What the Washington Post Missed on Disability

Yesterday, the Washington Post ran a story titled “Disabled or just desperate?” that painted a bleak picture of rural America. But rather than digging into what’s driving widespread unemployment and poor health in struggling rural counties, the article cherry-picks one of the counties with the highest rates of disability benefit receipt, to create a dystopian portrait where Social Security disability benefits represent out-of-control government spending riddled with rampant abuse.

Reality looks quite a bit different. As Shawn Fremstad and I have pointed out time and again, Social Security disability benefits are incredibly hard to get—fewer than 4 in 10 applicants are approved, even after all stages of appeal. To qualify for benefits, you must have one or more medically determinable physical or mental impairments expected to last at least 12 months, or to result in death. And many recipients do, in fact, die: 1 in 5 male and 1 in 6 female Social Security Disability Insurance (SSDI) beneficiaries die within 5 years of receiving benefits.

But having a disability alone is not enough to qualify for benefits. You also have to prove that your impairment, or combination of impairments, leave you unable to do any job that exists in significant numbers in the national economy at a level where you could earn even $11,070 per year.

According to the Organisation for Economic Development, the United States has the most restrictive—and least generous—disability benefit system of all OECD member countries, apart from Korea. While some unemployed workers—like Desmond Spencer, whom the article profiles—may apply for disability benefits out of desperation as the article’s headline suggests, they’ll be left empty-handed if they don’t meet Social Security’s strict eligibility criteria. Consider the recent economic downturn. Application rates increased as unemployment rose, but approval rates dropped significantly as people who didn’t qualify were denied benefits. It’s also worth noting that the Post focuses on Spencer’s decision to apply for disability benefits—but ends there. What we’re not shown is him being denied, if and when he’s found not disabled enough to qualify.

The Post sidesteps the eligibility requirements for SSDI, and focuses on the recent increase in the number of people receiving benefits. But as the agency’s chief actuary has explained—and in fact predicted decades ago—the growth is mostly due to baby boomers aging into their high-disability years, women entering the workforce in greater numbers in the 1970s and 1980s (so now we are insured under Social Security in case of disability at nearly the same rates as men), and population growth. In fact, these three factors alone explain more than 90 percent of the increase in beneficiaries between 1970 and 2008.

Notably, the program’s growth has leveled off, slowing to its lowest rate in a quarter-century. It is projected to decline further in the coming years, as the baby boomers retire (a fact left out entirely by the Post).

Because of misleading media coverage, people are more familiar with myths than they are with the facts.

Make no mistake, the Post’s article highlights a very real set of problems that call out for policymakers’ attention. For starters, the high rates of unemployment and pervasive economic hardship that plague rural communities, many of whose residents voted for Donald Trump in hopes that he would save or bring back their jobs. Then there is widespread lack of health insurance in rural areas. Spencer reports seeing his health decline following an injury he suffered on the job because “he’d never had health insurance.” It’s not a coincidence that he lives in Beaverton, Alabama—one of the states still refusing to expand Medicaid under the Affordable Care Act.

And third, there are the employment barriers many people with disabilities continue to face more than 25 years after the Americans with Disabilities Act was signed into law. They range from outright discrimination; to lack of affordable, accessible housing and transportation; to policies that allow disabled workers to be paid less than minimum wage. These inequities scream out for policies that would give workers with disabilities a fair shot, rather than blaming the lifeboat for the flood.

Unfortunately, the Washington Post’s storyline—long pushed by conservative critics of Social Security—has been a favorite of many in the media going back several years. Notably, NPR ran similar reporting back in 2012, which was widely debunked—including by a bipartisan group of eight former Social Security commissioners who teamed up to write an open letter correcting the record.  But in large part because of misleading media coverage, many people are more familiar with myths about Social Security disability benefits—and beneficiaries—than they are with the facts.

This puts the people who rely on SSDI’s modest benefits at serious risk. While Trump has pledged not to cut Social Security, his budget director Mick Mulvaney has hardly been quiet about his intention to target Social Security Disability Insurance for cuts, portraying disability beneficiaries as less deserving than retirees.

Misleading media accounts that have made the disability beneficiary into the modern day “welfare queen” risk giving him cover to do just that.

Correction: The article originally stated that Lamar county is tied for the highest rate of disability benefit receipt. It is in the top 5% of the rural counties that the Washington Post analyzed. 



The Labor Secretary Nominee Promised to Defer to Trump. That’s a Problem for Workers.

