Trump’s backdoor attack on Social Security disability

The Trump administration’s latest target for sabotage? The Social Security disability programs. PLUS: Trump’s final rule taking food assistance away from 700,000 struggling workers, explained.

This week on Off-Kilter… another proposed rule issued by the Trump administration — this time by Trump’s Social Security Administration — has gone largely unnoticed by the media, despite the tremendous harm it would do to millions of people with disabilities, and the fact that it’s a backdoor attack on Social Security. That proposed rule would effectively require certain beneficiaries of Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) to re-prove their disability every two years in order to continue receiving benefits. Rebecca brings back Rebecca Cokley, the director of CAP’s Disability Justice Initiative, and Matthew Cortland, a disabled, chronically ill lawyer who is himself an SSI beneficiary who would likely be impacted by this proposed rule.

But first… late last week, Trump’s U.S. Department of Agriculture issued a final rule that it estimates will take food assistance away from some 700,000 unemployed and underemployed workers and slash billions from the Supplemental Nutrition Assistance Program or SNAP (formerly known as food stamps). So Rebecca brings back Joel Berg, the CEO of Hunger Free America, for an explainer on what the rule will do, who’ll be hurt, and what comes next.

This week’s guests:

• Matthew Cortland, disabled, chronically ill lawyer & SSI recipient (@mattbc)
• Rebecca Cokley, director, Disability Justice Initiative, Center for American Progress (@RebeccaCokley)
• Joel Berg, CEO, Hunger Free America (@joelsberg)

For more on this week’s topics:

• Get caught up on Trump’s now-finalized rule slashing SNAP in this tweet thread, this statement from the Center on Budget and Policy Priorities, and this NBC News explainer
• Dig into the Urban Institute’s estimates of how many people would lose SNAP under Trump’s three attacks on the program, combined — and check out Hunger Free America’s and CAP’s polling finding overwhelming opposition to SNAP cuts and broad bipartisan support for expanding the program instead.
• Learn more about & get involved with the Action for Opportunity presidential forum on Jan. 5, 2020.
• Learn more about Trump’s proposed rule targeting Social Security disability beneficiaries in Alfred Lubrano’s piece for the Philadelphia Inquirer and in this video explainer from Community Legal Services.

This week’s transcript:

♪ I work and get paid like minimum wage

sights to hit the class by the end of the day

hot from downtown into the hood where I stay

the only place I can afford ’cause my block ain’t saved

I spend most of my time working, trying to bring in…. ♪

REBECCA VALLAS (HOST): Welcome to Off-Kilter, powered by the Center for American Progress Action Fund. I’m Rebecca Vallas. This week on Off-Kilter, another proposed rule issued by the Trump administration, this time by Trump’s Social Security Administration, has gone largely unnoticed, despite the tremendous harm it would do to millions of people with disabilities, and the fact that it’s a backdoor attack on Social Security. That proposed rule would effectively require certain beneficiaries of Social Security Disability benefits to reprove their disability every single two years in order to continue receiving benefits. So, I bring on two of my favorite disability experts, Rebecca Cokley, who leads the Center for American Progress’s Disability Justice Initiative, and Matthew Cortland, a disabled, chronically ill lawyer who is himself an SSI beneficiary who would likely be impacted by this proposed rule to unpack what it would do and how, of course, we fight back.

But first, late last week, Trump’s US Department of Agriculture issued a final rule that it estimates will take food assistance away from some 700,000 unemployed and underemployed workers and slash billions from the Supplemental Nutrition Assistance Program, or SNAP, formerly known as food stamps. So, I brought back my good friend, Joel Berg, CEO of Hunger Free America, for an explainer on what the rule will do, who will be hurt, and of course, what comes next. Let’s take a listen.

Joel, thanks so much for taking the time to come back on the show.

JOEL BERG: Thanks so much for focusing on this vital issue, which really shows this country is off kilter.

VALLAS: [laughs] You always get in the “off-kilter” reference. I love you for it.

BERG: Yeah.

VALLAS: So, Joel, we’ve talked a lot about many different attacks that this administration has waged on the Supplemental Nutrition Assistance Program. Over the course of the past year, really, it feels like Trump has spent the better part of 2019 basically trying to figure out how to dismantle this program by fiat. But the rule that was finalized last week after a long stretch of the kind of formal rulemaking process was the first of three attacks that he has waged this year. And this was the one that will take food away from people struggling to find work. So, remind us, how will this rule work, and who’s going to be hurt?

BERG: Well, 700,000 of the most vulnerable Americans are going to have their food taken away because they are either not able to find work or not able to take time out of their busy day to prove to a large state or county bureaucracy that they are looking for work or they have work. I often describe this as work reporting requirements, not so much as work requirements. And one of the greatest ironies of all is that single people without kids between 18 and 50 who are covered by this rule could actually be forced to leave work, often if they’re low-income and working on an hourly basis and lose wages just to travel to a government office to prove they’re worthy enough to get food. And so, this only applies to people who are unemployed. But the vast majority people who get SNAP benefits — the proper name for the food stamps program, although you’d never know that from the media; that hasn’t been called the food stamps program in over a decade — the SNAP program mostly serves working people, children, people with disabilities, and older Americans. And those who are able-bodied people who are adults without kids that are covered by this rule are usually unemployed for only short periods of time. But still, this punishes of them for the sin of being poor.

Mind you, this is the same USDA that’s given out over 420 billion — that’s billion with a B — in money to people who own land with agricultural operations that’ve been hurt by Trump’s insane trade policies, no work requirements for them, no work reporting requirements for them. And when I’ve asked Republican or Conservative members of Congress if they would impose work requirements for them, they basically laugh at me. So, it just shows you the double standard that we’re far more freaked out about a struggling unemployed person getting a average SNAP benefit of $1.40 per meal than we are about corporate landowners getting millions of dollars in subsidies.

VALLAS: Yeah. And you noted — but just to be really clear about who is going to be affected if this rule does take effect, and it’s scheduled to go into effect next April, if litigation does not stop it from taking effect, which it may well, as we’ve seen with many other attacks on programs that help families get by — but we’re talking about people who are aged 18 through 49 who are not raising minor children in their homes. That’s the target population. The administration likes to call them ABAWDs. It doesn’t even sound like human humans, right? It sounds more like robots, but that’s Able-bodied Adults without Dependents. That’s their kind of horrible term for these people. These are people who are — the Center on Budget and Policy Priorities did a little bit of analysis — these are people who are among the poorest of the poor people in this country. Their average income is just 18 percent of the incredibly austere poverty line that we know does a pretty crappy job of measuring who’s able to get by in this country. And we’re talking about people who are receiving, on average, food assistance of about $165 per month. That’s their food budget. That is what Trump is so hell bent on taking away from people.

