Trump wins big in disability country

(Bloomberg View) — The $150 billion federal disability program is a mess. It almost went broke (Congress had to give it an emergency infusion). It discourages employment and can be gamed. But woe to the office-seeker who tries to fix it.

No one understands this better than Donald Trump, who has defied Republican orthodoxy and courted Republican voters by opposing changes to entitlement benefits, which include the federal disability program that is part of Social Security and provides income to 11 million Americans.  

The portion of the working-age population receiving benefits is 4.8 percent, up from 2.8 percent in 1994. Applications are growing again, after leveling off last year. Recipients are mostly non-college-educated, white, blue collar and middle-aged. Trump voters, in other words.

The political terrain in the 20 states with the highest disability rates has indeed favored Trump.

There are no polls of disability recipients themselves, so it’s hard to prove any predominant preference for Trump. Yet Trump has won the Republican primary or caucus in 12 of the 15 states that have voted so far. Of the five states in the top 20 that have yet to vote, Trump is well ahead in the polls in Pennsylvania and Rhode Island, which vote on Tuesday, and leading in Indiana and West Virginia, which vote on May 3 and 10, respectively.

Part of the disability-population increase is due to the large number of women who have entered the workforce since the 1970s and earned the right to benefits if they become impaired. Another reason is that baby boomers have entered their more disability-prone years.

But federal disability payments are also a form of welfare for blue-collar workers. When the economy weakens, the disability rolls mushroom. From the late 1980s to 2009, for example, the number of beneficiaries doubled.  

Since 1984, when lawmakers broadened the eligibility standards to consider a person’s symptoms as opposed to requiring a doctor to attest to a specific diagnosis, qualifying for benefits became simpler. While many applicants are still denied, those with multiple maladies can qualify even if no single condition meets the criteria. About 40 percent of applicants succeed, often after lengthy appeals.

The recipients are concentrated in the Southeast, spreading northward through Appalachia and into hard-hit pockets of the Northeast and Midwest, where industries have moved production offshore or closed down entirely over the last few decades. Many Appalachian communities that depend on coal mining have turned against Democrats, especially President Barack Obama, for supporting limits on carbon emissions that reduce demand for coal.

These areas and states also happen to be where life expectancy is lowest. When you combine failing health with the falling fortunes of the poorly educated, the result is high rates of drug and alcohol abuse leading to physical and mental impairment, as economists Anne Case and Angus Deaton have shown in their research on higher death rates among middle-aged whites. The Centers for Disease Control and Prevention last week said life expectancy fell for American whites overall in 2014, to 78.8 years from 78.9.