Congress included disability insurance as an amendment to the Social Security Act in 1956. But that was only the beginning. It took decades of reform efforts to expand the policy so that Americans living with disabilities could access benefits. Revisions throughout the late 1950s and 1960s removed age group limitations and the erroneous six month waiting period for benefits, included dependents and widows, and expanded the definition of “disabled” to include a wider berth of Americans living with disabilities.

The tensions both at the federal level and between the federal government and states continue to prevent the program from running efficiently. As such, most presidents have taken measures to improve the efficiency of the program and expand benefits. However, President Trump deviated from this pattern with his recent budget proposal which includes millions of cuts to the programs providing insurance and support for Americans living with disabilities.

President Ronald Reagan

In response to stricter regulations enacted under the Carter administration, former President Reagan signed the Social Security Disability Benefits Reform Act (SSDBRA) into law in 1984. Former President Eisenhower signed Social Security Disability Insurance (SSDI) into existence in 1956, while President Nixon extended this insurance covered with the Supplemental Security Income (SSI) provision in 1969. Collectively, SSDI and SSI make up disability insurance, providing benefits to American “workers unable to do substantial work due to disability or illness.” According to Reagan, SSDBRA intended to “restore order, uniformity, and consensus in the disability program. It maintains our commitment to treat disabled American citizens fairly and humanely while fulfilling our obligation to the Congress and the American taxpayers to administer the disability program effectively.” Despite being intended to address potential work disincentives by providing payments to individuals capable of working, the law actually introduced loopholes that some Americans exploited to receive disability benefits. The new legislation relied on individuals’ reporting their own disabilities, permitted them to use their own doctors’ assessments rather than government approved doctors, and loosened requirements for mental health claims. By introducing this vague language and subjectivity into disability claims, some critics assert that the current expansive numbers of disability claimants faced by recent presidents can be attributed to Reagan’s measures.

President George H.W. Bush

As part of the 1990 Omnibus Budget Reconciliation Act, the Bush administration allowed the Social Security Administration (SSA) “permanent authority to continue paying benefits during appeal of disability cessation decisions.” After Reagan attempted to remove people from the disability rolls in the mid 1980s, many disabled individuals field suit for their disability payments, an issue that continued into Bush’s presidency. This provision allowed the SSA to continue administering benefits to these individuals and any others appealing a benefit termination decision. Language in this bill also “introduced various work incentive and vocational rehabilitation provisions for disability recipients.” Consistent with conservative critics’ fear that people exploited SSDI/SSI rather than working and contributing to the economy, these programs were designed to help disability recipients get back to work. Providing such work rehabilitation services also stood as consistent with Eisenhower’s approach to disability services, as the Eisenhower administration also favored this method rather than expansion of benefit payments.

Bush also signed the Americans with Disabilities Act (ADA) into law in 1990. However, while this conferred an incredible amount of anti-discrimination protections on people with disabilities, it stopped short of providing any further services. For the Bush administration, “the need for civil rights superseded the need for more intrusive and expensive social welfare initiatives” to provide Americans with the resources required to equally compete in the economy.

President Bill Clinton

Given the robust economy that Clinton oversaw during his presidency, the administration was able to expand benefits to the disabled. In a speech on the ninth anniversary of the ADA in 1999, Clinton reflected on his administration's approach to disability policy, sharing that in 1993, “Vice President Gore and I established three core principles for our Administration's disability policy -- inclusion, independence, and empowerment.” As part of this effort to promote independence and economic participation, Clinton announced a budget proposal on January 13, 1999 to create tax credits for workers with significant disabilities “to help cover the formal and informal costs that are associated with employment.” The next month, Clinton unveiled new regulations increasing the maximum income benefits that Americans with disabilities may receive from SSDI and SSI while maintaining their eligibility for “critical cash and medical benefits.” To further this initiative, Clinton signed the Ticket to Work and Work Incentives Improvement Act to allow SSDI and certain SSI beneficiaries “to seek the employment services, vocational rehabilitation (VR) services, or other support services needed to obtain, regain, or maintain employment and reduce their dependence on cash benefit programs.” Clinton utilized the economic vitality the country enjoyed during his presidency to expand the social safety net, making sure to particularly include people with disabilities in this support to ensure they could adequately pay for their care and participate in the economy.

President George W. Bush

Since 2000, when George W. Bush assumed the presidency, disability insurance programs’ expenditures increased by the billions; however, this was “in large part due to the aging of the baby boomers into their high-disability years, and the increase in women’s labor force participation resulting in women being insured for SSDI in case of disability” associated with reproductive issues. While Bush attempted to reform Social Security, these efforts did not come to fruition and did not impact disability provisions.

President Barack Obama

By 2015, about 5.2% of Americans were on disability insurance, demanding increasing portions of the Social Security budget. According to the Congressional Budget Office, disability benefit “spending would exceed income after 2018, and the trust fund would be exhausted in 2022.” Critics blamed Obama’s expanded healthcare provisions for people with disabilities under Obamacare and the expanded social safety net under the American Recovery and Reinvestment Act of 2009 for the rise in Americans claiming disability insurance. However, Americans on SSDI and SSI under the Obama administration “increased by about half as many as it did under George W. Bush, and the average annual growth rate under Obama was about a third of that under Bush.” Additionally, through economic revitalization efforts and better disability protection enforcement, enrollment in these programs decreased by about 2% since 2015 while the number of retired, Social Security collecting beneficiaries increased by roughly 6%. To fully ensure that Americans living with disabilities accessed full benefits, Obama proposed to “rebalance the Social Security program in a way that ensures workers with disabilities, retirees, and survivors receive the full amount of earned and expected benefits” through more long-term focused policy crafting with Congress.

President Donald Trump

The federal government sends approximately 14 million Americans disability checks each month, spending more money on these cash payments than it does on welfare. Citing concerns about over expenditure and fraudulent use, President Trump’s proposed budget for fiscal year 2019 includes a $72 billion cut to disability programs over the next ten years, including Social Security Disability Insurance and Supplemental Security Income (SSI). Despite claiming that he was “not going to cut Social Security like every other Republican” while campaigning, Trump appears to be taking the position of his budget director, Mick Mulvaney. In 2017, Mulvaney called disability insurance “ a very wasteful program” and claimed that the administration “want[s] to try and fix that.” Acting concurrently with the administration’s conservative approach to other elements of government-- reducing the bureaucracy, cutting discretionary spending, and taking more protective positions on trade-- Trump appears to be cutting this spending to encourage self-sufficiency through more austere methods. Interesting, these cuts will disproportionately impact those who elected Trump considering that “of the 20 counties with the highest share of working-age adults receiving disability benefits, 17 voted for Trump, by an average margin of 56 percentage points.”