Now, Joel, you were starting to describe that the people who are going to be hit are people who are jobless or maybe underemployed. But talk a little bit about how this rule is actually going to work. Because we know, and listeners of this show will know, that the SNAP program already has time limits in it — some people call them work reporting requirements — that limit people to just three months of food assistance if they fall into that category of being the age, as I mentioned, 18 to 49 and not raising minor kids in their homes. But this rule actually makes it even harder for people to get food assistance if they fall on hard times. How would it do that?

BERG: It would take away flexibility from states to meet the unique employment needs of their state. And so, after decades of the right railing that Washington doesn’t know how to make decisions best, but states and localities supposedly know how to make decisions best, this new proposal and this new rule, which is actually going into effect is taking away flexibility from states to best meet the needs of the local labor markets. I think even by the wonkish standards of your very wonkish listeners, I think this could go further deeper into the weeds. So, I don’t know that we need to do that, except to say there are complicated calculations that states, and in some states counties, use to determine who can get a waiver out of this requirement because there are high levels of unemployment. Places like the City of New York have done a really good job of including as much of the city as possible that they can legally justify. And this new rule would take away all that flexibility and basically say, no matter the challenges you’re facing, no matter the fact that we’re not spending an extra penny on job creation, not an extra penny on job placement, not a extra penny on raising wages, not a extra penny on job training. So, no matter that there’s no realistic way for an unemployed person covered by this to immediately get a job in a area with high unemployment, they’re going to say to the states, you can’t get them food in the interim.

I am reminded of the way the British reacted to the Irish hunger famine in the 1840s, where the British said, you can’t get food unless you’re working. And people literally starved to death because they were too hungry to work. This is the sort of same backwards, dehumanizing, counter-productive thinking that really starts with dehumanizing people the way many of the British leaders dehumanized Irish people and the way people today in power dehumanize hungry people.

And I will also add, the greatest irony of was the supposedly Conservative administration is building bureaucracy, is increasing big government. States that aren’t able to take the waivers have far more bureaucratic standards and paperwork reporting to report on work requirements than they would if they were able to take the waivers. So, yet another irony. These great Conservatives are actually increasing big government and increasing big mean government.

VALLAS: Yeah. Which they’re very happy to increase if it means taking food away from people who are struggling to put it on the table, in true hypocritical fashion, as you’ve pointed out many times on this show.

I want to get a little bit technical here, because as you noted, you know, some of the people who listen to this show are fairly wonky. But also, most media coverage isn’t actually going into the weeds. And so, for folks who are wondering, really, how is this going to play out? 36 states currently have waivers from these time limits in some form or fashion, whether that’s part of the state, some area where jobs are scarce or unemployment is particularly high. 36 states. And that is how many places now are going to be immediately impacted by these waivers being a lot harder for states to seek and for USDA to grant. And I want to be kind of concrete about how this is going to change that waiver process so that folks can think about, okay, well, what happens if, say, we enter another recession and we end up needing to look to SNAP as one of the tools to combat that recession and to help people who are now facing massively-increased unemployment rates? Well, states currently can request waivers from the federal government, from the US Department of Agriculture, when they see rapidly rising unemployment within their state’s borders. As you were describing, Joel, this is about meeting specific economic conditions of a state, and that’s something that we see when economic downturns hit. But under this rule, the way that it’s going to work, states are now only going to be in a position where they can point to historical data of their unemployment rates. So, that’s not actually going, in real time, to reflect the onset of economic downturns in time to help people. That’s one of the changes that’s in a really mean-spirited fashion and also really a boneheaded fashion taking effect with this rule.

And in addition, because these waiver criteria are being so significantly narrowed, if we actually see a widespread national recession, we’re, under this rule, going to see far fewer areas actually qualify for waivers. So, say we have national unemployment rising to 8 percent from its current levels of about just under 4 percent. And now say you see a state that actually has unemployment levels reach say, 9 percent. It wouldn’t qualify for the waiver because of the way that the criteria are being narrowed and how much higher the national unemployment levels, a state’s unemployment levels are going to have to be. So, just really, really cruel changes that will cause this program, SNAP, which has been one of our most important tools in fighting recessions to basically not be able to respond when we see major spikes in unemployment, either locally or even really nationally. And people on an individual level are not going to be able to get that food help that they need.

But also, at a sort of a macroeconomic level, Joel, one of the points that a lot of economists are making is this is going to weaken SNAP as a tool for fighting recessions. And we’re likely to see serious, broader economic consequences as well.

BERG: Right. Right on all points, as always! A recession will come, whether it’s tomorrow or a year from now. This idea that we’ve entered a new phase in human history where there are no longer economic cycles is preposterous. There will be a recession. And one of the greatest public policy successes following the great economic collapse in 2008 was the SNAP program and its so-called countercyclical nature. That when the economy got worse, it rapidly expanded. When the economy got better, it rapidly contracted. There was some extra money moved to the stimulus bill, the recovery bill to further aid, then that money’s been taken away. But there was a huge jump in food insecurity during the recession from in the mid-30s, meaning about 36 million Americans, to nearly 50 million Americans. But even with that, that’s the number of people who are struggling against hunger. We did not have massive developing-world style starvation after the recession because we had a SNAP program that dramatically increased and rapidly increased to help people who needed it. And so, the idea that we’re going to be taking away the flexibility of states to be able to respond rapidly to the recession and to not only make sure families get food, but make sure that the farmers, that the food manufacturers, the food retailers get all that income from the program is a huge, colossal mistake.

And I must say, as a point of personal privilege, as they say in Washington, having worked for President Clinton, the fact that USDA quoted him talking about the 1996 welfare reform bill supposedly to support this is an outrageous, out of context, really misleading statement about what Clinton was talking about. He was talking about cash assistance. Now, you and I may differ about what work requirements should or should not exist for cash assistance, but the records are absolutely clear that Bill Clinton opposed work requirements for SNAP, then called food stamps benefits. In fact, he vetoed two previous versions of the welfare reform bill, in large part not only because it didn’t have enough money for childcare, but because it was eviscerating the SNAP program. He consistently opposed work requirements for food. So, to quote Bill Clinton out of context as if he was supporting this really is outrageous. Although on the outrage matrix, there’s a long waiting list when it comes to this administration.

