Nine Million Older Adults Are Missing Benefits They Are Eligible For

A new interactive map launched recently by the National Council on Aging (NCOA) shows that, nationally, 9 million adults age 65 and over with limited incomes are eligible for but not enrolled in programs that can help them afford food, Medicare, and other daily expenses. Developed with the Urban Institute, the Benefits Participation Map provides national, state, and sub-state level estimates of participation rates for adults 65 and older for three benefits programs: Supplemental Nutrition Assistance Program (SNAP, monthly support for food), Supplemental Security Income (SSI, monthly cash aid), and Medicare Savings Programs (MSPs, help for Medicare premiums, deductibles, and co-insurance). Jessica Johnston, senior director of the Center for Economic Well-Being at NCOA, spoke with Spotlight recently about the new site. The transcript of that conversation has been lightly edited for length and clarity.

Let’s start with what prompted this study and the development of the interactive map.

The National Council on Aging has been connecting older adults with benefits for many, many years and we know from our work that older adults leave billions of dollars in unclaimed benefits on the table every year. We can look at a lot of national statistics and see that older adults are not connecting to SNAP benefits, for instance—only about 30% of those who are eligible are enrolled. But the challenge has always been that while we know there are millions of people that don’t have access to these benefits that are eligible, where do they live? How do we find them? And so, we did some work with the Urban Institute, and they thought by using an algorithm that they developed along with open-source data that they could provide estimates of the number of people who were eligible but not enrolled in SNAP benefits, Medicare Savings Programs and SSI benefits. We worked with them on this interactive map so that we could really zero in and understand where there are high concentrations of people who are eligible but not enrolled in these benefits.

And is that at the county level or does it drill down deeper than that?

The map goes all the way down to the county level, but there are some instances where we have multi-county groups.

What were some of the highlights or lowlights that you found for participation or lack of participation in these programs?

Participation rates vary substantially. For SNAP participation rates, for instance, they range from as low as 17% in California to as much as 51% in Rhode Island. Rhode Island is the only state that’s above the 50% participation mark and we’re really excited to do some initial analysis on Rhode Island specifically because one of the things that we know about Rhode Island is that they have a more streamlined benefits application process generally. I’m really interested to dig in and see does this streamlined application process actually work to connect more people to benefits. Oftentimes we look at this problem as an outreach issue, but the flip side is that signing up for benefits is an administrative issue as well. So, all the steps that states can take to reduce those administrative barriers, the easier it is to get people connected to benefits.

And anecdotally, does that increasingly seem to be the main barrier for a lot of folks? It’s just too hard or too much trouble to sign up?

I wouldn’t say it’s the main barrier, but it’s definitely one of them. Another barrier is there’s a lot of misconceptions about benefits out there. A lot of older adults often think that if they are receiving a benefit, that they’re taking it away from someone else who might need it more and that just simply isn’t true. But that’s a common misconception that we encounter. A lot of people also just don’t know where to get started. There’s still a lot of people who are not reliably connected to broadband and so much of what we do is based online now. And so, finding ways for people to get started, whether it be through a senior center or a community-based organization that they trust, is also a really important tool to get people connected.

And was there anything else that Rhode Island is doing that you think could be responsible for them getting over that 50% mark?

It is a really small state and so your ability to concentrate resources in a small area that is somewhat densely populated is certainly a factor. Rhode Island also doesn’t have a large population of older adults.

Of the three programs that you looked at, which one was leaving the most benefits on the table?

It depends on how you want to look at it. SSI is going to be the most generous benefit in terms of money and has the potential to have a huge impact. But the other important thing I want to note is every state’s eligibility requirements are going to vary a little bit, but oftentimes if you are eligible for one of these programs, you are probably eligible for other benefits. And so even getting people plugged into one of these benefits is likely going to open the door for other benefits as well, which is a really important thing to consider.

What is your expectation for how state and local officials could use this dashboard to their benefit?

Let’s use Florida as an example. Florida’s SSI participation rate is 49%, which is about the same as the national average. And so, you might think then that Florida’s not a state that we should be targeting to really increase SSI participation. But you start to drill down, and we see that there is a 90% participation rate in Miami-Dade County, the state’s most populous county, which is skewing the whole state’s numbers. Miami-Dade and one other county are the only counties that are above the national participation rate for SSI.

So, if I’m in local government, I want to know a couple of things. One, what is Miami-Dade doing that they got that many people connected to benefits? Because 90% is incredible. And then the other piece of it is, okay, what counties in Florida do I really need to be targeting and connecting community-based organizations to, to get people enrolled in benefits? And these benefits are such an important component of overall economic security for older adults. From a local government perspective, they can help keep them out of emergency rooms because they’re not making difficult choices like, am I going to spend money on food or my prescription drugs? And the more closely they’re connected with these benefits, the more likely are likely they are to get other information about things like preventative care and other wraparound services.

And is the plan to continue to update the site going forward with new data as it comes in?

Yes. we are exploring right now actually how to update this with 2023 data. And then we’re looking at a long-term strategy with regular updates so that we can make this kind of a longitudinal study to really see where we’re starting to close the gap on some of these benefits.

And do you plan to also do deeper dives into some of the specific like Miami-Dade County or Rhode Island and try to pull up some of the lessons learned and best practices that other places can follow?

Yes. Over the course of the next year, we’re going to be putting out spotlights and briefs that dive deeper into some of the analysis behind this map.

What surprised you the most about what you found?

It really often surprises me how many older adults are not involved in SNAP benefits—we’re not helping people make that connection. Beyond the communication barriers and the outreach barriers of getting people connected, older adults are often a forgotten demographic. An older adult’s minimum SNAP benefit is only $23. So, it’s really easy to say if I’m only going qualify for $23, is all this paperwork worth it? I think we should really be asking ourselves; how much money are we spending at the state and federal level on administrative burdens to administer $23-a-month benefit to an older adult who could really use it? Are we really that concerned about it?  I think there really needs to be some important policy conversations around balancing that. And I think that this map really helps to drive home that point.