a general method of linking data with  personally-identifying variables to their surveys, known as the Person  Identification Verification System (PVS). PVS seeks to produce a unique  identification number for a given person, called a Protected Identification  Key (PIK), across all data ever used as input and reference files that the  Bureau maintains from federal sources, such as SSA.
According to Bureau documentation, PVS uses blocking and matching  methods to estimate the probability that a given input record matches  verified reference files and can be assigned a PIK. Blocking variables,  such as the first three digits of a Zip code or first or last names, reduce  the space of potential matches to make computation feasible. Matching  variables, such as Social Security number, name, or date of birth, serve  as input for calculating multivariate weights that describe the degree of  record similarity across the matching variables. PVS assigns a PIK when  the value of the match weight exceeds a threshold of similarity, assumed  as an input parameter. The system contains multiple modules with  different blocking and matching variables and similarity parameters.  Records that are not assigned PIKs in one module move on to later  modules.
The Bureau research shows that PVS reliably assigns PIKs to federal  data sources, such as the SSR. Since the Bureau has access to detailed  data files on Social Security transactions, the agency can verify the  accuracy of PVS using reference files. A 2014 validation found that  observed false match rates varied from 0.005 percent to 1.174 percent for  Medicare data extracted in 2011, with similar results found for the same  file extracted in 2012. These low levels of misclassification are  acceptable for our purposes. The matched data have some additional  error from the record linkage process, but have substantially lower  measurement error of key variables, such as SSI receipt.
Although the Bureau research has found that the PIK is accurate, once it  can be assigned, PVS cannot always assign PIKs for all records in a  particular application. PIK assignment rates for 2008 SIPP panel waves  range from 89.4 percent to 90.6 percent. This adds commensurate  amounts of missing data to our analysis, which requires data from both  the SIPP and SSR.
The Bureau research has found that survey records without PIKs  assignment are unlikely to be missing at random. This suggests that  analysis of survey and administrative data matched using the PIK should  adjust for potential bias from the PIK assignment process. We discuss our  method of adjustment below.
We matched the 2008 SIPP public-use core files to the Bureau version of  the SSR using the PIK and unique identifying variables in each file. We  then joined the two files using the PIK. This approach is not documented  publically, but follows guidance we received from the Bureau staff.
section_title: Missing Data, Imputation, and Weighting
paragraphs: Since the SIPP is a longitudinal survey, missing data can accumulate  across waves as members of the original sample stop participating.  According to Bureau documentation, sample loss rates range from 19.4  percent in wave 1 to 53.1 percent in wave 16.
Our analysis used data from multiple waves for each reference month of  interest, including later waves that have moderate levels of unit  nonresponse. To adjust for potential bias, we used the weighting cell  adjustments that are integrated into the weights provided by the Bureau.  As a further check, we compared select estimates to known values from  SSA publications. Specifically, we compared, by age group, estimates of  total beneficiaries and total and mean SSI benefits. If our estimates’  confidence intervals did not span the control values, we applied an  additional post-stratification adjustment to align the results. Because  many of our key estimates involve total beneficiaries and benefit amounts  by age group, post-stratification adjusted for unit nonresponse bias for our  specific population, supplementing the general Bureau adjustments.
When the Bureau cannot assign a PIK to SIPP respondents, as  discussed above, they have a zero probability of matching the SSR and  contribute additional unit missing data. Rates of PIK assignment in our  matched data ranged from 89.4 percent to 90.6 percent, depending on  the SIPP wave, which implies that the matching process adds a small  amount of missing data. However, Bureau research suggests that  younger, non-white, and lower household income respondents, among  others, are more likely to lack PIKs. As a result, we estimated the  relationship between variables relevant to our analysis, such as age,  income, and disability status, and the probability of a missing PIK, in order  to mitigate potential bias and scale up estimated totals back to the  controls used in the Bureau post-stratification adjustment. The latter goal  is particularly important, because our analysis estimated many population  totals.
We used nonparametric weighting class methods to adjust for missing  data due to record linkage. First, we cross-classified the adjustment  variables to obtain a categorical variable identifying joint group  membership, collapsing groups containing less than 0.1 percent of the  sample into a residual group to avoid excessive weight variance and  instability. Letting Xij denote the joint adjustment variable for respondent i,  having levels j = {1, 2, …, J}, and letting Yi = I(Missing PIK), we estimated  the probability of a missing PIK conditional on the adjustment variable  with  where wi is the final person weight provided by the Bureau . We  calculated the adjusted weight as  Following the Bureau methods, we used the adjusted weight for the  household reference person as the adjusted household weight.