VALLAS: [laughs] Fair enough. And a really important clarification, because I think that’s been a lot of what Conservative media have been doing is saying, oh, wait a second, wasn’t this a Bill Clinton policy? You know, how can this be something that folks are angry at the Trump administration for doubling down on? I want to also clarify: people may be listening and thinking to themselves, you know, yeah. But honestly, is it that cruel to take food assistance away from someone who just doesn’t want to work, right? That’s sort of the Fox News spin on this. One thing to be really, really clear about, because the Trump administration has been just outright lying in how they describe this rule and who it’s going to hi, it is not enough to be looking for work. It is not enough to be pounding the pavement, searching as hard as you can for a job. It is not enough to be working and trying to get enough hours from your employer, but unsuccessfully able to get enough hours from your employer to satisfy these requirements. It’s not enough to want to be in a job training program, but say your state doesn’t have enough job training slots. And states, by the way, are not required to provide job training slots to the people who are impacted by this. So, all of those things that I think we’re hearing from the Trump administration, not accurate. It does not matter how hard someone is trying to comply with these work reporting requirements if through no fault of their own, they can’t find work, can’t get enough hours at their job, or can’t get a job training slot, they are still going to lose their food assistance anyway.

And Joel, one of the other —

VALLAS: And the vast majority of people receiving SNAP are already working and want to work. And the other thing I point out, Rebecca, as you know, you’re a longtime champion of rights for people with disabilities, is a lot of people with disabilities, particularly mental health disabilities, are falsely classified as able-bodied or never had the correct classification that they do have a disability. So, this would also be taking away for food, people with undiagnosed or diagnosed but not officially recorded with the government disabilities.

VALLAS: Yeah, such an important point. And you’re actually totally reading my mind in one of the other points that I think is really important to make here. The Trump administration has repeated over and over again that people with disabilities are going to be protected and exempt, and they are not. Because only if you are receiving Social Security Disability benefits will you actually be protected from losing your food assistance. And as we know, that is a small fraction of people with disabilities who actually receive those benefits. So, you are totally right, Joel, those are going to be some of the folks who are hardest hit.

So, the Trump administration has made this sound like this is about saving money, like we can’t afford to be spending as much as we are on SNAP. But Joel, that’s just kind of one of these, you know, myths at this point that also, frankly, I’m surprised that any in the media continue to even give any level of airtime to after the tax law.

BERG: Yeah! Trillions for tax cuts for the ultra-rich, major corporations are not paying a penny in taxes, $20 billion in bailouts to farmland owners. And I’m clear not to say “farmers.” It’s not small farmers by and large getting the money. It’s people who own the land for large agricultural operations, $20 billion. And they’re claiming we’re going to balance the budget off slashing SNAP benefits of $1.40 per meal to unemployed people. It’s really [bleep]. And point out again, this, what just went through is one of three initiatives of the Trump administration to go around the will of Congress to get around SNAP, take SNAP away from people. This is the first to be formally implemented, assuming it’s not held up by court challenge, and I don’t know that it will be.

And so, I just say, boy, if you served in the Trump administration appointee working on these issues and your grandkid asks you, “Well, Daddy, Granddaddy, Grandma, what did you do during the Trump administration,” and your answer is, “I spent four years repeatedly trying to find new ways to take food away from vulnerable people,” I’m not sure you’d be really proud of that’s the legacy you leave to your kids.

VALLAS: Yeah. And to put some numbers on what you just said about the tax law, I mean, I feel like any media covering this rule who, without context, note that this is about savings and the amount of quote-unquote “savings.” It’s about 44.5 billion that the Trump administration estimates that they’re going to slash from SNAP. They call that savings. I call that cuts. But the tax cuts for just the wealthiest 1 percent in this country that Trump lavished on incredibly rich people just less than two years ago cost more than the entire SNAP program! Right? So, just to put in context what we’re talking about here and why this is not about savings or about deficits by any stretch.

And I also feel like it’s important to note, as much as the Trumpers will say, oh, this is about work. This is, you know, people should be working. “The dignity of work” is the phrase that gets used all the time. You know, it makes me want it just bang my head against the wall. This couldn’t be any less about helping people work given that research tells us time and again that taking food away from people isn’t going to help anyone find a job any faster. That actually, adequate nutrition is what people need if we want to support them in being able to find a job, thrive in a job, keep a job, and be able to support their families, right? So, this policy actually is affirmatively counterproductive if the goal that we’re after is work.

So, Joel, in the last —

BERG: I want to point out, we conducted a poll that showed the vast majority of Americans support increasing SNAP, not decreasing it. Even most Republicans support increasing funding for SNAP, especially low-income Republicans have stands on these issues pretty similar to the Democrats. The only subcategory of people who supported taking food away from vulnerable people were wealthy Republicans. So, it shows the support for this effort is even going against much of Trump’s base.

VALLAS: Yeah. And so, that’s exactly where I wanted to go next, because that poll that you guys did, Joel — in the last minute or so that I have with you — you looked at the popularity or lack thereof of cutting SNAP. But you also looked at the popularity of expanding it. And you found, and this just bears repeating, and I want to say so folks can kind of take this number home with them, expanding SNAP, increasing funding for SNAP is five times more popular than cutting it when you actually ask the American people. So, the takeaway for me here is that Trump is not just sidestepping Congress by trying to dismantle the SNAP program. And I say that because Congress took up this exact policy, debated it when they were in the context of the farm bill reauthorization last year, and they decided to reject it on a bipartisan basis! Republicans joined forces with Democrats and said, no, we actually don’t want to do this exact thing that this rule now will do once it takes effect. And so, Trump said, you know, I’m bummed that I didn’t get my way, just kind of like with the Affordable Care Act and with Medicaid. And then he turned around and said, you know, I didn’t get to repeal the healthcare legislatively, so I’m going to do all this healthcare sabotage. This is the same playbook, just played out with the SNAP program.

So, here he is sidestepping Congress. But your poll also really underscores he’s also sidestepping the will of the American people, including his own voters, who are loud and clear saying what they actually want is this meager program that, as you said, provides just a dollar and 40 cents per person per meal, they want to see it expanded so that it can actually help not just more people, but help people afford nutritious food throughout the entire month. Currently, most families report that their benefits run out about two to three weeks into the month, right? And that’s what people understand should not be in the richest nation on earth.

