Is the 2010 Affordable Care Act Minimum Standard to Identify Disability in All National Datasets Good Enough for Policy Purposes?

Published: 2014


Using linked 2009 Current Population Survey (CPS)-Annual Social and Economic Supplement/Social Security Administration records data and a definition of disability based on the six-question disability sequence (6QS) in the CPS-Basic Monthly Survey we perform a face validity test that shows that the 6QS captures only 66.3 percent of those who administrative records confirm are receiving Social Security benefits based on their disability.  Adding a work-activity question to the 6QS increases our capture rate by another 23.1 percentage points for a total of 89.3 percent. We find little difference in the distribution of conditions between those who only report a 6QS-based disability and those who only report a work activity-based disability. The four function-related questions in the 6QS do a relatively good job of capturing those receiving benefits based on these conditions. But the work-activity question does a far better job of capturing those receiving benefits than the two activity-related questions in the 6QS.

Key Findings

    • This study evaluates the efficacy of national datasets that seek to determine the effect of public policy on individuals with disabilities.
    • The six-question sequence instituted as the national standard for collection of health statistics by the Affordable Care Act of 2010 only identifies 66.3% of individuals in the Current Population Survey that matched Social Security Administration (SSA) records verify are receiving disability-based Social Security benefits.
    • When we add a work-activity question to the sequence, we capture 23.1 more percentage points of this Social Security benefit population, bringing the total to 89.3%.
    • The additional population captured by the work-activity question shares the same health characteristics as the population captured by the six-question sequence.
    • The inability of the current six-question sequence to capture those who have a work limitation and are judged disabled enough to receive Social Security benefits leads to an overstatement of labor force participation and employment rates and an understatement of poverty rates of the true working age population with disabilities.