Disability policy in the U. S. : current challenges and future opportunities
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Nearly a quarter of a century after the passage of the Americans with Disabilities Act (ADA), people with disabilities remain severely under-employed. All the while, they command a disproportionate share of public monies through Social Security Disability Insurance (SSDI), and Supplemental Security Income (SSI). This report seeks to contribute to the conversation on current disability policy, as well as offer short-, mid-, and long-term solutions. The document opens with a history of the Social Security Administration (SSA), the federal agency responsible for setting national disability policy. This is followed by a discussion of SSA’s primary categories of client support: health care and employment initiatives. The health section details the medical coverage attached to both SSDI and SSI, with a particular focus on the Affordable Care Act (ACA). Next is a review of work incentives offered to SSDI/SSI beneficiaries. Concluding this chapter is an investigation of the causes of under-employment that continue to plague the disabled circle, in spite of these many interventions. The study continues by exploring various issues affecting today’s U.S. disability policy. These include both exogenous and endogenous factors, including the growth of SSDI and SSI; the structural issues inherent to the current paradigm, as well as a number of disincentives to employment. The analysis then turns to disability policy in the international community. Of particular interest are the experiences of Sweden and the Netherlands as they established fiscally sound policy while assisting the nation’s disabled. From these case studies emerge several lessons pertinent to the U.S. This chapter closes with a thorough analysis of these European nations’ responses to their ever-growing disability programs, and the implications for disability policy makers and advocates. Concluding the report are several recommendations that can guide policy makers and advocates as they strive to place the disability community on the path to self-sufficiency. Most relevant and promising to the U.S. are the passage of the ABLE Act, instituting a national Medicaid Buy-In, and establishing a central disability agency. With successful implementation of these reforms, American with disabilities can potentially finally realize what the ADA promised 25 years ago.