So, really excited us to see that polling come out, Joel, because it really, I think, underscores the conversation we should be having as a country and that we’re increasingly starting to see candidates in the 2020 field starting to talk about and to try to shift the debate to. So, in the last maybe 30 seconds or minute that I have with you, Joel, I mentioned candidates. That’s actually a big part of what Hunger Free America is up to right now and you’re up to right now is actually looking to center issues of hunger and poverty in the presidential debate. Is there anything you’re able to share with our listeners about exciting stuff you’ve got coming up?

BERG: We’re working to try to get all the leading candidates of both parties to Columbia, South Carolina on January 5th, Sunday, January 5th, to a forum to talk about economic opportunity for low-income people, poverty, hunger, and homelessness. To find out more, go to ActionForOpportunity.org. That’s ActionForOpportunity.org. We’d love you to sign up to attend, if you can, to host a viewing party if you can’t get to South Carolina, and to weigh in with presidential candidates that they should all attend. So, thank you for highlighting that, Rebecca, and thank you for this vital podcast that is getting the country on kilter.

VALLAS: [laughs] Always good talking to you, Joel. At some point, it’ll be about expansion and some of the proposals from Barbara Lee and Alma Adams and others where we’ve got hundreds of co-sponsors on in the House trying to actually make the conversation about increasing benefits and expanding who’s eligible so that we’re not just talking about cuts over and over again. But Joel, you’re my favorite person to talk to about this stuff, and I really appreciate you taking the time.

BERG: And I can’t wait till that all happens in the Vallas administration.

VALLAS: That’s right. [laughs] Joel Berg is the CEO of Hunger Free America and one of my favorite SNAP gurus to have on this show. Joel, talk to you soon.

BERG: Thank you.

VALLAS: Don’t go away. More Off-Kilter after the break. I’m Rebecca Vallas.

[hip hop music break]

You’re listening to Off-Kilter. I’m Rebecca Vallas. Another proposed rule issued by the Trump administration, this time by Trump’s Social Security Administration, has gone largely unnoticed by the media and the public, despite the tremendous harm it would do to millions of people with disabilities and the fact that it’s a backdoor attack on Social Security. That proposed rule would effectively require certain beneficiaries of Social Security Disability Insurance, or SSDI, and Supplemental Security Income, better known as SSI, to reprove their disability every two years in order to continue receiving benefits. With me to unpack the rule are two of my good friends, Rebecca Cokley, who leads CAP’s Disability Justice Initiative, and Matthew Cortland, a disabled, chronically-ill lawyer who is himself an SSI beneficiary who would be impacted, likely be impacted, by this proposed rule. Rebecca and Matt, thanks so much for taking the time, guys.

REBECCA COKLEY: Thank you for having us.

MATTHEW CORTLAND: It’s great to be with you.

VALLAS: And that felt really weird. I didn’t call you Cokes.

COKLEY: I know. That is weird.

VALLAS: And I was like, wait, who’s that? Who’s Rebecca?

COKLEY: I think that’s why there was that pause there.

VALLAS: [laughs]

COKLEY: I was like, wait. Is the third Rebecca in here?

VALLAS: Better known as Cokes.

So, Matt, I want to go to you first, because this is probably one of the wonkier rules that the Trump administration has issued since Trump has been in the White House. But it’s also, perhaps, one of the most evil and nefarious. So, just to unpack a little bit, because this one gets complicated, what would the rule do? How would it work? How would this reproving disability every two years actually play out?

CORTLAND: You’re right. It’s pretty in the weeds. It’s also fairly evil, which is a very difficult combination to sort of wrap your mind around and figure out what to do with. When someone’s approved by the Social Security Administration for disability benefits, whether it’s SSDI or SSI, that’s not a permanent thing. There’s a time limit, an expiration date of sorts, on the benefits that someone’s awarded on the basis of disability. And what happens is the Social Security Administration will come back to someone that they’ve found to be disabled at some point in the future and say, “Are you sure you’re still disabled? Really? Can you prove it maybe?” The Trump administration has decided that that happens too infrequently. They want to drastically increase the frequency of what are known as “continuing disability reviews” or CDRs for short. And the CDRs are a process by which the Social Security Administration tries to make sure that someone is still really, truly disabled. They’re not faking. There’s this myth, this pervasive myth that people are on Social Security Disability, either SSI or SSDI, because it’s a great time. And so, the CDR process is really designed to make sure that people are still disabled.

And the Trump administration wants to greatly increase the frequency of those CDRs. And the way that they’re going to do that is really, really quite wonky. But there’s something called a medical diary. And when someone applies for Social Security Disability and are awarded benefits, they’re assigned to a diary category. And these categories have names like “medical improvement expected” or “medical improvement possible” or “medical improvement not expected.” And the category that you get slotted into determines when you’re going to get hit with a Continuing Disability Review. So, for the most frequent category, it’s anywhere from six to 18 months after your initial award. For the medical improvement not expected category, it goes all the way out to five to seven years. And what the Trump administration wants to do is create a new slot in the middle called “medical improvement likely,” where every two years, someone who is assigned to that diary category would be hit with a CDR.

VALLAS: And so, Matt, and Cokley, I want to bring you into this as well, there’s a particular population of folks that the Trump administration is looking to sort of target for these more frequent Continuing Disability Reviews, these moments when people have to reprove their disability in order to continue to receive benefits. Cokes, who are the people that this rule is specifically targeting?

COKLEY: This is Cokley. They are specifically really looking at targeting people with unapparent disabilities: things like mental illness, people who have behavioral impairments, those that are traditionally seen as largely undeserving. I think a lot of times we talk about the people who are on SSDI as a result of back injuries, that we’ve talked about before, being sort of penalized and looked at with a certain level of side-eye and scrutiny from government. And so, these are people that are typically seen as people who are undeserving. It really plays into that moralistic model of disability that it’s not that you’re sick or in need of help. You’re just wrong. Like your existence is wrong. You are problematic. And so, I think as we saw, and we’re going to talk about this in a little bit, it’s following a path very similar to what we saw in the UK around the specific and deliberate targeting of people with emotional-behavioral disabilities, with mental illness, etc. and targeting those folks that really live at the nexus of multiple oppressions and multiple systems that don’t work. And as we’ll see, this isn’t helpful. This isn’t right.

