SUMMARY OF OPTIONS PREFERRED BY A MAJORITY OF EXPERTS WITH COST
                            ESTIMATES
SSI Program Costs, SSA Administrative Costs, Medicaid Costs, and
                        Food Stamp Costs


OPTIONS                                                COST
(MILLIONS OF DOLLARS)
                                               1993      1994
1995
1996
1997

BENEFIT PAYMENT ISSUES
Benefit Adequacy
Increase  the  Federal  benefit  standard for an individual, in 5
equal  annual increments, to 120 percent  of  poverty  guideline.
Keep the  couple's  benefit  standard  at 150 percent of that for
individuals.Program
Admin.
Medicaid2,567
                                                              250
                                                              435
                                                            7,092
                                                              710
                                                      1,82512,706
                                                              460
                                                      2,95019,527
                                                              470
                                                            4,310
                                                           27,707
                                                              510
                                                            5,995


Couples
Eliminate the concept of
"holding out" in defining a spouse.Program
Admin.
                                                        Medicaid2
                                                              (a)
                                                             (a)3
                                                              (a)
                                                             (a)3
                                                              (a)
                                                             (a)4
                                                              (a)
                                                             (a)4
                                                              (a)
                                                              (a)
Give  each  member  of  a  couple  a full set  of  earned  income
exclusions.Program
Admin.
                                                        Medicaid1
                                                              (a)
                                                               52
                                                               10
                                                              203
                                                              (a)
                                                              253
                                                                0
                                                              253
                                                              (a)
                                                               35
State Supplementation
Permit States to reduce or terminate supplements once the Federal
SSI   benefit   standard  reaches   100   percent   of   poverty.
"Grandfather"   extant    supplementary    levels   for   current
beneficiaries. Require States, for at least  3  years,  to  spend
"freed  up"  supplementation  funds  for  other services to needy
aged, blind, or disabled.Program
Admin.
                                                        Medicaid0
                                                              (b)
                                                             4350
                                                              (b)
                                                           1,8250
                                                              (b)
                                                           1,9950
                                                              (b)
                                                           2,1950
                                                              (b)
                                                            2,410

Require  States  by  July  1,  1995,  to:  have no  more  than  3
supplementary   payment   level   variations  based   on   living
arrangements,  6  based on categorical  distinctions,  and  3  by
geographic area; or  pay  SSA for the costs of administration; or
take over administration of supplementation.Program
Admin.
                                                        Medicaid0
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                                0
Payment Limits for People in Institutions
Increase the payment limit  to $35, indexed annually, and rounded
to the next higher dollar.Program
Admin.
                                                        Medicaid8
                                                                0
                                                            (a)16
                                                              (a)
                                                            (a)20
                                                                0
                                                            (a)23
                                                                0
                                                            (a)27
                                                                0
                                                              (a)
Accounting Periods
 Change to prospective monthly accounting.Program
Admin.
                                                      Medicaid(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                              (b)

Continue Medicaid coverage when  SSI  eligibility  is lost solely
due to a calendar-related income fluctuation.Program
Admin.
                                                        Medicaid0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                              (a)

When   it   is   not   cost-effective,   do  not  require  income
verification.
Program
Admin.
Medicaid
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)

                                                              (b)
                                                              (b)
                                                              (b)



Define  SSI  eligibility in terms of income  below  the  combined
Federal/State payment level in States with federally-administered
supplements.

Program
Admin.
Medicaid

                                                                4
                                                              (a)
                                                              (a)

                                                                5
                                                          (a) (a)

                                                                5
                                                              (a)
                                                              (a)

                                                                5
                                                              (a)
                                                              (a)

                                                            5 (a)
                                                              (a)
Test method(s)  of  annual accounting, beginning with prospective
annual accounting, by running computer simulation(s).Program
Admin.
                                                        Medicaid0
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                                0


