During the Clinton-era push for welfare reform, congressional attacks targeted SSI and SSDI for people with substance use disorders, among the first populations for whom the SSI Coalition would advocate. The coalition also fought to preserve access to Medicaid for Illinois’ general assistance population.
Amidst calls for welfare reform and fiscal conservatism, Congress first imposed a three-year limit on SSI benefits to those beneficiaries whose alcoholism or addiction was a “contributing factor” to their disability, then soon removed these conditions as a basis for disability altogether. Legislation soon followed that also mandated additional case reviews and tightened the definition of disability and eligibility for SSI children – moves that would eventually culminate in the PRWORA in 1996. In Illinois, while more than 70% of Medicaid recipients were low-income families, the bulk of spending was for long-term care for the elderly and disabled. Nonetheless, in a series of moves aimed at reigning in costs, Gov. Edgar and the legislature focused on enrolling poor people in managed-care programs.
Support for this work came from the Chicago Community Trust.