Chapter 4 Study Guide Policy

ADC (Understand how all of these "fit together")

"Aid to Dependent Children" Title IV of the Social Security Act of 1935 authorized federal grants to states that chose to provide Aid to Dependent Children. By 1950 new provisions allowed grants under the program to take into account not only the needs of dependent children but also those of their caretakers, usually their mothers.

AFDC

"Aid to Families with Dependent Children" In 1962, the Kennedy administration proposed several revisions to ADC. Most noticeably, the program was renamed Aid to Families with Dependent Children in an effort to emphasize the family context.In 1982, newly elected president Ronald Reagan popularized the call to "end welfare as we know it". He added a work requirement to AFDC through the Family Support Act of 1988. He called it "workfare".

AIME

"Average indexed monthly earnings" Benefits are based on this number.

CPI

"Consumer Price Index"A measure that examines the weighted average prices of a basket of consumer goods and services, such as transportation, food and medical care. It is calculated by taking price changes for each item in the predetermined basket of goods and averaging them.

22. Describe the effects of the 1996 passage of PRWORA with regard to the following programs

Aid to Families of Dependent Children (AFDC), Supplemental Security Income (SSI), and Temporary Assistance to Needy Families (TANF).

Title IV Eligibility

Children in foster care or children who are adopted domestically

Prior to passage of the Social Security Act, how were U.S. workers expected to handle costs associated with retirement, disability, or medicine/health care?

Personal savings

Means-tested programs

Programs that have requirements based on your income level in order to access it.

31. Which means-tested programs are authorized by the Social Security Act?

Temporary Assistance to Needy Families (TANF), Supplemental Security Income (SSI), and Medicaid

In 1964, opposition to Medicare came from what groups?

The AMA (American Medical Association), business groups, insurance industry

Explain the TANF program's lifetime limit under federal law.

There is a lifetime limit of 5 years on your ability to receive TANF

COLA

"Cost Of Living Adjustment".Indexes annual increases to the Consumer Price Index. In other words, it follows inflation to calculate adjusted benefits for the year.

DI/SSDI

"Disability Insurance" (Social Insurance Program)

FICA

"Federal Insurance Contributions Act"

Part A Medicare

"Hospital Insurance" Coverage provided at no charge to recipients and covers most of the cost (subject to deductibles and copayments) of many services provided in hospitals and brief stays in nursing homes, as well as home health services and some hospice care.

Part C Medicare

"Medicare Advantage" Participants can choose to enroll in managed care plans. Basically, signing up with a private insurance company to have them manage Medicare benefits.

OAS

"Old Age Security" ?????

OASI

"Old Age and Survivors Insurance"

OASDI (Understand how all of these "fit together")

"Old-Age, Survivors, and Disability Insurance"Financed through a payroll tax authorized under the Federal Insurance Contributions Act (FICA).

PRWORA

"Personal Responsibility and Work Opportunity Reconciliation Act"In 1996 it effectively dismantled a New Deal guarantee of a minimum income for needy children. The act abolished the AFDC entitlement, substituting a block grant to the states. Federal guidelines require states to enforce work participation requirements and established a five-year lifetime limit for assistance under the new program, called TANF.

SSI

"Supplemental Security Income".This program was authorized by the Social Security Act Amendments of 1972 to provide a minimum guaranteed income for elderly, blind or disabled persons. combined several state-administered categorical programs into a single entity. It is administered as a federal-state partnership in which state agencies manage eligibility determination and may supplement SSI payments while the Social Security Administration manages federal contributions and regulations of the program. PRWORA made it so legal immigrants lost access to SSI and food stamps unless they or their spouses had worked for 10 years and had not received benefits previously.

TANF

"Temporary Assistance to Needy Families".Funded by a federal block grant to the state. That being said, states enjoy consideration discretion in the operation of TANF. Thus, decisions made at the state level have greater impact on recipients' lives under TANF than was the case under AFDC. Under the maintenance of effort provision (MOE) states must contribute funds to the program. State and federal funds may be spent to address four goals set forth in PRWORA: (1) provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives; (2) end the dependence of needy parents on government benefits by promoting job preparation, work, and marriage; (3) prevent and reduce the incidence of out of wedlock pregnancies; and (4) encourage the formation and maintenance of two parent families. Notably absent from these goals is any intent to reduce poverty or easy hardship among needy families in the US. The TANF program does considerably less than AFDC in this regard.