NEEDS-BASED ELIGIBILITY ISSUES

Unearned Income
Increase the general income exclusion to $30 and apply it only to
unearned income.Program
Admin.
                                                      Medicaid203
                                                              150
                                                           260303
                                                              370
                                                           935321
                                                               40
                                                         1,105338
                                                               30
                                                         1,280355
                                                               30
                                                            1,475
Exclude  from  income  up   to  $200  annually  of  interest  and
dividends.Program
Admin.
                                                        Medicaid3
                                                                0
                                                               54
                                                              (a)
                                                               55
                                                                0
                                                               55
                                                                0
                                                               55
                                                                0
                                                                5
Adopt the current "earned and unearned" income formula for use in
all parent-to-child deeming situations.Program
Admin.
                                                       Medicaid11
                                                              (a)
                                                            (a)15
                                                              (a)
                                                            (a)15
                                                              (a)
                                                            (a)15
                                                              (a)
                                                            (a)16
                                                              (a)
                                                              (a)

Deduct  itemized special expenses  of  a  disabled  child  before
deeming parental income.Program
Admin.
                                                       Medicaid10
                                                              (a)
                                                            (a)15
                                                              (a)
                                                            (a)17
                                                              (a)
                                                            (a)18
                                                              (a)
                                                            (a)20
                                                              (a)
                                                              (a)

In parent-to-child  deeming,  treat  as  earned  income  benefits
intended  to  replace  a  parent's  earnings (e.g., unemployment,
worker's  compensation, and disability  and  survivorship  social
insurance benefits).Program
Admin.
                                                       Medicaid18
                                                              (a)
                                                            (a)27
                                                              (a)
                                                            (a)29
                                                              (a)
                                                            (a)32
                                                              (a)
                                                            (a)35
                                                              (a)
                                                              (a)

Exclude up  to  $2,000 per year of income from individually- held
Indian trust land.Program
Admin.
                                                      Medicaid(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                              (a)
In-Kind Support and Maintenance
Eliminate consideration  of  in-kind  support  and maintenance as
income.Program
Admin.
                                                      Medicaid600
                                                               60
                                                         1401,003
                                                              170
                                                         5101,066
                                                                0
                                                         6001,122
                                                              (4)
                                                         6951,178
                                                              (4)
                                                              805

Resources

Increase  resource  limits  to  $7,000  and  $10,500  with  fewer
resource exclusions.Program
Admin.
                                                       Medicaid55
                                                               40
                                                            75191
                                                              100
                                                           265215
                                                               10
                                                           315236
                                                               10
                                                           365257
                                                               10
                                                              420

Change  all  periods for time-limited resource exclusions  to  12
months.Program
Admin.
                                                      Medicaid(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                              (a)

Change the calculation  of  overpayments  resulting  from  excess
resources.Program
Admin.
                                                        Medicaid3
                                                              (a)
                                                             (a)3
                                                              (a)
                                                             (a)3
                                                              (a)
                                                             (a)2
                                                              (a)
                                                             (a)2
                                                              (a)
                                                              (a)
In deeming parental resources, exclude $2,000 for each ineligible
child.Program
Admin.
                                                        Medicaid7
                                                              (a)
                                                            (b)11
                                                              (a)
                                                              (b)
                                                               12
                                                              (a)
                                                            (b)13
                                                              (a)
                                                              (b)
                                                               14
                                                              (a)
                                                              (b)
DISABILITY & WORK INCENTIVE ISSUES
Disability: Definitions
Redefine  "substantial  gainful  activity"  in the SSI program to
recognize that persons who need substantial support  services  in
order   to   work   are   not   performing   substantial  gainful
activity.Program
Admin.
                                                      Medicaid(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                              (b)
Study the feasibility of:
(a) eliminating use of substantial gainful activity  in  both the
SSI  and  the  disability insurance programs; and (b) formulating
disability  criteria   in   terms   of   being  disadvantaged  in
participating in major life activities.Program
Admin.
                                                        Medicaid0
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                                0


