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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.[Footnote 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.[Footnote 
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 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.[Footnote 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.[Footnote 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 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 enclosure 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 [hyperlink, 
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, 

Signed by: 

Charles Jeszeck:
Acting Director, Education, Workforce, and Income Security Issues: 

Enclosures - 5: 

[End of section] 

Enclosure I: 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.[Footnote 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 enclosure 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.[Footnote 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 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. 
[Footnote 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, 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. 

[End of section] 

Enclosure II: Comments from the Social Security Administration: 

Social Security: 
The Commissioner: 
Social Security Administration: 
Baltimore, MD 21235-0001: 

November 20, 2009: 

Mr. Charles Jeszeck: 
Acting Director, Education, Workforce and Income Security Issues: 
U.S. Government Accountability Office: 
441 G Street, NW: 
Washington, D.C. 20548: 

Dear Mr. Jeszeck: 

Thank you for the opportunity to review and comment on the Government 
Accountability Office draft report, "Social Security: Options to 
Protect Benefits for Vulnerable Groups When Addressing Program 
Solvency" (GAO-10-101R). Our comments on the report are enclosed. 

If you have any questions, please contact me or have your staff 
contact Candace Skurnik, Director, Audit Management and Liaison Staff, 
at (410) 965-4636. 

Sincerely, 

Signed by: 

Michael J. Astrue: 

Enclosure: 

[End of section] 

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. 

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. 

[End of section] 

Enclosure IV: Related GAO Products: 

Social Security Reform: Issues for Disability and Dependent Benefits. 
[hyperlink, http://www.gao.gov/products/GAO-08-26]. Washington, D.C.: 
October 26, 2007. 

Retirement Security: Women Face Challenges in Ensuring Financial 
Security in Retirement. [hyperlink, 
http://www.gao.gov/products/GAO-08-105]. Washington, D.C.: October 11, 
2007. 

Social Security Reform: Implications of Different Indexing Choices. 
[hyperlink, http://www.gao.gov/products/GAO-06-804]. Washington, D.C.: 
September 14, 2006. 

Options for Social Security Reform. [hyperlink, 
http://www.gao.gov/products/GAO-05-649R]. Washington, D.C.: May 6, 
2005. 

Social Security Reform: Answers to Key Questions. [hyperlink, 
http://www.gao.gov/products/GAO-05-193SP]. Washington, D.C.: May 2005. 

Social Security: Program's Role in Helping Ensure Income Adequacy. 
[hyperlink, http://www.gao.gov/products/GAO-02-62]. Washington, D.C.: 
November 30, 2001. 

Social Security: Evaluating Reform Proposals. [hyperlink, 
http://www.gao.gov/products/GAO/AIMD/HEHS-00-29]. Washington, D.C.: 
November 4, 1999. 

Social Security: Criteria for Evaluating Social Security Reform 
Proposals. [hyperlink, http://www.gao.gov/products/GAO/T-HEHS-99-94]. 
Washington, D.C.: March 25, 1999. 

[End of section] 

Enclosure V: U.S. Senate Special Committee on Aging: 

10/26/2009: 

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.[Footnote 8] 

Social Security benefits are paid to workers who meet requirements for 
time worked in “covered employment.”[Footnote 9] 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. 

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. 

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.[Footnote 10] 
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. 

In 2005, GAO analyzed several options for Social Security reform using 
its criteria for evaluating Social Security reform proposals.[Footnote 
11] 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.[Footnote 12] 

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. 

For more information, contact Charles Jeszeck at (202) 512-7215 or 
jeszeckc@gao.gov. 

[End of Background: The Social Security Program] 

Background: Social Security and Economically Vulnerable Groups: 

The Vulnerable Groups (section contains 3 decorative drawings, Source: 
GAO (images): 

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. 

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,[Footnote 13] 

* 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: 

[Refer to PDF for image: illustration] 

55.7% received at least half of their income from Social Security; 
25.3% received 90% of more of their income from Social Security. 

Note: Social Security benefits include Social Security pensions, 
survivors’ benefits, and permanent disability insurance payments. 

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

[End of figure] 

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. 

Vulnerable groups may also receive benefits from other programs, 
including SSI, Medicaid, and the Supplemental Nutrition Assistance 
Program (SNAP). 

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.) 

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. 
[Footnote 14] 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. 
[Footnote 15] 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.[Footnote 16] 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.[Footnote 17] 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. 

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.[Footnote 18] 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.[Footnote 19] 

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. 

[End of Background: Social Security and Economically Vulnerable Groups] 

Reform Options Have Been Proposed to Address Benefit Adequacy but also 
Affect Program Solvency and Administration: 

Various Social Security reform proposals include options intended to 
address concerns about benefit adequacy for vulnerable groups (see 
enclosure 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, low-income 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. 

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) 

[End of Reform Options Have Been Proposed to Address Benefit Adequacy 
but also Affect Program Solvency and Administration] 

Option: Guaranteeing a Minimum Benefit: 

Targeted Group: Lifetime low earners: 

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 
minimum- or 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.[Footnote 
20] 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 minimum-wage 
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. 
[Footnote 21] 

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 will be higher. Additionally, most of the 
options we reviewed set the benefit amount at some multiple of the 
poverty line.[Footnote 22] 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.[Footnote 23] 

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. 

