Abstract
Background. Many individuals and families eligible for means-tested social welfare programs do not seek these benefits, and the reasons for this phenomenon are not fully understood. Supplemental Nutrition Assistance Program (SNAP) uptake is preceded by family, health, and economic shocks resulting in sharp increases in food insecurity, and it is followed by moderate decreases in food insecurity. The result in cross-sectional data is that SNAP recipients have higher food insecurity overall than eligible non-recipients. We examined if similar patterns existed for Supplemental Security Income (SSI) recipients and uninsurance. Methods. We compared rates of uninsurance between SSI recipients to eligible non-recipients using nationally representative data from the Survey of Income and Program Participation. We conducted two difference-in-differences analyses. The first difference-in-differences analysis compared SSI recipients and eligible non-recipients at two time points a year apart just before SSI receipt. The second difference-in-difference analysis compared SSI recipients and eligible non-recipients at time points before and after SSI receipt. Results. In the lead up to SSI uptake, SSI recipients had a statistically significant increase in uninsurance in comparison to eligible non-recipients. After SSI receipt began, SSI recipients had a statistically significant decrease in uninsurance in comparison to eligible non-recipients. Conclusions. Levels of uninsurance among eventual SSI recipients rise prior to SSI receipt and fall afterwards. It is plausible the shocks leading to uninsurance are a driver for SSI receipt in a manor analogous to shocks leading to food insecurity are a driver for SNAP uptake.