Disability: Claims Process
Use specially trained field office disability  experts to conduct
initial disability interviews.
Program
Admin.
                                                      Medicaid(b)
                                                             (20)
                                                           (a)(b)
                                                             (20)
                                                           (a)(b)
                                                             (20)
                                                           (a)(b)
                                                             (30)
                                                           (a)(b)
                                                             (30)
                                                              (a)
Disability:  Very Young Children
Develop  appropriate  criteria  for  assuming  the  existence  of
disability  in  very  young children.  Permit continued  payment,
based  on  an assumption,  up  to  age  4,  without  creating  an
overpayment.Program
Admin.
                                                        Medicaid8
                                                                0
                                                              531
                                                               10
                                                             2035
                                                                0
                                                             2038
                                                                0
                                                             2542
                                                                0
                                                               25
Disability:  Appeal of DecisionsIn both the SSI and the insurance
programs:
(a) eliminate  the  reconsideration  level  of  appeal;  and  (b)
provide   opportunity  for  a  face-to-face  interview  with  the
decisionmaker prior to issuing a disability denial.
Program
Admin.
                                                      Medicaid(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                              (b)
Disability:  Time Limits on Claims
and Appeals

Establish 90-day  time limits which, if exceeded, would result in
benefit payments not  to  be considered overpayments.  Apply such
limits  to:   initial SSI disability  determinations;  completing
cases at the administrative law judge level; and completing cases
at the Appeals Council level.  Study the effects after 4 years of
experience.Program
Admin.
                                                      Medicaid(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                               (b)Work Incentives

Seek  legislation   authorizing   all   of   the  following  work
incentives:
(a) Raise the earned income exclusion to $200  plus two-thirds of
any remaining earned income.Program
Admin.
                                                      Medicaid149
                                                               80
                                                           140328
                                                              200
                                                           510351
                                                               20
                                                           605370
                                                               20
                                                           695388
                                                               20
                                                              805

(b)  Eliminate continuing disability reviews triggered  by  work;
defer   scheduled   medical   reviews  for  3  years  after  work
begins.Program
Admin.
                                                      Medicaid(b)
                                                              (a)
                                                              (b)
                                                              (b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                              (b)

(c) Treat as earned income:  unemployment  compensation, workers'
compensation, sick pay, and similar benefits  related  to  recent
work activity.Program
Admin.
                                                       Medicaid10
                                                              (a)
                                                            (a)14
                                                              (a)
                                                            (a)15
                                                              (a)
                                                            (a)16
                                                              (a)
                                                            (a)16
                                                              (a)
                                                              (a)


(d)  Eliminate the time limit for completing a plan for achieving
self-support.Program
Admin.
                                                      Medicaid(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                           (b)(b)
                                                              (a)
                                                              (b)
(e)  Allow   aged   individuals  to  be  eligible  for  all  work
incentives.Program
Admin.
                                                      Medicaid(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                              (b)

Simultaneous  with  the  preceding  option,  conduct  a  national
demonstration of its work incentives.Program
Admin.
                                                        Medicaid0
                                                              (b)
                                                             (a)0
                                                              (b)
                                                             (a)0
                                                              (b)
                                                             (a)0
                                                              (b)
                                                             (a)0
                                                              (b)
                                                              (a)

Grandfather demonstration policies for demonstration participants
after expiration of the project.
Program
Admin.
                                                      Medicaid(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                              (b)
 Disregard deemed income of an ineligible spouse when determining
continued Medicaid eligibility under section 1619(b).
Program
Admin.
                                                        Medicaid0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
(a)Require  SSA to make  a  decision  on  a  plan  for  achieving
self-support within 30 days.  If there is no decision within that
time, assume the plan is acceptable.Program
Admin.
                                                        Medicaid0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                             (a)0
                                                              (a)
                                                              (a)

Require  States   which   supplement   regular  SSI  payments  to
supplement payments under 1619(a). Program
Admin.
States
                                                        Medicaid0
                                                              (a)
                                                              (a)
                                                             (a)0
                                                              (a)
                                                              (a)
                                                             (a)0
                                                              (a)
                                                              (a)
                                                             (a)0
                                                              (a)
                                                              (a)
                                                             (a)0
                                                              (a)
                                                              (a)
                                                              (a)
 Provide   Medicaid   under   section   1619   to   all   working
individuals.Program
Admin.
                                                        Medicaid0
                                                              (a)
                                                              100
                                                              (a)
                                                              150
                                                              (a)
                                                              150
                                                              (a)
                                                              150
                                                              (a)
                                                               15