UI

"Unemployment Insurance" -- temporary replacement of lost wages for workers who had strong attachment to the labor force.Financing for UI program is provided through state and federal payroll taxes paid by employers. The federal unemployment tax covers the administrative costs of state UI and job service programs, as well as half of the cost of extended unemployment benefits.

5. Where was Europe's first Social Security program established? Describe this program.

1880s Germany, Otto von Bismarck. StateProgram.To secure the allegiance of the German working class (negative entropy function)

Programs available Title IV

Children who are at-risk of maltreatment, including prevention, remediation, out-of-home placements, and reunification services.

35. What are some of the reasons and outcomes for the conversion from AFDC to TANF?

During the 1970s and 1980s, growth in the welfare rolls exceeded population growth. At the same time, real wages eroded and public support for welfare deteriorated. In 1982, newly elected president Ronald Reagan popularized the call to "end welfare as we know it". Responding to this call, Congress and the president enacted the Family Support Act of 1988, which added a work requirement to AFDC. In 1996 PRWORA effectively dismantled the New Deal guarantee of a minimum income for needy children. The act abolished the AFDC entitlement, substituting a block grant to the states. Federal guidelines required states to enforce work participation requirements and establish a five-year lifetime limit for assistance under the new program called TANF. This conversion left a lot of people high and dry by getting stripped of their benefits.

32. Describe the ways that federal block grant funds provide for the delivery of SSA Health and Social Service Programs. Why are these services not directly provided by federal staff?

In addition to soical insurance and public assistance, the Social Security Act authorizes the use of federal funds to provide some health and social services. Although federal staff are employed under these titles (title IV, title XX, title XXI... etc), they do not provide direct services because doing so is generally considered incompatible with constitutional limitations on the power of the federal government. Instead, federal staff members administer grants to the states. States then deliver services or arrange for their delivery in ways that are compatible with the federal regulations governing each program.

Title XXEligibility

Low income populations, vulnerable children and adults (e.g. persons with mental health diagnoses or developmental disabilities) who are at risk for-Maltreatment and/or exploitation, inappropriate institutionalization, and those who are appropriate candidates for institutional care.

Title V Eligibility

Low-income and/or rural mothers and children Benefits include some medical coverage, and some program eligibility

25.Identify and describe the organization that is responsible for the administration of the Medicaid program.

Medicaid was authorized under Title XIX of the Social Security Act to operate as a federal-state partnership with most of the cost borne by the federal government and most of the administrative responsibilities borne by the states.

DI Eligibility

Permanently and totally disabled workers, aged 50-64 & adult disabled children of deceased/ retired workers.

Monetary Guidelines

Persons with low income are eligible Medical coverage, some program eligibility (e.g. long term care provision)

Equity

Providing a fair investment (if you put more money into the system, you should get more money out of the system)

Adequacy

Providing sufficient income

According to the text, what alternatives for restoring the solvency of OASI were proposed in the 2010 report by the Senate Committee on Aging?

Raising payroll taxes, eliminating the wage cap, investing the trust fund for greater return, increasing the retirement age, and reducing benefits.

17. According to the text, what does current law dictate with regard to social security disability benefits for individuals who are disabled by virtue of alcohol addiction?

There is no coverage under DI for persons whose disability resulted primarily from addiction.

CHIP

This program authorizes funding for states to provide health coverage to uninsured, low-income children. It targets children in families with incomes between 100 and 200 percent of the federal poverty threshold. These families are not eligible for Medicaid but generally cannot afford to purchase private insurance. States enjoy flexibility in designing their CHIP programs. They man either expand their existing Medicaid coverage or establish separate programs. The CHIP program limits enrollees' costs by prohibiting deductibles and limiting copayments above nominal amounts. Usually premiums are not allowed.

16. According to the text, how is disability insurance financed?

Through payroll taxes

33. Describe the four amendments made in the Social Security program in 1983 upon recommendations from the 1981 National Commission on Social Security Reform. (1) Revisions in the COLA These included a on-time delay of the COLA and a "stabilizer" on future COLAs. If the trust fund falls below certain measures, the COLA will be indexed, not to the CPI but to the average increase in wages (if it is lower). This provision has not been applied to date. (2) Taxation of benefits

Up to half of benefits were made subject to federal income tax. (3) Increased retirement ages: Starting in 2003, the age for receipt of full retirement benefits was set to rise gradually. By 2027, the retirement age for full benefits would be 67. (4) Work incentives: Early retirement would bring 70 percent rather than 80 percent of the regular benefits, and the delayed retirement credit for workers who pospone retirement up to age 70 was increased to 8 percent per year for those turning 65 after 2007. Provisions also increased the amount beneficiaries could earn through employment before their Social Security benefits were reduced and eliminated the reduction of benefits altogether for workers over 70.

