The Accelerated Benefits Demonstration tested whether making medical benefits immediately available to new Social Security Disability Insurance (SSDI) beneficiaries would improve their health and increase the likelihood they would return to work. SSDI pays cash benefits to eligible workers who are disabled. Financed by Social Security taxes paid by workers, employers, and self-employed persons, SSDI pays monthly benefits based on the Social Security earnings record of the insured worker. In addition, SSDI beneficiaries become eligible for Medicare coverage.

However, access to health insurance is an important concern for the 700,000 new Social Security Disability Insurance (SSDI) beneficiaries each year who must wait up to 29 months to become eligible for Medicare. Under current program rules, new beneficiaries receive cash benefits five months after receiving their disability determination and become eligible for Medicare coverage an additional 24 months after the start of cash benefits. During this period, a beneficiary’s health condition may deteriorate because of the natural progression of the condition, lack of medical access and medical care, and physical inactivity from not working.

The U.S. Social Security Administration (SSA) contracted with MDRC and several partners to design and evaluate the Accelerated Benefits (AB) Demonstration. The project tested whether a short-term investment in health care for certain newly entitled SSDI beneficiaries had long term pay-offs, in terms of improving beneficiaries’ medical conditions and increasing the likelihood that they would return to work. After one year, the program increased health care use, reduced reported unmet medical needs, and modestly improved health and functioning. It also increased job prep and search activities but did not raise employment levels.