Compared to Social Security, family assistance, and health care, political scientists have paid relatively little attention to disability policy and politics. Historians Edward D. Berkowitz and Larry DeWitt remind us, however, that this oversight leaves us with a blinkered view of the American welfare state. An exceptional historical account of Supplemental Security Income (SSI), The Other Welfare explains how a program initially designed to simplify and professionalize public assistance, to rectify all that was callous and ineffectual with state-administered programs for the poor, ended up a poster child for welfare fraud and government ineptitude. The book opens with President Richard Nixon’s proposal in 1969 to create a guaranteed minimum income for the nation’s poor and closes shortly after President Bill Clinton’s signing of welfare-reform legislation in 1996. Bracketing these two major reform episodes, Berkowitz and DeWitt weave a compelling narrative of American antipoverty politics over the last four decades.
Serving as the foil for the rest of the book, Chapter 1 explains how SSI came to be. Administered by the Social Security Administration (SSA) and using the latest in computer technology to deliver cash benefits, SSI converted the state-run system of assistance programs for the aged and disabled into a single program with uniform benefit levels and eligibility rules, and without the ignominy of traditional “welfare.” Embodying the can-do optimism of 1960s-era liberalism, SSI was only one piece in a flurry of legislation in the late 1960s and early 1970s that dramatically expanded Social Security, Medicare, and Medicaid.
The rest of the chapters trace the unraveling of this can-do optimism. Almost from the start, SSI was a troubled program. Chapters 2 and 3 cover the years 1974–75 in which the SSA rushed to implement SSI, its revolutionary new public-assistance program, and explain why, despite the agency’s best efforts, the launch of the program was a disaster of long lines, missed payments, erroneous payments, broken-down computers, and angry claimants. Taking readers into the thicket of disability politics, Chapters 4 and 5 discuss policymakers’ tortured efforts to parse the “deserving” from the “undeserving” poor, noting why this distinction was all but impossible to maintain in the case of the disabled, as President Ronald Reagan quickly discovered during his ill-fated attempt in 1981–84 to purge the Social Security disability rolls of people who were not “truly disabled.”
The disability reviews energized liberal advocacy organizations, which found SSI to be a useful vehicle for providing assistance to all sorts of marginalized but “deserving” groups. As Chapter 6 explains, throughout the late 1980s and 1990s, SSI grew incrementally to include the homeless, people with AIDS/HIV, and children with disabilities. Finally, Chapter 7 and 8 explain how years of program liberalization led to the program’s undoing. Although there was little proof that people systematically cheated their way onto SSI, media stories of fraud and abuse helped turn people with disabilities into the “welfare queen” of the 1990s and laid the groundwork for congressional efforts to scale back the program as part of welfare-reform legislation in 1996. But as Chapter 9 makes clear, advocacy groups were able to mitigate the worst of these cuts, and Congress again discovered that there were many groups “worthy” of special dispensation under SSI.
In discussing the history of SSI, Berkowitz and DeWitt traverse policymaking over the three branches of American government and move between state and national politics, avoiding single-institution and single-program analysis to illustrate for readers the difficulties that the Social Security Administration faced translating legislation into the rules and practices that bring policies and programs to life. In their analysis, SSI stands at the crossroads of major debates about Social Security, health care, welfare, and disability, not least because no program is an island unto itself. The programs of our welfare state are linked together through eligibility criteria and program rules, and changes to any one program have far-reaching consequences for all the other federal and state programs tied to it. There is an important lesson here for political scientists, who tend to focus on big, episodic moments of reform. The story of SSI is not so much one of singular legislative triumphs but of lawmakers constantly patching disconnections between programs. Perhaps it is no surprise that the dream of simplifying social welfare became ever more attractive to reform-minded presidents, as programs grew in number and policymaking evolved from an insular group of congressional committees and program administrators in the early 1970s to today’s sprawling network of advocacy organizations, the federal courts, congressional committees and subcommittees, and state and local governments.
A significant contribution of the book is its attention to public administration, which in Berkowitz and DeWitt’s deft analysis emerges as yet another arena in which political actors contest policy. Although SSI was touted as a nationally uniform program that would simplify aid to the “deserving” poor, the authors reveal that it was anything but. Episodes of reform raised hopes for a fresh start, but once legislation was passed, well-established stakeholders—in particular, the intergovernmental lobby—resurfaced to exert significant influence over policy details and to promote their desired changes outside the scrutiny of the public eye.
Another contribution of the book is the skill with which Berkowitz and DeWitt capture the subjectivity of disability, a constant theme in virtually all scholarship on disability policy, and how it comes to life in everyday politics. Although reformers, conservatives and liberals alike, aspired to uniformity and clarity, in the real world people defied the orderly categories of “deserving” and “undeserving,” “truly disabled” and “able-bodied.” Because political leaders insisted on distinguishing among groups of the poor and tailoring benefits to the specific needs and circumstances of each group, complexity and irrationality prevailed. As a result, grand ambitions for simplicity ran aground on the thousands of exceptions made through incremental policymaking. Meanwhile, narratives about fraud and abuse sometimes took on a life of their own, much to the detriment of the poor, who were pitied at one moment and vilified at another. Touted in the 1970s as a “new” way of welfare, more professionally administered and technologically sophisticated than the state programs it replaced, SSI today embodies stereotypes of “traditional” welfare: cumbersome, expansive, seemingly full of perverse incentives that undermine work and encourage abuse.
Berkowitz and DeWitt write as historians, and political scientists will have to do some work to link their narrative to our own theories of state and policy development, but doing so is well worth the effort, given the richness of the historical analysis. An old adage of the Social Security Administration was that “poor people make poor programs.” Using archival material not previously available, the authors bring this adage to life with a cautionary tale for would-be reformers. When programs are poor and poorly run, citizens come to doubt the capacities of government. In this way, programs for the have-nots both suffer from and foster the very antipathy that can contribute to their undoing. As the Obama administration struggles to implement the Affordable Care Act, perhaps the most ambitious piece of social legislation since SSI, The Other Welfare is an example of policy history at its best and at its most timely.
