The federal Supplemental Security Income (SSI) program—administered by the Social Security Administration (SSA)—pays need-tested monthly cash benefits to adults and children with qualifying disabilities and to older adults, regardless of their disability status. As a need-tested program, SSI is available only to eligible individuals whose income and resources (i.e., assets) are at or below limits set in federal law. In December 2024, SSI made payments averaging $697 per month to roughly 7.4 million recipients, 1.0 million of which were children under age 18. In 2024, federal SSI payments to all recipients totaled approximately $63.1 billion, with about $10.3 billion being payments made to child recipients. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA, P.L. 104-193) made significant changes to disabled children’s eligibility for SSI. Before PRWORA, children were considered statutorily disabled for purposes of SSI if they had a medically determinable physical or mental impairment(s) of “comparable severity” to one that would disable an adult. The adult disability definition under SSI law is work-limiting, meaning that adults must have medically determinable impairments that prevent them from performing substantial work in order to be considered disabled for program purposes. Because children are not generally expected to work, SSA needed to determine—in its regulations and policies—how it would decide disability for children under the “comparable severity” definition in law. A series of legislative, regulatory, and judicial actions affecting the disability determination process for children in the 1980s and early- to mid-1990s contributed to the almost tripling of the SSI child caseload from 1990 to 1995 and an increased share of children qualifying for SSI payments based on mental impairments. PRWORA was enacted in 1996 in response to the growth in the child caseload and perception that children with non-severe disabilities were being awarded benefits. PRWORA made changes to the definition of disability and the disability determination process for children that tightened eligibility criteria for certain children relative to prior law. Among other changes, PRWORA replaced the “comparable severity” disability standard with a new statutory definition of disability for children. Under the now current law definition, children under 18 are considered disabled if they have severe medically determinable physical or mental impairments that result in “marked and severe functional limitations” and which can be expected to result in death or which have lasted or can be expected to last for a continuous period of not less than 12 months. Since PRWORA, there have not been major legislative developments in the SSI program for children. Despite a lack of major legislative changes affecting SSI for children after PRWORA, the size of the SSI child caseload has fluctuated noticeably since its enactment. The factors driving those fluctuations are not well understood. In recent years, a policy focus in the SSI program for children has been improving outcomes for youth entering adulthood (i.e., transition-age youth). Research has found that youth who receive SSI generally face challenges in adulthood—such as with employment, education, criminal justice system involvement, and independent living—whether or not they continue to receive SSI benefits. Past SSA demonstration projects have temporarily tested whether providing various employment and other support services to transition-age youth receiving SSI improves their employment and earnings outcomes and decreases their use of SSI benefits. These demonstrations have generally found some positive short-term effects of the tested interventions on the employment or earnings of participating youth, but have generally not found evidence that these interventions significantly reduced use of SSI benefits. There have also been proposals to simplify SSA’s work incentives and earnings rules to encourage work among transition-age youth or to allow SSA to make direct referrals of these youth to state vocational rehabilitation agencies. Another issue that has received attention from policymakers is the scope and goals of the SSI program for children. Current SSI law does not include a statement of the purpose of the SSI program for children. The lack of such a statement makes it challenging to assess whether the program is currently serving children with disabilities effectively. Over the years, researchers and policymakers have offered a number of potential purposes of the SSI program for children, such as covering the extra costs of caring for a child with a disability, compensating for lost family income because one or both parents reduced their work activity to care for their child with a disability, and meeting the child’s basic needs for food, clothing, and shelter. There have been recommendations for Congress to provide an explicit statement of the purpose of the SSI program for children to ensure that the program is meeting its intended goals.
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