Date: February 2, 1996
PROVISIONS OF THE BALANCED BUDGET ACT OF 1995 (H.R. 2491)
AS VETOED BY THE PRESIDENT ON DECEMBER 6, 1995
On December 6, 1995, the President vetoed H.R. 2491, the Balanced Budget Act of 1995. This legislation included the following provisions of interest to SSA:
SUPPLEMENTAL SECURITY INCOME DISABILITY-RELATED PROVlSIONS
SSI Benefits for Individuals Disabled by Drug Addiction or Alcoholism (DAA)
- Would prohibit SSI eligibility, including cash SSI benefits and Medicaid coverage, to individuals whose DAA is a contributing factor material to a finding that they are disabled.
Would require SSA to notify affected SSI DAA recipients within 90 days of enactment. If such an individual reapplies for benefits within 120 days of enactment. SSA would be required to complete a redetermination of their eligibility not later than January 1, 1997.
Would be effective upon enactment for new applicants for benefits.
Would continue until January 1997 SSI eligibility for recipients on the rolls as of enactment.
- Would require that SSI disability benefits be paid to a representative payee if SSA determines that such payment would be in the best interest of the disabled individual because he/she has a DAA condition that prevents him/her from managing such benefits. Such individuals would be referred to the appropriate State agency administe ring a substance abuse treatment program under the Public Health Service Act.
Would be effective upon enactment for new applicants for benefits.
For recipients on the rolls on enactment date, would be applicable on and after the date of such recipient's first continuing disability review occurring after enacunent date.
For SSI disability recipients who have attained age 65, would be applicable in such manner as determined appropriate by the Commissioner.
- Would also provide $50 million in each of fiscal years 1997 and 1998 to supplement other funds appropriated for State and Tribal substance abuse programs funded under the Public Health Service Act.
SSI Eligibility Based on Childhood Disability
- Would eliminate the comparable severity standard and provide, instead, a new statutory definition of childhood disability.
This definition would provide that a child under age 18 would be considered under a disability if he/she has a medically determinable physical or mental impairment which results in marked and severe functional limitations and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
- Would direct SSA to discontinue the use of an individualized functional assessment in evaluating disability in individuals under age 18.
- Would also direct SSA to eliminate references to maladaptive behavior in the domain of personal/behavioral function in sections 112.00C.2. and 112.02B.2.c.(2) of the Listing of Impairments.
- Would provide that the amount of the SSI benefit payable to a child who is determined to be disabled would be based on newly developed criteria related to the need for personal assistance . Children who meet the following criteria would receive 100 percent of the SSI benefi t amount prov ided by current law:
For a child under age 6 - such individual has a medical impairment that severely limits hislh er ability to function in an age-appropriate manner and who without special personal assistance would require specialized care outside the individual's home; or
For a child age 6 or older - such individual requires personal care assistance with (I) at least two activities of daily living : (2) continual 24-hour supervision or monitoring to avoid causing injury or harm to self or others; or (3) the administration of medical treatment; and who without such assistance would require full-time or part-time specialized
care outside the individual's home.
All other disabled children would receive 75 percent of the SSI benefit amount provided by current law.
- Except as noted, would be effective--
- for new applicants for months beginning on or after the date of enactment; and
- January 1, I997, for SSI childhood disability recipients who are eligible for SSI benefits on the date of enactment. (SSA would be required to notify individu als whose eligibility would be affected by these amendments within 90 days of enactment and to redetermine the eligibility of these individuals with in one year of enactrnent.)
The two-tiered benefit payment system would be effective January 1, 1997, for new applicants and current recipients.
- Would require SSA to issue necessary regulations within two months and to submit for review to the Senate Committee on Finance and the House Committee on Ways and Means any final regulation. with supporting documents, pertaining to the eligibility for SSI benefits of individuals under the age of 18, at least 45 days before the effective date of such regulation.
- Would provide 5300 million for SSA to use only for SSI CDRs and redeterminations with reviews and redeterminations of children affected by the provisions dealing with maladaptive behavior and the individualized functional assessment given the highest priority.
