Burden Reduction in a Social Safety Net Program Reduces Mortality

Many eligible individuals do not enroll in social safety net programs because of burdensome administrative procedures, ranging from confusion about eligibility guidelines to complicated paperwork. But what happens when eligible individuals don't take up benefits for which they’re eligible? While we know the short-term impacts, such as forgone income and benefits, the long-term consequences of these losses remain poorly understood. We examine the mortality impacts of burden reduction – particularly learning costs associated with understanding eligibility and benefits – for the Supplemental Security Income (SSI) program. Using data from a large-scale randomized controlled trial (N=4,016,461) in which informational letters were sent to older adults likely eligible but not enrolled in SSI, we estimate the mortality effects of older adults’ subsequent enrollment in SSI. The intervention increased SSI awards by an estimated 1.8 percentage points (or a 340 percent increase from a baseline enrollment rate of 0.5 percent). Among those who enrolled in SSI, we estimate a meaningful reduction in mortality (Hazard Ratio=0.6101, 95% CI=0.5127 - 0.7075). These results demonstrate that burden reduction increased access to social welfare programs like SSI in the short term and may have significant downstream impacts by reducing beneficiaries’ mortality risk.