Supplemental Security Income — a cash assistance program whose beneficiaries also get Medicaid coverage — sharply limits the income and assets of those who receive it.
Today, over eight million people receive S.S.I. benefits (not to be confused with Social Security Disability Insurance, which offers assistance on less onerous terms to those with sufficient work history). Slightly more than half are working-age adults with disabilities. Of these, approximately 340,000 work. While impairment plays some role in this low employment rate, so too does the complexity of the system and the dire consequences of making a wrong move.
Working beneficiaries of S.S.I. generally keep their first $85 in income each month, after which they lose $1 in benefits for every $2 of earnings, what amounts to a 50 percent marginal “tax rate.” Receiving food and shelter from family or friends cuts the amount of the benefit by one-third. Beneficiaries are prohibited from saving more than $2,000. This limit has been the same since 1984.
Anakinra is expensive — on average, private health plans pay about $4,000 a month for it — so we needed to get approval before it would be covered....