Eligibility Redeterminations and Continuing Disability Reviews
- Would require SSA to conduct continuing disability reviews (CDRs) at least once every three years for SSI childhood disability recipients with nonpermanent impairments and would require SSA to review the continuing disability of a child whose low birth weight is a contributing factor material to the finding of hislher disability within 12 months of the child's birth. At the time of such review, the representative payee would be required to present evidence demonstrating that the child is and has been receiving appropriate treatment for hislher disability. If the representative payee refuses, without good cause, to comply with this requirement, the SSA would be requi red to terminate the payment of benefits to the representative payee if it is in the best interest of the recipient.
- Would require SSA to redetermine the eligibility of SSI recipients, under the adult criteria, during the one year period following their attainment of age 18.
- Would be effective with respect to benefits for months beginning on or after enactment date.
OTHER SSI-RELATED PROVISIONS
Receipt of Benefits in Two or More States
Would prohibit SSI eligibility for 10 years for individuals who have been
convicted in a State or Federal court of having fraudulently misrepresented their
State of residence in order to receive SSI, AFDC, Medicaid, or food stamp
benefits simultaneously from two or more States. Effective upon enactment.
Fugitive Felons and Parole and Probation Violations
Would prohibit SSI eligibility for fugitive felons and parole and probation violators and require SSA to provide to law enforcement personnel, upon their request, the addres ses of SSI recipients who are fleeing to avoid prosecution, custody. or confinement, arc involved in parole or probation violations, or have information related ,to official law enforcement activities. Effective upon enactnent.
Payments for SSI-Eligible Children in Medical Facilities
Would provide that individuals who are unde r age 18 and who are in a medical facility and whose care is being paid for through private insurance would be eligible for an SSI benefit of up to $30 a month.
Delay in Child's Eligibility for SSI
- Would provide that, in the case of parents who disposed of their assets or their child 's assets (or a guardian who disposed of his ward's assets) within 36 months of the child 's application for SSI benefits, the child's eligibility for benefits will be delayed for a number of months equal to the compensated value of the divested resource divided by the SSI Federal benefit rate.
An individual shall be considered to have established a trust if any of his or her assets are placed in a trust. In the case of a revocable trust, all assets in the trust shall be considered assets of the individual. In the case of an irrevocable trust, any portion of the trust that could be made available to, or used for, the benefit of the individual shall be considered to be an asset of the individual.
The disposal of assets provision would become effective with respect to the transfer of resources for less than fair market value that occur at least 90 days after the date of enactment. The trust provision would become effective January I , 1996 and shall apply to trusts established on or after such date.
Additional Accountability Requirement for Pawes of SSI Beneficiaries
- Would provide that a representative payee must pay any lump-sum payment for
the benefit of an SSI-eligible child into a dedicated savings account that could
only be used for:
- education and job skills training;
- personal needs assistance;
- medical treatment;
- special equipment or housing modification;
- therapy and rehabilitation; or,
- any other item or service deemed appropriate by the Commissioner.
Funds contained in, and interest earned on, such account would be excluded from the determination of the individual's resources under SSI. Would provide penalties for misuse of the funds. Effective with respect to payments made after the date of enactment.
Limited EIigibility of Noncitizens for SSI Benefits
- Would provide generally that noncitizens would be ineligible for SSI, with the
following exceptions for those lawfully present in the United States who are:
- refugees under section 207 of the Immigration and Nationality Act (INA) during the first 5 years after their arrival in the United States,
- asylees under section 208 of the INA during the first 5 years after the date asylum was granted, or
- entrants whose deportations have been withheld under section 243(h) of the INA during the first 5 years after deportation was withheld,
- lawfully admitted for permanent residence who are credited with 40 qualifying quarters of coverage and did not receive Federal means-tested benefi ts during any of these quarters (noncitizen spouses and ch ildren can meet the work requirement if their spouse or parent has worked for 40 quarters);
- active duty United States military personnel or honorably discharged veterans who were and their spouses and unmarried dependent children.
Effective upon enactment for new applicants. The SSI eligibility of noncitizens on the rolls at the time of enactment who do not meet one of the exceptions would continue until January 1, 1997.