Last week’s political news was dominated by the stunning failure of congressional Republicans’ health care bill. The resulting chaos will ultimately preserve health insurance for 24 million Americans, but it allowed the March 22 confirmation hearing for Alexander Acosta, President Trump’s second choice to lead the Labor Department, to slide by unnoticed.

In a party-line vote, the Senate Committee on Health, Education, Labor, and Pensions advanced Acosta’s nomination today, putting 160 million American workers one step closer to having a protector-in-chief whose views are largely unknown. During his hearing, Acosta fought to keep his opinions concealed. He repeatedly dodged questions about the department’s most significant recent activities, including updating overtime rules, reducing exposure to deadly silica dust, and requiring retirement advisers to act in their clients’ best interest.

But, despite his relative silence on labor issues, Acosta’s past has a giant red flag.

From 2003 to 2005, when Acosta was leading the Civil Rights Division of George W. Bush’s Department of Justice, the division became intensely politicized. An investigation by the Office of the Inspector General found the division violated federal law and DOJ policy by conducting hiring based on candidates’ political and ideological affiliations. Although the report did not find Acosta directly responsible for illegal behavior, former DOJ employee Kristen Clark wrote, “This egregious conduct played out under Acosta’s watch and the Inspector General found that, despite the special litigation section chief informing Acosta of the wrongdoing, Acosta failed to take sufficient action to address the illegal and unprofessional actions.”

Acosta used his authority to push the administration’s agenda.

Acosta’s worrisome record doesn’t end with turning a blind eye to illegal activity. During his tenure at DOJ, Acosta himself was accused of partisan meddling. Just days before the 2004 presidential election, Ohio Republicans challenged and purged the voter registration of thousands of mostly African-American voters through a practice known as “voter caging.” When the case was challenged in federal court, Acosta took the unusual step of sending a letter to the court claiming that the purge was allowed under the Voting Rights Act. Typically, federal agency chiefs go out of their way not to influence elections—but if this behavior sounds like déjà vu, you can thank FBI Director James Comey.

In other words, when the interests of the Bush administration—which favored restrictions on voting rights—conflicted with his responsibility as a civil rights chief, it appears Acosta chose to use his authority to push the administration’s agenda.

And if he is confirmed as labor secretary, Acosta will once again be tasked with protecting a marginalized group of Americans—workers. One of his first tasks will be deciding whether he will enforce a spate of new rules that are designed to protect workers, passed during the end of the Obama administration. The rules themselves are straightforward: companies would have to disclose worker exposure to a cancer-causing dust often found in construction, federal contractors would have to disclose labor law violations, and employers would have to pay overtime to additional eligible workers.  But in some cases, Trump has already criticized them.

If his previous actions are any guide, Acosta will likely place partisan loyalty above enforcement of his agency’s mission. And when he repeated during last week’s hearing that he’d defer to Trump as the “boss,” he gave little assurance that he won’t place ideology above the labor rights and civil rights of working Americans.



We Already Have the Path Through Trump’s America

Late last month, the White House invited leaders from the Historically Black Colleges and Universities (HBCUs) to participate in a listening session and to meet with President Trump, Vice President Pence, and Secretary of Education Betsy DeVos.  The group talked about improving education, school infrastructure, collaborations with private industry, and jobs for HBCU students.

Days after the meeting, Morehouse College President John Wilson described its tone as “troubling.” He noted that President Trump’s promises to “do more for HBCUs than any other president has done before” were impossible to measure, and Secretary DeVos’s reference to HBCUs as “pioneers of school choice” showed willful ignorance of Jim Crow and segregation.

It was just the latest insult in a month that began with Trump using the legacy of Martin Luther King, Jr. to attack the media—rather than mention any of King’s accomplishments—saying:

Last month, we celebrated the life of Reverend Martin Luther King, Jr., whose incredible example is unique in American history. You read all about Dr. Martin Luther King a week ago when somebody said I took the statue out of my office. It turned out that that was fake news. Fake news. […] I think it was a disgrace, but that’s the way the press is. Very unfortunate.

These examples highlight a persistent moral awkwardness afflicting the Trump administration.  The yawning gap between President Trump and the leader he was almost honoring (who was a graduate of an Atlanta HBCU, Morehouse College), doesn’t just make the two men seem at odds. It calls for a reassessment of the road that lies ahead.

In 1967, King delivered a powerful speech calling racism, economic exploitation, and militarism “triple evils.” He said a society where machines, profit motives, and property rights are considered more important than people required a revolutionary shift in values—one that questioned past and present policies, and looked glaringly at the contrasts between poverty and wealth.