VALLAS: Well, and I want to get more into how we’ve kind of seen this movie before, because there’s actually a lot of instances of that, and the UK is one of them. So, we’re going to come back to that.

Matt, I want to go back over to you to talk a little bit about what we think the consequences of this rule are likely to be. As part of the rulemaking process, the administration is required to release a whole bunch of estimates of what they think is going to happen, how many people will be impacted. What do we know about who would newly be subject to these expedited, these two-year reviews, and thus, who would likely to be at risk of losing benefits?

CORTLAND: The rule, wonky though it may be, is really quite clear that as a result of this change, if it ultimately happens, if the administration is successful in implementing these increased-frequency CDRs, millions of people are going to be cut from Social Security Disability. The sort of brilliance of this, the sort of evil brilliance of this rule is that it looks neutral. But we know, because the Social Security Administration has to publish this sort of data, we know that for every dollar the Social Security Administration puts into a CDR process, they end up cutting $19.90 in Social Security Disability benefits. So, the return on investment for the Trump administration here is just phenomenal. They spend a dollar in the CDR process. They get to cut $19.90 because they anticipate completing something like 1.8 million what are called full medical reviews. That’s when they dive into the medical records. They go really in-depth, really granular, making you produce medical records from all of your treating physicians, from therapists, from physical therapists, from occupational therapists as part of the full medical review process.

They’re also looking at something like 2.6 million mailers going out where they send out, you get a piece of mail from the Social Security Administration asking you. It looks like a benign questionnaire, but it’s actually a trick. It’s a trap is what it is. And they’re looking for certain things that you might answer a question that looks sort of neutral, and you might put in you’ve started a new medication. That might be evidence that you have medically improved and trigger the full medical review where they’re looking at your entire medical record. And so, they’re estimating a couple of million people approximately would end up losing their Social Security benefits as a result of this increase in frequency and these Continuing Disability Reviews.

VALLAS: And Matt, you’re a lawyer who understands this system really well, who has practiced in this system, represented people who are going through it, seeking benefits, wrongfully denied, and so forth. You’re also an SSI beneficiary, so you’ve seen this system from both sides. One of the things that you’ve pointed out that this nefarious rule is perhaps even more evil because of is that most people who are going through the Continuing Disability Review process — and this was something I saw back in my legal aid days as well — don’t have lawyers. Most people going through this review process are unrepresented when they are effectively doing battle with the Social Security Administration to prove that they are still disabled and thus eligible for benefits. Talk a little bit about the kind of the intangibles of what the consequences are that are likely to stem from this rule in addition to just people outright losing their benefits.

CORTLAND: That is such an important point. I have the advantage and the privilege of having a law degree and a license to practice. Most people, the vast majority of people, are not lawyers. They made better life decisions than I did.

VALLAS: [laughs]

CORTLAND: And so, the maximum amount that an individual beneficiary on SSI can get right now this month is $771, which is only 74 percent of the federal poverty rate, federal poverty line. On 74 percent of the federal poverty line, there isn’t money to hire a lawyer. You can’t go to someone in private practice and say, “Please help me through this thicket, this byzantine, bureaucratic maze full of traps for non-lawyers. Please help me through that so that I can continue getting my benefit that’s 74 percent of the federal poverty line.” There’s no money to hire anyone to do that. SSDI is, in terms of the average benefit, slightly better, but still not enough money for the vast majority of SSDI beneficiaries to hire counsel either. And so, going through this sort of process unrepresented is incredibly difficult and challenging. It’s stressful because the people on the other side are professional, and it really is the other side. It’s not billed as an adversarial process, but it is. It absolutely is. The people who are going to be reviewing your CDR review CDRs for a living. Most disabled folks don’t, for a living, do CDRs. So, there’s this great mismatch in experience, in training between the people in the Social Security Administration and individual disabled individuals.

There are some great groups out there, legal aid groups, that represent people through this sort of system. The legal aid system right now is I mean, it’s usually stretched thin. It’s usually overtaxed. But as we’re three years into this administration, it is threadbare. And so, finding help for folks is incredibly challenging, and most people there’s just not help available. And so, they’re left on their own, confronted with the possibility of loss of their benefits that they’re using to pay rent, they’re using to buy food, they’re using for transportation. It’s their lifeline. And they get something in the mail one day saying we might take that away. Here’s a form to fill out. Depending on how you fill it out, if you fill it out right, if you fill it out wrong, maybe you keep your benefits, maybe you don’t.

And so, especially for a community of people who are dealing with, many of whom are dealing with very serious illness, that sort of stress, that sort of additional work, that additional burden of dealing with yet another bureaucracy can have really real health consequences. It can exacerbate certain conditions. You know, I have an immune-mediated disease called Crohn’s disease, which is a form of inflammatory bowel disease. And one of the tips you always get in the flyers in the waiting room at gastroenterologist offices is, try to reduce stress in your life. That’s hard to do when the Social Security Administration says, hey, we might take away the only way you have to pay rent unless you jump through these hoops, unless you figure out this process that you have no training in. And so, there aren’t very real health consequences there as a result of this sort of thing.

VALLAS: And Matt, I want to get even a little bit wonkier than you even just did in terms of why this is likely to be a population of folks who are, by and large, without any form of legal help. You mentioned resources being incredibly limited on the part of beneficiaries who are receiving basically poverty benefits or sub-poverty-level benefits. You mentioned that legal aid is incredibly stretched thin, something I felt years ago and which has, as you said, only gotten worse. But there’s one other reason that I suspect the Trump administration is very, very aware of for why these are people who, by and large, are not going to be able to secure legal help to protect their rightful benefits that they very much need. And that is because the private bar, who currently does play a particularly important role in representing a lot of folks who are wrongfully denied Social Security Disability Insurance and SSI benefits, the private bar generally takes those cases, not because we’re talking about folks who have a lot of money to throw around, but because the process takes so long for people to demonstrate their eligibility, that by the time someone is actually found eligible — they’ve gone through the process, maybe they’ve been denied, they’ve gone to a hearing, they’ve gone in front of an administrative law judge — the lawyers know that there’s going to be back benefits that have accumulated over time that that person is now entitled to. And so, they’re able to take a cut from those back benefits legally to pay their legal fees. And that’s a big part of why we actually see lawyers, private lawyers, willing to represent a by and large low-income population of folks trying to demonstrate their eligibility for these benefits.