Title V of the 1935 Social Security Act

allowed for grants to states in support of maternal and child health services. Grants for maternal and child health did not require states to provide matching funds, but the program's regulations did stipulate that states had to use funds to extend or improve upon existing services and that states were required to focus on needy, typical rural, areas and groups with the severest hardships.Today, these services are provided in each state under the Maternal and Child health Services Block Grant. With a focus on low-income mothers and those in rural areas, these block grant funds are used to meet the health objectives established under the Public Health Service Act of 2000. States have latitude in allocating these funds. Typical services provided include immunizations, visiting nurse activities, rehabilitative services for blind and disabled children, and case management for children with special health-care needs. In addition to the state allocations, federal funds are available under Title V for training health personnel and conducting research on health-care deliver, genetic testing and counseling, hemophilia, and early interventions.

Title IV of the 1935 Social Security Act

established a program of grants-in-aid from states to set up their ADC programs. The title also allowed for child welfare services, allocating 1.5 million dollars for that purpose. Today, child welfare services under Title IV include federal payments for foster care and adoption assistance, preventive services designed to keep children in their homes, services to develop alternative placements for children for who foster care or adoption are not feasible, and family reunification services. Funds are also provided for training of child welfare professionals and research in methods for improving services in the field.

Solvency

refers to one's ability to pay legitimate debts. This word comes up when discussing Social Security's solvency. The controversy has to do with older adults who are receiving Social Security checks they don't need to survive. Social Security is a "pay as you go" program. Most of the revenue goes to pay for the benefits of current recipients. The remainder goes into four separate reserve funds: Old Age and Survivors Insurance (OASI); Disability Insurance (DI); Hospital Insurance for Medicare Part A (HI); and Supplementary Medical Insurance for Medicare part B (SMI).

Eligibility (varies from state to state)3 factors

the worker's earning history, the reason for unemployment, and the worker's availability for work.Most states require that a worker be in covered employment for the first four of the last five calendar quarters prior to filing a claim.Earnings must be above a minimum that is set by the state.Joblessness must be due to factors beyond the worker's control .Recipients of unemployment benefits must actively seek employment and must accept suitable employment if it is offered.

Title XX of the Social Security Act

was passed in 1975 to provide social services to vulnerable Americans. It is funded by the Social Services Block Grant (SSBG) through the Omnibus Budget Reconciliation Act of 1981. The SSBG provides funds to states for social services directed toward achieving economic self-sufficiency; preventing or remedying neglect, abuse, or exploitation of children or adults; preventing or reducing inappropriate institutionalization; and securing referrals for institutional care. Within these broad goals, states have flexibility to decide what services they will provide. SSBG funds are typically used to provide day care for children, home-based services for elderly or disabled, and protective services.

Part B Medicare

"Physician Care" .Purchased through monthly premium (means tested)In addition to premiums, has deductible and copay costs.Covers costs related to physicians, therapies, ambulances, diagnostic services, DME, prostheses, etc.

Part D Medicare

"Prescription Coverage" Participants can choose to enroll in coverage plans

SCHIP

"State Children's Health Insurance Program" The same as CHIP ^^

3. What components were included in the originally formulation of the U.S. Social Security Act? Three types of programs authorized under SSA

- Social Insurance - Public Assistance - Health and Social Services

29. Describe the debates about establishing a national health insurance program in the US. According to the text, when did these debates begin?

Discussion of national health insurance in the United States began as early as 1912 with a proposal from Theodore Roosevelt's Bull Moose Party. In 1935, the designers of the Social Security Act were concerned about medical costs, but most believed that unemployment and old age were more immediate risks to workers than inability to pay for medical care. There was also the threat that physicians would oppose national health insurance. President Truman made national health insurance a legislative priority in the 1940s. He was shut down by Congress. Medicare was not enacted until 1964. The American Medical Association had favored national health insurance in 1916, but by the time Medicare came up for debate, the AMA vigorously opposed any government-sponsored health insurance.

15. According to the text, where does funding for the states' contributions to unemployment insurance come from?

Employers have to pay UI taxes.