During his campaign for the U.S. presidency, Donald Trump stood on the platform of the “triple evils” that King condemned. Trump espoused populist contempt for traditional political elites, promoted authoritarian views of crime and justice, and launched xenophobic, racist, and misogynistic attacks that the media amplified. Trump’s statements are not pithy one-offs—they are rank hallmarks of his deeply-held views.

King would not have been sanguine about this.

As a private businessman, Trump was responsible for a laundry list of highly-public positions that are both racist and dangerous. In 1973, the Department of Justice filed a civil rights case against Trump charging him with discriminating against African Americans who applied to rent apartments in buildings Trump owned. In 1989, Trump spent $85,000 for a full-page ad calling for “murderers and muggers to be forced to suffer and to be executed when they kill” after five black and Hispanic teenagers were accused of raping and beating a white woman in Central Park. Though all five men they were proven innocent, Trump has never apologized and has maintained that the five men must be guilty. Then in 1991, Trump’s Plaza casino and hotel was fined $200,000 by the New Jersey Casino Control Commission because the casino’s manager regularly removed African-American card dealers at the request of certain affluent gamblers, and ordered all black staff off the floor when Trump and came into the casino.

Now, after just one month in office, we are witnessing the policy implications of a demagogue who becomes commander-in-chief.

Trump has already attempted to sever health care access for millions of Americans, cleared the path for the Dakota Access Pipelines, ordered the construction of a border wall with Mexico, vowed to punish “sanctuary cities,”  issued two executive orders to temporarily ban travel from several majority Muslim countries, and issued three other executive orders granting more authority to local and federal police. These early policies are reflective of the profit-driven, racist, militaristic ideals that characterize oppression.

King would not have been complicit or sanguine about this.

In 1961, King declined an invitation to John F. Kennedy’s inauguration, even though Kennedy had lobbied for King’s release from an Atlanta jail months prior.  King’s self-imposed absence from Kennedy’s inauguration was strategic—he was unwilling to let Kennedy (or anyone else) paternalistically set or dictate the tone and timetable for civil rights.

Many so-called leaders, who have rushed to sit at the table Trump has laid, could take a lesson from Dr. King.

King used his absence to help nudge Kennedy to take a firmer stance on civil rights. Weeks after the inauguration, King wrote to Kennedy outlining how the new president could use the power of his office to end racial discrimination.  King’s stance is critical for us as women, men, workers, mothers, fathers, and LGBTQ people reckoning with our lives in Trumpland.

By example, King showed us what it looks like to preach, march, teach, sit-in, and push the media to tell the truth.

King’s dream did not envision accepting status quo militarism, racism, violence, or economic exploitation. King’s dream did not envision handing out socks, food, and toiletries as the endgame. King’s dream showed us what is possible, if we forge ahead with mutuality, community, respect, and love.

King’s dream gave us a roadmap through Trumpland.

Correction: This article originally misstated the crime that the Central Park Five were charged with. 



3 People Explain How Last-Minute Medicaid Changes Make the GOP Health Care Bill Even Crueler

After seven years of demanding the repeal of the Affordable Care Act (ACA), House Republicans have reached their moment of truth. They have slapped together a bill to replace the law—the American Health Care Act (ACHA)—and President Trump is demanding that the House pass the bill today, or he will move on and leave the ACA in place.

That leaves House leaders in a tight spot, since their bill is deeply unpopular with lawmakers and voters. Late Wednesday night, in an effort to gain support from the ultra-conservative House Freedom Caucus, they added new provisions that make the bill’s Medicaid cuts—which already slashed the program by $880 billion—even more extreme.

The “manager’s amendment” includes a provision that encourages states to impose work requirements on adults who receive Medicaid. In theory, the provision ensures that “able-bodied adults” who receive Medicaid benefits are either working or looking for work. But in reality, this amendment could take health insurance away from Americans with disabilities or serious illnesses, and even new moms experiencing complications from childbirth—stripping them of the health care that would enable them to return to work.

Here are three Americans who would be at risk of losing needed coverage under House leaders’ latest proposal:

Robin Conrad — Center Ossippee, New Hampshire

In 2012, Robin was laid off and lost her health insurance. She went without health insurance while she worked temp jobs, until she was hired full-time nearly two years later. In 2015, she was diagnosed with Stage 4 metastatic breast cancer and was eventually forced to take long-term disability leave. Her employer terminated her job—and her health insurance—when she still had pressing health care needs.