- Would require Federal agencies administering programs affected by these changes in noncitizen's eligibility to provide general netification to the public and program recipients about these eligibility changes. In addition, requires individual notification to all currently eligible noncitizens affected by the provision within 90 days after the date of enactment. Noncitizens who want to reapply for benefits after receiving notification would have to do so within 4 months after enactment, and the Commissioner would be requ ired to make a determinat ion of their eligibility within 1 year after enactment.
Deeming of Sponsor's Income and Resources
- Would require that the income and resources of a noncitizen shall be deemed to include all the income and resources of sponsors who execute new, legally binding affidavits of support (including the income and resources of their spouses) until the noncitizen is naturalized.
Would be effe ctive for applic ations filed on or after the date of enactment by noncitizens whose entry into the United States is based on a legally enforceable affidavit of support.
Affidavits of Support
- Would make the sponsorship affidavit of support legally enforceable by the
Federal, State. or local government that provides means-tested
suppon--including SSI--to an alien for a period of 10 years after the alien last receives benefits.
Would require the Federal, State, or local government that provided assistance to the alien to request reimbursement from the sponsor. If the sponsor does not respond or refuses to abide by repayment plans, the government entity may take legal action against the sponsor.
The Secretary of State would be required to formulate the new affidavit of support ' no later than 90 days after the date of enactment and the new affidavit and associated liabilities placed on sponsors are effect ive no later than 90 days after its formulation.
OTHER PROVISIONS OF INTEREST
Expansion of the Federal Parent Locator Service
- Requires HHS to trans mit to SSA, for ver ification purposes, certain information about individual s and employe rs maintained under the Federal Parent Locator Service. SSA would be required to verify the accuracy of, correct, or supply to the extent possible, and report to HHS the name, SSN, and birth date of individuals and the employer identification number of employers. SSA would be reimbursed by HHS for the cost of this verification service.
Collection and Use of SSNs for Use in Child Support Enforcement
- Provides that State child support enforcement procedures would have to require that the SSN of any applicant for a professional license, commercial driver's license, occupational license, or marriage license be recorded on the application. The SSN of any person subject to a divorce decree, support order, or paternity determination or acknowledgement would have to be placed in the pertinent records. SSN' s would also have to be recorded on death certificates.
Prohibition on Payment of Federal Benefits to Certain Persons
- Generally, prohibits payment of Federal benefits, including Social Security
benefits, with some exceptions, to any person who is not lawfully present in the
United States. A person lawfully present in the U. S. includes a U.S. citizen, a
permanent resident alien, an alien whose deportation has been withheld under
section 243(h) of the INA, an asylee, a refugee, a parolee who has been
paroled for a period of at least 1 year, a national, or a national of the U.S. (as
defined in section 101(a)(17) of the INA).
Credit for Employer Tax on Tips
- Would revise the provision for a business tax credi t for tips for food and beverage establishments (enacted in OBRA of 1993) by providing that the credit would be available regardless of whether the tips are reponed under section 6053 of the Internal Revenue Code (which provides for informational rerurns with respect to tips).
The provision would affect neither the amount of tips covered and taxable for Social Security purposes nor the amount of Social Security taxes credited to the Social Security trust funds.
Medical Savings Account
- Would provide rules for the establishment of medical savings accounts (trusts exclusively created for the purpose of paying for medical care or long-term care insurance for an individual and his or her spouse or dependents). Also would provide for exclusion of employer contributions to these accounts from gross income for income tax purposes and from covered wages for Social Security tax and benefit purposes.
- Would define persons engaged in the business of distributing newspapers or shopping news as direct selle rs for Social Security and income tax purposes-- i.e., independent contractors (self-employed), if substantially all their pay is related to sales or other output rather than hours worked, and the work they do is pursuant to a written contract providing that they with not be treated as employees for Federal tax purposes. The proposal would be effective January 1,1996.
Employer-Provided Educational Assistance
- Would reinstate a provision that expired January 1, 1995, under which certain
employer-pro vided educational assistance was excluded for Social Security and
income tax purposes. The exclusion would apply to taxable years beginning
after December 31, 1994 and ending before January 1, 1997; however, for
taxable years beginning after December 31, 1995, the exclusion would not
apply to graduate-level education.