Rates of item nonresponse and Bureau imputation are extremely low for  the SIPP variables of interest. Item imputation rates generally do not  exceed 5 percent for the SIPP variables we analyzed, which mostly  include household, family, and age variables. Of the small fraction of data  that are imputed, most are imputed responses from prior waves or  logically implied by other, observed variables. The remaining imputed  values are statistical estimates. Given the low rates of item missing data  and the high rates of non-statistical imputation, we used the imputed data  that the Bureau provides and assume that statistical imputation error is  ignorably small.
section_title: Estimation
paragraphs: The SIPP is a multi-stage, stratified, cluster sample of households. Since  the Bureau does not provide sample design variables to preserve  respondent privacy, we used the supplied bootstrap replicate weights to  calculate balanced repeated replication estimates of sampling variance.  We analyzed small subpopulations, so we applied a Fay adjustment to  ensure stable estimates across groups, consistent with Bureau  guidelines. All estimates of interest are linear functions of weighted totals  (e.g., mean and total recipients, benefits, or income), so standard  estimators are appropriate.
section_title: Other Federal Programs for Low- Income Individuals and Families
paragraphs: To better understand the potential effects of changing an SSI recipient’s  benefits on other federal benefit programs, we reviewed relevant program  rules and relevant data for three federal programs—Medicaid, Temporary  Assistance for Needy Families (TANF), and the Supplemental Nutrition  Assistance Program (SNAP). We selected these programs because they  each serve large numbers of low-income individuals, and households with  SSI recipients may be eligible to receive these benefits as well. To  understand the extent SSI recipients receive benefits from each of these  programs, we reviewed relevant studies on Medicaid and SSI, federally  available TANF caseload data from the U.S. Department of Health and  Human Services, and the U.S. Department of Agriculture, Food and  Nutrition Service’s report on the characteristics of SNAP Households.
section_title: Interviews with SSA Staff
paragraphs: To gather information on the characteristics of multiple recipient  households, SSA’s administration of SSI claims for individual recipients  and multiple recipient households, and how changing the amount of  benefits received by multiple recipient households may potentially affect  SSA, we conducted interviews with staff from SSA headquarters and  select field offices. Specifically, we interviewed staff from SSA’s Office of  Research, Demonstration, and Employment Support; Office of Systems;  and the SSI Simplification Workgroup. In addition, we conducted  interviews with field office managers and SSI claims representatives from  five SSA field offices located in Los Angeles, California; Louisville,  Kentucky; Baltimore, Maryland; Brooklyn, New York; and Houston, Texas.  We selected these field offices to account for geographic dispersion, with  at least one office representing the east coast, west coast, mid-west, and  southern United States. We also selected these field offices based on  their location in states and cities with high concentrations of SSI  recipients, to better ensure the likelihood that the field offices we selected  were managing claims of multiple SSI recipient households. Of the five  states we selected, we included one state where at least 40 percent of its  population lived in rural areas. The views of staff from these field offices  are not generalizable to all field offices nationwide. To gain additional  perspectives from SSA field office staff, we interviewed 10 additional SSA  field office managers affiliated with the National Council of Social Security  Management Associations.
section_title: Appendix II: Data Estimates Related to Multiple Supplemental Security Income (SSI) Households
subsections: section_title: All one recipient households
section_title: All multiple recipienthouseholds Multiple recipient households with earned income Multiple recipient households with unearned income
paragraphs: 15,005 –  34,700                   54,396  516,439 –  788,617  $147.50  $69.10 - $226.00  $622.10  $560.20 - $683.90  95 percent  confidence  interval  2.5 – 9.2  95 percent  confidence  interval  15.6 – 27.0  $1,000 - $1,455  $2,838 - $3,280  67.4 – 75.3  95 percent  confidence  interval  (in dollars)
section_title: One recipient households All recipient households
section_title: One recipient households
section_title: Appendix III: Comments from the Social Security Administration
section_title: Appendix IV: GAO Contact and Staff Acknowledgements
subsections: section_title: GAO Contact
section_title: Staff Acknowledgements
paragraphs: In addition to the contact named above, Rachel Frisk (Assistant Director),  Kristen Jones and Michelle Loutoo Wilson (Analysts in Charge), William  Carpluk, David Forgosh and Jeff Tessin made key contributions to this  report. Additional contributors include Carl Barden, Holly Dye, Alexander  Galuten, Sheila McCoy, Mimi Nguyen, Monica Savoy, Mark Ward, and  Margaret Weber.