Robin can get the medication she needs because she’s covered by the ACA’s Medicaid expansion. She noted that without it, “I probably would not have been able to get coverage even if I could afford it, because my situation would have been considered a pre-existing condition.”

Sarah Borgstede — Belleville, IL

Sarah was married and was unemployed when she became a new mom.  She and her husband decided that she should stay home with their baby boy, so that they wouldn’t have to worry about paying for child care.  Her husband continued working as a musician and a teacher, but neither job offered insurance—he either purchased private insurance went without it entirely.

Sarah’s husband passed away when he was just 28, after a long battle with sepsis. Sarah says that if she been forced to look for work within 60 days of having a child—like the new Medicaid work requirements demand—she would have needed to work full-time just to afford child care, while her husband continued working 80 hours a week to cover the rest of the bills. Then, Sarah says, “my son would have grown up without both of his parents.”

Ericka McClung — Clendenin, West Virginia

Six weeks after she qualified for Medicaid coverage under the ACA, Ericka found out she had Stage 3 breast cancer.  After chemotherapy, radiation, and a double mastectomy she’s now cancer free, but she needs to continue hormone treatments for another eight years.

“If the cancer came back I could never afford the treatments,” Ericka says. “My whole entire family put together could not afford my treatments.”



The Republican Health Care Plan Is Already Making People Sick

Thursday afternoon, the House of Representatives is scheduled to vote on the American Health Care Act—the Trump-era response to Obama’s Affordable Care Act. The vote is close, and a lot of the political news this week has focused on the last-minute deals and old-fashioned salesmanship that Schoolhouse Rock forgot to mention when it taught us how a bill becomes a law.

So far the debate on Capitol Hill—unlike the conversations taking place in town halls—has been abstract and detached. But for the millions of Americans living with the uncertainty and inevitable consequences of these decisions, these numbers are deeply personal. Congress is arguing about their health, and the stress of it all is making them sick.

Alaskan small-business owners Colleen Mondor and her husband, Ward, are two of the 24 million Americans who stand to lose coverage if the new bill passes. They have not had a single night of uninterrupted sleep since 2005—that’s when their then-3-year-old son was diagnosed with a rare form of Type 1 diabetes that requires them to wake up to check his blood sugar.

Colleen and Ward are both cancer survivors, and before the Affordable Care Act they got their insurance through a $1,000 per month high-risk pool that required them to pay $10,000 out-of-pocket before their coverage kicked in. They have the coverage they need now, but the years of fighting to get and stay insured has taken a physical toll on their health.

“Luckily, nothing bad like the return of cancer, but we both experience intense, hallucinatory migraines and severe exhaustion,” Colleen says. “I think about stress all the time… I never thought as much about insurance before but now feel dread and a sick feeling in my stomach every year when we receive the letter to re-enroll. Until you face the threat of losing or not being able to get quality insurance, you just don’t know.”

The Republicans’ new health care bill will usher in insurance plans that will cost more but cover less, forcing millions of Americans to choose between the care they can afford and the care they need. When a family lacks the security of quality health insurance, it too often leads to greater financial burdens, instability, and increased stress levels that produce poorer health outcomes. That will add to the strain of an already stressed-out nation, jeopardizing the health and well-being of folks who can least afford to be sick.

Though its toll is often poorly recognized and underestimated, the cumulative wear and tear of stress leads to an increased risk of illnesses like high blood pressure, depression, and heart disease. It even accelerates aging and may cause premature death. That’s compounded by any unhealthy, inadequate coping habits, like smoking or substance abuse, which make the harmful effects even worse.

Source: HeartMath (2015)
Source: HeartMath (2015)

As the gap between the rich and the poor continues to widen, individuals and families struggling to maintain financial security are being exposed to unprecedented stress levels, and the impact is grave. People of color and individuals struggling with poverty, who bear the brunt of the growing inequality, are also absorbing the impact of the deadly stress that comes with it.


President Trump and the Republican-controlled Congress are pushing a health care plan that casts millions of already chronically-stressed Americans—like Colleen Mondor and her family—into an even more dire state of anxiety as they struggle to find new coverage (let alone good, affordable insurance). But right now, the House of Representatives has a choice: They can move forward with their destructive health care law, or they can reject it and develop a plan that doesn’t threaten the health care—and actual, physical health—of millions of people.

As for Colleen, she’s also hoping for something that should have been present all along.

“Empathy is the major missing component in this conversation,” she says. “I always say: you are fifteen minutes away from being me.”