[End of Option: Guaranteeing a Minimum Benefit] 

Option: Reducing Work Requirements for Eligibility: 

Targeted Group: 

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. 

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. 

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.[Footnote 24] 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 Provision[Footnote 25] with some 
modifications, could be applied to those benefits.[Footnote 26] 

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. 

[End of Option: Reducing Work Requirements for Eligibility] 

Option: Supplementing Benefits for Low-income Single Workers: 

Targeted Group: 

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. 

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. 

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.[Footnote 27] 

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. 

[End of Option: Supplementing Benefits for Low-income Single Workers] 

Option: Adopting Earnings Sharing: 

Targeted Group: 

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. 

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 single-earner 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. 

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 single-earner 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.[Footnote 28] 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. 

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. 

[End of Option: Adopting Earnings Sharing] 

Option: Reducing the Marriage Duration Required for Spousal Benefits: 

Targeted Group: 

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. 

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.[Footnote 29] 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. 

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.[Footnote 30] 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. 

[End of Option: Reducing the Marriage Duration Required for Spousal 
Benefits] 

Option: Providing Caregiver Credits: 

Targeted Group: 

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. 

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. 

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.[Footnote 31] 

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. 

[End of Option: Providing Caregiver Credits] 

Option: Increasing Survivor Benefits: 

Targeted Group: 

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 two-thirds 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. 

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. 

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.[Footnote 32] Benefit increases expected under this option 
could be negated by this provision. 

[End of Option: Increasing Survivor Benefits] 

Option: Providing Longevity Insurance: 

Targeted Group: 

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. 

What This Option Would Do: 

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. 

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.[Footnote 33] 

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. 

[End of Option: Providing Longevity Insurance] 

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 figure 2).[Footnote 34] 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: 

[Refer to PDF for image: pie-chart and horizontal bar graph] 

Percentage of those beneficiaries who did not receive SSI, Medicaid, 
or SNAP: 91%; 

Percentage of those beneficiaries who received SSI, Medicaid, and/or 
SNAP: 9%. 

Number of those Social Security Beneficiaries who also received SSI: 
461,198; 

Number of those Social Security Beneficiaries who also received 
Medicaid: 2,112,843. 

Number of those Social Security Beneficiaries who also received SNAP: 
988,042. 

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. 

[End of figure] 

[End of Benefit Adequacy Options Could Reduce Other Benefits for 
Vulnerable Groups, but Approaches to Mitigate These Effects Are 
Available Other Programs] 

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. 

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.[Footnote 35] 
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). 

Table 1: An Example of How SSI Eligibility Relates to an Individual’s 
Income: 

Social Security benefits: Less income disregard; 
$620: -20; 
$693: -20; 
$694: -20. 

Social Security benefits: Total countable income for SSI; 
$620: 600; 
$693: 673; 
$694: 674. 

SSI eligible? SSI benefits; 
$620: Yes; 74; 
$693: Yes; 1; 
$694: No; 0. 

SSI eligible? Total income; 
$620: $694; 
$693: $694; 
$694: $694. 

Source: GAO analysis of SNAP eligibility requirements. 

[End of table] 

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. 

[End of Other Programs: SSI] 

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. 

“Medically Needy”: 

The medically needy population incurs medical expenses such that their 
incomes, less those expenses, become low enough to qualify for 
Medicaid. 

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.[Footnote 36] 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 figure 3). 

Figure 3: Social Security Beneficiaries, Age 65 or Older, 
Participating in Medicaid, by SSI Status, 2007: 

[Refer to PDF for image: pie-chart] 

Received SSI benefits: 20.5%; 432,697; 
Did not receive SSI: 79.5%; 1,680,147. 

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

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

[End of figure] 

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.[Footnote 37] 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 cost-sharing to beneficiaries with incomes at or below 
100 percent of the federal poverty line.[Footnote 38] For individuals 
with higher incomes, states may vary in the amount of premium and cost 
sharing assistance they provide. 

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. 

While Social Security beneficiaries who lose Medicaid would still have 
Medicare coverage, some beneficiaries could still incur significant 
out-of-pocket health care expenses.[Footnote 39] 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. 

[End of Other Programs: Medicaid] 

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. 

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.[Footnote 40] 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 figure 4). 

Figure 4: Social Security Beneficiaries, Age 65 or Older, 
Participating in SNAP, by SSI Status, 2007: 

[Refer to PDF for image: pie-chart] 

Received SSI benefits: 19.4%; 191,505; 
Did not receive SSI: 80.6%; 796,537. 

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

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

[End of figure] 

SNAP’s eligibility rules are based on higher income limits than those 
of SSI, and SNAP limits vary by household size (see table 2).[Footnote 
41] 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.[Footnote 42] 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. 

Table 2: Fiscal Year 2010 SNAP Income Limits for Households with an 
Elderly Member: 

Size of household: One; 
Net monthly income: $903. 