18. Describe the development of medical insurance in the US.

First proposed in 1912, but not enacted until 1964. President Truman tried to enact national health insurance, but failed in the 1940s. President Johnson passed US federal medical insurance in 1964.

. Describe the phenomenon of "Townsend Clubs" as presented in the text. What motivated the development of these clubs?

In 1933, Dr. Francis E. Townsend, 67, wrote a letter to a Long Beach California newspaper advocating the establishment of a Government sponsored old age pension plan. The response was immediate and overwhelmingly favorable; 1933 was perhaps the worst year of the Depression and times were especially bad for the elderly. This led to the establishment of "Townsend Clubs" all across the country and eventually to the Social Security Act of 1937. These medals are from their first national convention in 1935.

28. What workers are eligible for Social Security unemployment insurance benefits?

It varies from state to state, but broadly most states require that (1) a worker be in covered employment for the first four of the last five calendar quarters prior to filing a claim, (2) the job loss must be due to factors beyond the worker's control, and (3) recipients of unemployment benefits must actively seek employment and must accept suitable employment if it is offered.

Non-Monetary Guidelines

Live in the state where benefits are received & be a US citizen or meet certain immigration requirements.Funding comes from taxpayer money

27. How do US income tax rates compare to other developed nations?

Our tax rate is lower than the average taxes in the world's developed nations.

What is the "solvency issue" with regard to Social Security programs?

The legitimacy of the debt that is owed, particularly to older adults who are not financially needy.

Medicaid

The nation's third largest source of health insurance (after employer coverage and Medicare)

Replacement rate

The proportion of earnings that you receive in retirement.

26. According to the text, for widows of husbands who were retired before their deaths, what is the effect of the spousal death for most widows' Social Security income?

The widow now receives her spouse's social security check, along with her own.

In the context of the Social Security program, what does the term "equity" mean?

To achieve equity, benefits are computed on the basis of contributions. Benefits are based on a person's "average indexed monthly earnings".

SSA (Social Security Act)

US's collective response to many social problems. Three types of programs were authorized under the SSA: Social Insurance, Public Assistance, and Health and Social Services.

In Social Security policy debates, what does the term "privatization" refer to?

Under a privatized system, individual retirement accounts are established for investment of all, or part, of workers' retirement savings.

Privatization

Under privatized systems, individual retirement accounts are established for investment of all, or part, of worker's retirement savings. These accounts are then invested in private equities. Privatization if the transfer of risk from the collective to the individual. There have been mixed results from switching to a private system. The introduction of individual accounts inevitably raises administrative costs, which must be weighed against the possibility of greater returns. The transition from traditional systems to privatized systems imposes costs as well, because revenue that would otherwise fund public retirement benefits is diverted to private accounts.

Describe what occurs under the idea of "earnings sharing" with regard to social security benefits.

Under the approach of earning sharing, spousal benefits would be eliminated. The earnings of a married couple would be combined, with half credited to each partner for each year of the marriage. Retirees would receive benefits based on their accumulated earnings. It would benefit people who divorce after less than ten years of marriage, giving them credit for half of their spouses' earnings.

2. Identify and describe de Swaan's conditions that facilitate collective solutions to personal adversity.

Union leaders and socialist leaders were quickly integrated into the states fabric.

Caregiver credits

aim to provide retirement income to those (still primarily women) who leave work to care for children and older adults.Earnings sharing.Under this approach, spousal benefits would be eliminated. The earnings of a married couple would be combined, with half credited to each partner for each year of the marriage. Retirees would receive benefits based on their accumulated earnings.

Title XXI Eligibility

children in low income families (above FPG, but without means to secure insurance, typically +200% of FPG)

Describe the ways in which Social Security programs in Europe served a "state-building" function.

workers were offered a stake in political order and gained enough central order.

SSA Insurance Program

you pay into this when you pay your social security bills (monthly payment). Offers "welfare" to low-income seniors (retired workers at least age 62), "investment" to the middle and upper classes, and a measure of security for all. The program integrates the principles of equity and adequacy -- Equity is achieved when benefits drawn are based on contributions paid (when individuals receive a return that is proportional to their investment program). Under the principle of adequacy, benefits should be sufficient to maintain a decent standard of living, regardless of individual contributions. Also covers surviving spouses (and some divorced spouses) and children of deceased qualified workers.

4. What were the "three fears" of industrial workers?

• Poverty in Old Age • Illness/Disability• Unemployment