But when it comes to Continuing Disability Reviews, there are no such back benefits. And that is just yet another reason why we are likely to see folks, by and large, having to do their own battle pro se with the Social Security Administration to try to say, actually, no, I’m still eligible, but I don’t have the legal speak or the know-how to argue this case effectively. So, just another super wonky-point, but something that I expect the Trump administration is fully aware of for why they’re crafting the rule the way that they did.

Cokes, one of the things that you’ve been on this show talking about before, and Matt, you have as well, is actually some of the prior attacks that the Trump administration has waged that are sort of backdoor attacks on Social Security and on Social Security Disability beneficiaries in particular. And some of those actually feel like they’re going to interact pretty heavily with this rule, if it takes effect. One of them has to do with social media surveillance that the Trump administration is seeking to perpetrate against disability beneficiaries. Remind us a little bit, Cokes, of what’s going on there and how you think that might feed into this particular rule if it takes effect.

COKLEY: In the 2020 budget, there was funds allocated within the Social Security Administration to monitor the social media presence of individual beneficiaries for the purposes of being able to determine fraudulent use of benefits. And I think this is the sort of thing that we’ve talked about and have been unabashedly outraged at over the last several years. Everybody knows someone who has run into something like this, who has had a good day post-chemo, let’s say, and went and took their kid to the park or God forbid, went on vacation. And sure enough, as soon as that happens, they post pictures online. They are a little naive about privacy preferences perhaps on their social media. And there’s a letter in the mail from Social Security talking to them about reviewing their benefits. You know, the fact that there has now been actual funds tied to this program at the same time that we’re seeing this proposed new rulemaking, it’s not coincidental. I mean, and I think I’ve probably said this on every episode of this show that I’ve been on, which is just because you’re paranoid does not mean they are not out to get you. Because they are, you know. And I think we’re going to see this used for this explicit purpose: to knock folks off of benefits that are seen as undeserving, that are seen as the fakers, the takers, the money makers, as we alluded to them before, as opposed to having any sort of understanding that disability and chronic illness in itself is a fluid experience. And you may have a good day. You may have a good hour, but that does not summarize your total lived experience with your particular diagnosis or condition.

VALLAS: I’m talking with Rebecca Cokley, the director of the Disability Justice Initiative at the Center for American Progress. I’m also speaking with Matthew Cortland. He’s a lawyer, and he’s a chronically ill and disabled lawyer who himself receives SSI benefits and is a deep expert in the Social Security Disability process. Matt, I want to go back over to you to talk about another change that didn’t get any attention within the Social Security Administration processes and policies under the Trump administration that also is potentially going to play into this and that has to do with how these reviews get done and which types of medical evidence and which types of doctors actually get considered.

CORTLAND: It’s a good point. And it’s, I’m just screaming internally because it got lost in the maelstrom of news coverage, this never-ending news cycle that we are all stuck in. But back in 2017, the Social Security Administration changed the way that it looks at medical evidence. Before March 27th of 2017, the Social Security Administration would look at a chart, a medical chart, or a letter from a doctor who is your doctor, is your treating physician, the doctor you have an established relationship with, the doctor who knows you, the doctor who’s prescribed medications and ordered tests. Your doctor! The Social Security Administration would say, that doctor, if they provide a chart to us, if they write a letter, we’re going to give their medical opinion extra weight. In fact, it’s going to be controlling. They signed the form, right, they jump through a few hoops. But if they do that, we’re going to give their opinion of your medical condition what’s called controlling weight, which just means we’re going to trust your doctor. We’re going to believe what they tell us about your medical condition.

After March 27th of 2017, the Social Security Administration says, will not defer or give any specific evidentiary weight, including controlling weight, to any medical opinion, including those from your medical sources. And if you translate that out of legalese, it just means yeah, you can send the stuff from your doctor. But we might listen to the doctor we send you to for a five-minute exam. We might choose to believe the doctor we pay to examine you over the doctor you have a long-standing relationship with.

My gastroenterologist is, in addition to being incredibly kind and competent, a world-leading expert in the treatment of inflammatory bowel diseases. Her CV is something like 55 pages long with dozens of peer-reviewed publications in the literature, on the Board of many of the leading journals, including the New England Journal of Medicine as a reviewer. And her CV is incredibly impressive, and I’m lucky that she takes care of me and has kept me alive. The Social Security Administration now thinks that some random physician they send me to, who may or may not be a gastroenterologist, should be given as much deference as my world leading expert who has taken care of me for over a decade.

And the reason that they did it is quite simple, because it’s a way of reducing the number of claims that they have to approve. If they can pick and choose which doctors to listen to, if they can choose to listen to their own doctors on their own payroll over your treating physician who has your best interest and knows your medical record deeply and knows your treatment history and has been with you through your illness history, if they can pick and choose which evidence that they listen to, then they get to really, that they get to determine who they approve and who they don’t approve. They get to pick winners and losers, not on any sort of fair basis. They get to stack the deck.

VALLAS: And it makes it a lot easier for them to deny claims, as you point out, if they can just pick their own doctors who have seen you for 10 minutes and are just sort of rubber stamping, nope, I don’t think this person qualifies. Which is often what we see when those doctors’ opinions are the ones who get looked at rather than treating physicians who actually know the person inside and out, quite literally.

So, one of the things that really comes to mind to me as sort of a, we’ve seen this movie before, right? This is not just theoretical what’s going to come from this rule if it takes effect, like actually this country has done this, something very similar to this before and actually not that long ago. So, just a little bit of history to share for listeners who are wondering if we’re maybe being a little histrionic or if we’re saying, oh, millions of people are going to lose their benefits. And, you know, no, this actually is not theoretical. So, back in the 1980s — a little bit of a history lesson — back in the 1980s under then-President Reagan, the Social Security Administration actually did something incredibly similar to what Trump is proposing to do here. They changed the frequency and the volume of these Continuing Disability Reviews and they kind of dialed them way up so that people were being reviewed left and right and being told, oh, you’re not disabled anymore. You’re not disabled anymore. And so many of the folks, many of the folks who were actually being reviewed — we’re talking about people with developmental disabilities, chronic conditions, life-threatening conditions, right — the people who were being told they’re, quote, “not disabled anymore” were without question still with the same diagnoses and conditions and prognoses that they had been when they had been initially evaluated. But nonetheless, they were being cut off left and right for all the reasons that Matt, you were enumerating, because they were not able to get legal help. And so, we actually saw about half a million people lose their SSI and SSDI benefits back in the early 1980s as a result of these reviews.

