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Examining Trump Administration Aims To Change Disability Benefits


What does the president want to do to disability benefits in America? The administration budget proposes changes in requirements to go on disability. This affects a lot of people across the country, so let's check the facts and the implications of something we heard on this program this week. White House budget director Russell Vought said there is a chance to save money on disability.


RUSSELL VOUGHT: There's about $7 billion in improper payments in the program, so we obviously want to root those out. But in general, we want to get people back to work in the labor force. Right now, the inability to speak English is a qualifying factor that allow you to get disability. We think that's not how the program was meant to work. And so that's an example of one of the reforms that we have within the disability program.

INSKEEP: So much to dig into there, and NPR's Selena Simmons-Duffin is in our studios to help us do that. Good morning.


INSKEEP: First, $7 billion in improper payments - is that much money available to be saved?

SIMMONS-DUFFIN: Well, I asked OMB for the source of that figure, and they sent me a report that shows the $7 billion in improper payments across disability programs in fiscal year 2018. But here is an important point. That is out of hundreds of billions in payments to beneficiaries. OMB puts the rate of improper payments at about 4%. Other estimates say it's closer to 1%. That is decimal dust, according to a source I talked to about this.

And another important point - Vought says root out, but most of these improper payments are because of inefficiencies or administrative issues, not because of fraud, people trying to game the system in some way.

INSKEEP: OK. First, decimal dust is a phrase...


INSKEEP: ...I'm going to save for later.


INSKEEP: Thank you very much. I appreciate that. Second, he said the thing about speaking English - that if you don't speak English, well, you can get disability. And he didn't seem - the president doesn't seem to like that. Is that correct?

SIMMONS-DUFFIN: Kind of. You cannot get disability benefits just because you don't speak English. You have to first have a serious medical condition that prevents you from working. If you do, language skills might be considered, along with other things like age and education level. The thinking is, say you have a physical condition and can't do manual labor, for instance, but you could work in a desk job. You don't have the education or work experience or language skills to do that. All of that might be taken into consideration.

INSKEEP: Although, if we're talking about language, it sounds like a measure here to target immigrants. But it sounds like that's not necessarily what's going on here. This is not - it's not just about immigrants claiming disability per se.

SIMMONS-DUFFIN: Right. It's part of this really complex grid of considerations. And the Trump administration tells me it's close to finalizing a new regulation to remove that consideration out of the grid. And some experts I talked to said that that process does need to be modernized, but English language consideration would not be the place they would start. It's a pretty small piece of the pie.

INSKEEP: OK. Russell Vought also said that the administration wants to ask people much more often if they really are qualified for disability. Let's hear that.


VOUGHT: We want to have ongoing disability reviews. Instead of having a disability review every seven years, we want you to have it every two or three years.

INSKEEP: What's the story there?

SIMMONS-DUFFIN: OK. Part of what he's saying is not quite right. Seven years is the very outer limit between what are called continuing disability reviews. This is for people who have really serious conditions like an intellectual disability. Down syndrome might be an example. There is a recent proposal from the Trump administration on this, but it would not change reviews from seven years to two years. It would make some other changes to the frequency of these reviews.

These changes aren't final yet, but disability advocates have been sounding the alarm. And some people told me that the frequency is not the issue; it's that there isn't enough staffing or funding for these field offices. That's where they would start.

INSKEEP: Oh, in order to actually check up on people regardless of the timeline.


INSKEEP: Selena, thanks so much for coming by.


INSKEEP: NPR's Selena Simmons-Duffin checking some facts here, adding some context.

(SOUNDBITE OF TUNNELVISIONS' "GOBI") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Selena Simmons-Duffin reports on health policy for NPR.