Size of household: Two; 
Net monthly income: $1,215. 

Size of household: Three; 
Net monthly income: $1,526. 

Size of household: Four; 
Net monthly income: $1,838. 

Size of household: Five; 
Net monthly income: $2,150. 

Size of household: Six; 
Net monthly income: $2,461. 

Size of household: Seven; 
Net monthly income: $2,773. 

Size of household: Eight; 
Net monthly income: $3,085. 

Size of household: Additional members; 
Net monthly income: +$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. 

[End of table] 

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. 

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: 

Monthly net income: $500; 
(A) Maximum monthly SNAP allotment: 200; 
(B) Net monthly income multiplied by 30 percent: 150; 
SNAP benefits (A-B): 50; 
Total income: $550. 

Monthly net income: $600; 
(A) Maximum monthly SNAP allotment: 200; 
(B) Net monthly income multiplied by 30 percent: 180; 
SNAP benefits (A-B): 20; 
Total income: $620. 

Source: GAO analysis of SNAP eligibility requirements. 

[End of table] 

[End of Other Programs: SNAP] 

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-of-living adjustments.[Footnote 43] 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.[Footnote 44] 

* 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. 

[End of Steps Could Be Taken to Mitigate Potential Benefit Reductions] 

[End of section] 

Footnotes: 

[1] Kathleen Romig, Social Security Reform: Possible Effects on the 
Elderly Poor and Mitigation Options, (Congressional Research Service: 
2008). 

[2] See the bibliography (enclosure III) for a list of proposals that 
we reviewed. 

[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, [hyperlink, 
http://www.gao.gov/products/GAO-08-26] (Washington, D.C.: Oct. 26, 
2007). 

[4] GAO, Social Security: Criteria for Evaluating Social Security 
Reform Proposals, [hyperlink, 
http://www.gao.gov/products/GAO/T-HEHS-99-94] (Washington, D.C.: Mar. 
25, 1999). 

[5] GAO, Social Security Reform: Issues for Disability and Dependent 
Benefits, [hyperlink, http://www.gao.gov/products/GAO-08-26] 
(Washington, D.C.: Oct. 26, 2007). 

[6] GAO, Social Security: Criteria for Evaluating Social Security 
Reform Proposals, [hyperlink, 
http://www.gao.gov/products/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. 

[7] GAO, Social Security: Evaluating Reform Proposals, [hyperlink, 
http://www.gao.gov/products/GAO/AIMD/HEHS-00-29] (Washington, D.C.: 
Nov. 4, 1999). 

[8] 42 U.S.C. § 401 et seq. 

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

[10] 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). 

[11] GAO, Options for Social Security Reform, [hyperlink, 
http://www.gao.gov/products/GAO-05-649R] (Washington, D.C.: May 6, 
2005). 

[12] GAO, Social Security: Criteria for Evaluating Social Security 
Reform Proposals, [hyperlink, 
http://www.gao.gov/products/GAO/T-HEHS-99-94] (Washington, D.C.: Mar. 
25, 1999). 

[13] 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. 

[14] 42 U.S.C. § 1381 note. 

[15] There is also an earned income exclusion where $65 of earned 
income and one-half of any earnings above $65 are excluded. 

[16] An asset limit of $2,000 also applies where individuals above 
that level are generally ineligible. 

[17] 42 U.S.C. § 1901 et seq. 

[18] 7 U.S.C. § 2013. 

[19] Gross 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. 

[20] The “special minimum benefit” provision was added by the Social 
Security Amendments of 1972, 42 U.S.C. § 415(a)(1)(c)(i). 

[21] Other 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. 

[22] How 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. 

[23] This 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. 

[24] Andrew 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). 

[25] 42 U.S.C. § 415(a)(7). 

[26] The 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. 

[27] One 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). 

[28] Benefit 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). 

[29] According to the Census Bureau, the median duration of first 
marriages that ended in divorce was 8 years in 2001. 

[30] In 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, [hyperlink, 
http://www.gao.gov/products/GAO-08-105] (Washington, D.C.: Oct. 11, 
2007). 

[31] The credit would remain income tested if the parents are living 
apart. 

[32] 42 U.S.C. § 402(f)(2); (f)(3) and (q). 

[33] This proposal presents different options for implementing the 
increase, for example, adding the supplement to the cost-of-living 
adjustment each year. 

[34] For 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. 

[35] For 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. 

[36] Because not all states offer all eligibility pathways, an 
individual’s options for coverage may be affected by where he or she 
lives. 

[37] Medicare does not provide coverage for these services. 

[38] Beneficiaries must also have resources that are at or below an 
established level to qualify for this assistance. 

[39] In 2007, all Social Security beneficiaries age 65 and older 
received Medicare benefits. 

[40] California converted SNAP benefits to cash included in state 
supplementary payments. 

[41] Households 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. 

[42] Net income limits are higher in Alaska and Hawaii. In determining 
net income, households in all states are allowed to make certain 
deductions. 

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

[44] 42 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. 

[End of section] 

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