Things got so bad that people were literally dying by great numbers. People were actually dying by suicide in many cases because they didn’t know how to make ends meet anymore and had lost their lifeline, as you put it, Matt, the thing that allowed them to buy food and to pay rent. And so, things got so utterly bad that states actually started to reject these changes and to oppose and to rebel against the Reagan administration and its Social Security officials. And so, you ended up seeing this whole kind of chaos play out in the courts: all of this kind of state versus the feds battle that was going on because it was just so inhumane the way that this mass ripping away of benefits was playing out on the ground. And so, ultimately, Reagan, where this movie ends, is Reagan had to reverse course. Congress unanimously rejected the policy and actually legislated to undo it to protect people. And that was what gave us the modern day Continuing Disability Review process and laws and protections that allow people the stability of knowing that they’re going to have their benefits and that they’re actually going to have reasonable protections to continue to receive the benefits that they rely on. And Reagan himself had to sign those protections into law in 1984 after Congress unanimously handed him those protections by law! So, that’s what happened the last time we saw a president — a Republican president, I might add — target disability beneficiaries to lose their benefits by great numbers, by mucking around with how these reviews work.

And Cokes, we were just talking before we actually started rolling about how something very similar played out not that long ago over in the United Kingdom when they did something very similar to this. What’s the short version of what happened in the UK?

COKLEY: Well, I would be very quick and adept to point out that if anybody really wants to see the true play-by-play about how things went down in the UK, check out the writing by our dear friend Mary O’Hara, who has written on poverty and austerity measures in the UK for forever. Quite literally, if you Google “austerity and the UK,” her name comes up on at least half a dozen bylines.

VALLAS: She’s the author of a book called Austerity Bites, one of the better titles I can remember of any book.

COKLEY: Easily one of the best titles out there. And I think one of the things that she really hit on is at the same time that these cuts are taking place on individual benefits, we saw the UK government cutting institutional benefits as well. And so, there was nowhere for folks to go to get help. They talked about how, in the rampant increase of suicides in the early-2010s, early to mid-2010s, there was a number of Freedom of Information requests to the government where the government was forced release mortality statistics on people who had died after being declared fit to work. And the government was really deliberate in not putting out how people died. And of course, they warned with a giant blanket statement, like, there is no known causal link between people losing their benefits and people dying or committing suicide as a result of those loss of benefits. Do not look behind the curtain! There is no man standing here, you know.

And while this was happening, while these suicides continued to ramp up and statistically impacted men at a higher percentage than impacted women, charities were being overrun by demand. And because the cuts were not just to individuals, but they were also to programs and services, charities were unable to meet the needs. Emergency rooms were full of people trying to get the scraps of help for their health care, you know. And they saw this systematically across the board in a number of countries that chose to go the austerity route versus the stimulus route, including Germany, Sweden, and Iceland, where they went the stimulus direction versus the austerity measures which were implemented, as we saw, in Greece, Italy, Spain, and the UK, where the numbers of folks in poverty, where the number of folks committing suicide were very similar across the board when these austerity measures were implemented.

And I think we still see it today. You know, we routinely hear from our colleagues across the pond on Twitter, on other sorts of social media, talking about going in for Continuing Disability Reviews.

VALLAS: Which they call “fit to work” tests over there. But same thing here.

COKLEY: Yep. And just being inundated with paper. And it really is death by bureaucracy.

VALLAS: Yeah. No, it’s just really important given that we’ve got history here in the States. We’ve got very recent history over in the UK. We’ll have to have Mary O’Hara back at some point soon to actually give us maybe a more in-depth reminder of what was happening over there in austerity, because it is such an important cautionary tale as the Trump administration considers this policy.

So, Matt, going back over to you for a minute — and we only have a few minutes left for this conversation, although I could talk to you both all day about this, because this one is just so incredibly evil and so important for people to understand and getting absolutely no attention whatsoever in the media as we speak — the politics here. So, Trump promised famously when he was running for office that he would not cut Social Security, or I should note, Medicare or Medicaid. Both promises that he’s since broken as well. But he’s repeatedly proposed cuts to Social Security’s Disability programs, breaking that promise pretty much every year he’s been in the White House. And he’s got Mick Mulvaney, who folks will remember as his OMB director who —

COKLEY: OMB director, CFPB administrator.

VALLAS: Chief of Staff.

COKLEY: Chief of Staff.

VALLAS: He’s played pretty much every role in this administration.

COKLEY: Concurrently.

VALLAS: And Mick Mulvaney has been one of his kind of spokespeople on this. He actually, just about a year ago, came right out and said that he did not believe that cutting the disability programs violated Trump’s promise, because somehow these programs aren’t actually real Social Security, right ?

COKLEY: Correct.

VALLAS: He was like explicitly trying to welfare-ize these programs and paint them as something other. But Matt, something that you have done a tremendous amount of writing and speaking about and tweeting about over the past several years — and you too, Cokley — is that this type of policy in a lot of ways should be no surprise, given that years of media coverage that have framed disability beneficiaries, frankly, as the new quote-unquote “welfare queens” has kind of paved the way for these kinds of cuts and has really kind of provided a basis for elected officials, including Trump, to say that what they’re doing is trying to go after waste, fraud, and abuse. Matt, I would feel remiss if we closed out this segment without doing a little bit of myth busting, given how sticky some of those kind of media-reinforced myths are. What about the people who are listening at home and going, Yeah, but isn’t it just really easy to get disability benefits? Maybe we just need to clamp down a little bit. What do you say after you stop banging your head against the wall when you hear someone ask that kind of a question?

CORTLAND: So, the first thing I have to do is stop screaming at Mick Mulvaney. Social Security Disability Insurance, SSDI, it’s right in the name. “Social Security” is literally in the name of the benefit. And as for SSI, the application I submit on behalf of myself, if I’m working with clients, they’re going to the Social Security Administration, the Social Security Administration. It’s right in the name. Putting that aside, it’s incredibly difficult when you submit those applications to be approved for disability. Initial applications, the applications that most people fill out on their own, because there’s not a sort of legal safety net, much of a legal safety net in this country, the initial approval rate in FY 2017 was about 34, 35 percent, which means most, the vast majority of applications are denied.

