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Loss of Affordable Care Act May Grow SSDI Backlog

With promises by the new president to scrap the Affordable Care Act, also known as “Obamacare,” there is a high likelihood that the number of people seeking Social Security Disability Insurance benefits will grow at an even higher rate than they would otherwise.doctor

It is true that the number of people receiving SSDI increased from 2.5 percent of Americans in 1990 to 5 percent in 2015. However, there are several reasons for that, among them the fact there are more women in the workforce and also older workers who are living longer but are more likely to suffer long-term disability.

But the ACA had two main provisions that helped to reduce the rolls to less than what they would otherwise be. One of those was the provision that forbid insurers from refusing customers on the basis of pre-existing conditions or charging them higher rates. The second provision allowed those with a low income to receive lower premiums.

Historically, people with no insurance – and no way to get it – would apply for disability just so they could have their necessary medical bills covered. The ACA took care of that even with those two provisions.

However, now that the ACA is on the chopping blog, it’s plausible we’re going to see many more people applying. The SSDI backlog could be even more greatly exacerbated by the fact that this current administration seeks to slash the SSA department as a whole, even at a time when the agency had planned to ask for an additional 200-plus administrative law judges to help ease the existing caseload.

The benefit of the ACA for individuals was outlined recently in a New York Times Sunday Review essay.

A man wrote about how she suffered a debilitating brain injury at the age of 18. He spent a month in a coma, had health insurance as he battled her way through rehabilitation, earned her degree, got a job and became a homeowner and a husband.

Things were going great – until suddenly, they weren’t. is headaches were back. He started having tremors. His short-term memory was getting worse. He visited a neurologist, who informed him he likely had Parkinson’s disease. He continued for a little while to work full-time, but eventually, his doctors advised him to leave his work. He was devastated – not just emotionally, but financially.

He applied for SSDI benefits ad received them relatively quickly after applying, about one month. However, his Cobra was $1,300 monthly and consumed his disability paychecks. He feared bankruptcy and loss of his home.

But then, he applied for a plan through the ACA exchange. Instead of paying $1,300 a month, he would pay $450 a month. It was still expensive, but at least manageable. Whereas medications and therapy for his symptoms – including dementia – would normally be about $900 monthly, they are $130 a month under the ACA. Without the ACA, he explained, he will lose the capacity to function cognitively and emotionally. He will likely soon be placed in a nursing home, which is ultimately going to cost the government much more. Without ACA coverage, he explained, his condition will rapidly decline.

This is an extreme case, and plaintiff likely would have needed to quit his job and seek disability payments regardless. Still, there are many others who, with appropriate preventative care made possible through the ACA, will not need to go on disability or can substantially delay it.

There are always merits to health reform as no system is perfect. However, cutting ACA without any other system in place is likely to increase SSDI applications.

If you or a loved one is seeking Social Security Disability Insurance in Boston, call for a free and confidential appointment at 1-888-367-2900.

Additional Resources:

Without Obamacare, I Will Get Sicker, Faster, Until I Die, Jan. 14, 2017, By Cameron Zeigler, The New York Times

More Blog Entries:

Over 1 Million Wait for Social Security Disability Benefits, Feb.  9, 2017, Boston SSDI Attorney Blog