Is the 2010 Affordable Care Act minimum standard to identify disability in all national datasets good enough for policy purposes?

Abstract

We provide a face validity test of the Department of Health and Human Services' (HHS) approved minimum six-question sequence (6QS) to capture the population with disabilities. Using linked 2009 Current Population Survey/Social Security Administration records data we find that the 6QS captures 66.3% of those whom administrative records confirm are receiving disability-based Social Security benefits. Adding a work-activity question increases our capture rate to 89.3%.

We find little difference in the distribution of conditions of those reporting only a 6QS-based disability and those only reporting a work activity-based disability. The four function-related questions do a relatively good job of capturing beneficiaries based on these conditions. But the work-activity question does a far better job of capturing beneficiaries than do the two activity-related questions. We conclude that the 6QS is fundamentally flawed and that any minimum standard for capturing the population with disabilities must include a work-activity question.