You might think, on hearing just that statistic, that a lot of people who aren’t really disabled are applying. But when you find out that the vast majority of those initial rejections are eventually approved on appeal when, as you said, the private bar steps in and people have counsel to help them navigate this bureaucratic nightmare of applying for Disability and doing an appeal and appearing before what’s called an administrative law judge who works for the Social Security Administration, determining whether or not someone meets the definition of disability that SSA uses, should tell you that, because the vast majority of those appeals are eventually approved, it’s not that people who aren’t disabled are applying for benefits as some sort of scam. It’s that the system is really set up to be adversarial, to deny people benefits. And you need the firepower of a lawyer on your side, in many instances, to succeed.

So, it’s actually incredibly difficult to get Social Security benefits. And the myth that it’s somehow easy, you know, anyone who believes that should just go down to their local Social Security field office sometime and watch people just in tears at the window as they’re trying to figure out why their benefits weren’t approved or why their benefits were interrupted or why they’ve gotten a notice saying that they have to appear at a certain time and place. It’s the misery in that place is palpable as people are really struggling with these issues that are all too often the difference between homelessness and not, being able to have medical coverage or not. No one’s getting rich off of Social Security Disability Insurance. It’s just not happening.

VALLAS: And Cokes, I’m looking over at you because I have to say this is bringing back a lot of memories of you and I and some others of our colleagues at the Center for American Progress doing some pretty serious battle with The Washington Post not that long ago when they did a year-long series of myth-laden stories, really kind of reinforcing all of this misinformation about who receives benefits and all those myths that you just so wonderfully sort of busted there, Matt. And I just want to call that out, right, for folks who are wondering, what do we mean when we say the media has kind of handed this to us? The Washington Post really deserves more than a rap on the wrist for being part of the problem here.

COKLEY: Thanks, Terry.

VALLAS: [laughs] Yeah. So, Matt, in the last minute or so that I have with you guys, we really need to give our listeners a sense of what comes next and what to watch for. I mentioned that this was a proposed rulemaking. Listeners of Off-Kilter are perhaps better versed than anyone else in the country on what a notice of proposed rulemaking is at this point, because, boy, is that all it seems we ever get to talk about on this show. And earlier in the show, we were just talking about SNAP and the attacks on SNAP that have come through the same form of administrative process. Remind us what comes next when the comment period closes and what listeners need to know about how they can fight back against this evil and nefarious rule.

CORTLAND: You’re exactly right. We’re in the commenting window. And that commenting window now closes on January 31st. They extended it a few days when — The Regulations.gov website that we’ve all become more familiar with than I think any of us would really like, as we’ve fought the Medicaid worker requirements, the cuts to SNAP, the Regulations.gov website was down for a little while because someone forgot to renew the security certificates.

COKLEY: Womp womp.

VALLAS: [laughs]

CORTLAND: Right. They pushed the commenting deadline back to January 31st. And we’re going to fight this by a commenting program where we’re going to submit comments. There will be commenting guides out there — look for them coming soon — that will walk you through submitting a comment that will be used in what I’m sure will be eventual litigation, because this rule will be challenged in court. You know, we’re going to fight this.

VALLAS: So, folks can stay tuned for more on where to comment. In the meantime, we will have a link on our nerdy syllabus page because of course, we will to the Regulations.gov spot where you can submit a comment if you just can’t wait. But if you can hang on for just a minute, we will have a commenting guide, as Matt mentioned, and also a dedicated website where folks can actually go to submit their comments, similar to what we’ve had in the ongoing, yearlong fight to protect SNAP from administrative attacks.

Cokley, anything else that you want to get in for the good of the order on what this rule is about and what folks need to know?

COKLEY: I would just like to say I acknowledge the fact that everyone’s really tired, that we’re going into the holidays, and we’ve just come off of the Trump administration’s third ridiculous attack on SNAP and taking the food out of the literal hands of people that don’t have any food. And to quote Carrie Wade, this year has been a long decade! This is something we have to find the energy to fight for. This is something that is so reprehensible that I was in a room of civil rights leaders yesterday who were like, “Oh, it’s another NPR womp, womp.” And then as I explained what it was, watching the literal horror spread around this table of 40-plus people who do this for a living and find themselves be pretty jaded at this point and are like, this is a new low. We have to mobilize. We have to push back on this. Each of our communities has to engage. Let us know how we can be in solidarity with all of you right now. Because I can’t think of a single family that I know that isn’t going to be impacted by this. I can’t think of a single community, whether race or ethnic, whether religious, whether immigrant, that will not be impacted by this. And yeah, I mean, just when you think, just when you think it can’t get worse! Thanks, Trump.

VALLAS: Yep. So, this is one day to find the energy for, as Cokes said, because of how many millions of people are potentially at risk of losing their sole or main source of income. Matt, I really, really appreciate you taking the time to help unpack this. This one, as you said, is wonky, but really well worth understanding. So, lots more to come as we continue to track and keep our listeners posted on this proposed rule and how folks can fight back. And again, check out our nerdy syllabus for more on how you can comment and also @Off-KilterShow on Twitter, which we’ll be keeping you posted with updates as well with that commenting guide when it’s ready, that dedicated comment page, and other resources as well. And we suspect our friends over at #CripTheVote are likely to have some stuff coming as well.

I’ve been speaking with Matthew Cortland. He’s a disabled, chronically-ill lawyer who is himself an SSI beneficiary who would likely be impacted by this proposed rule and many of the other attacks on Social Security beneficiaries that we’ve been talking about today. And Rebecca Cokley, better known as Cokes, who leads CAP’s Disability Justice Initiative. I really appreciate you both for taking the time and look forward to working with you to raise some more attention on this rule that is totally, totally getting buried.

And that does it for this week’s episode of Off-Kilter, powered by the Center for American Progress Action Fund. I’m your host Rebecca Vallas. The show is produced by Will Urquhart and David Ballard. Find us on Facebook and Twitter @OffKilterShow, and you can find us on the airwaves on the Progressive Voices Network and the We Act Radio Network or anytime as a podcast on iTunes. See you next week.

♪ I want freedom (freedom)

Freedom (freedom)

Now, I don’t know where it’s at

But it’s calling me back

I feel my spirit is revealing,

And now we just trynta get freedom (freedom)

What we talkin’ bout…. ♪