Provide  SSI  benefits  for  individuals  who  lose their  social
insurance  cash  benefits  due  to substantial gainful  activity.
Program
Admin.
                                                      Medicaid(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                              (b)


Do not permit States to count resources  set  aside  under a plan
for  achieving self-support when determining Medicaid eligibility
using their own rules.Program
Admin.
                                                        Medicaid0
                                                              (b)
                                                             (a)0
                                                              (b)
                                                             (a)0
                                                              (b)
                                                             (a)0
                                                              (b)
                                                             (a)0
                                                              (b)
                                                              (a)


DEFINITION OF "AGED" ISSUE
Lowering the "Aged" Limit

Lower the age requirement to 62, phased in over 3 years.Program
Admin.
                                                       Medicaid40
                                                              (a)
                                                            20178
                                                               10
                                                           115351
                                                               10
                                                           255481
                                                               10
                                                           390528
                                                              (a)
                                                              460
AGENCY SERVICE ISSUES





Services

Increase staffing (6,000 positions).Program
Admin.
                                                        Medicaid0
                                                              280
                                                               00
                                                              297
                                                               00
                                                              315
                                                               00
                                                              335
                                                               00
                                                              356
                                                                0
Place  renewed  emphasis  on personal contact and  individualized
service.Program
Admin.
                                                        Medicaid0
                                                              (b)
                                                                0
                                                                0
                                                              (b)
                                                                0
                                                                0
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                                0

Outreach

Establish specific funding  for  outreach  by  increasing the SSI
administrative budget by at least 5 percent.Program
Admin.
                                                      Medicaid(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)
                                                              (b)

Information and Referral
Adopt the expanded community liaison model.Program
Admin.
                                                        Medicaid0
                                                              100
                                                             (b)0
                                                              110
                                                             (b)0
                                                              120
                                                              (b)
                                                                0
                                                              130
                                                             (b)0
                                                              130
                                                              (b)

Helping the Homeless
Provide emergency payments to homeless persons with severe mental
illness.Program
Admin.
                                                       Medicaid13
                                                               10
                                                             1045
                                                               10
                                                             3550
                                                                0
                                                             4055
                                                                0
                                                             5060
                                                                0
                                                               55

Provide   continued   payment  protection  for  all  hospitalized
individuals.Program
Admin.
                                                       Medicaid31
  (a)
                                                            (a)43
                                                              (a)
                                                            (a)46
                                                              (a)
                                                            (a)48
                                                              (a)
                                                            (a)50
                                                              (a)
                                                              (a)

Pay SSI benefits to individuals  in public emergency shelters for
the homeless without any time limit.Program
Admin.
                                                      Medicaid(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                              (a)
                                                              (a)
                                                              (a)
                                                           (a)(a)
                                                              (a)
                                                              (a)

Expand nationwide outreach services now being tested.  Program
Admin.
                                                      Medicaid(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                           (b)(b)
                                                              (b)
                                                              (b)

Create backup mailing addresses for the homeless or mentally ill.
Program
Admin.
                                                        Medicaid0
  (a)
                                                               00
                                                              (a)
                                                               00
                                                              (a)
                                                               00
                                                              (a)
                                                               00
                                                              (a)
                                                                0
Representative Payment

Develop legislation mandating specific  recruitment, training and
monitoring   of   representative   payees;   provide   reasonable
compensation   to    nonrelative  noncustodial  payees   out   of
administrative funds.Program
Admin.
                                                        Medicaid0
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                               00
                                                              (b)
                                                                0

PROGRAM LINKAGE ISSUES





Medicaid

Require all States to  use  SSI eligibility  criteria and mandate
Federal determinations of Medicaid eligibility. Program
Admin.
                                                        Medicaid0
                                                              (a)
                                                           1,5900
                                                              (a)
                                                            1,750
                                                                0
                                                              (a)
                                                           1,9150
                                                              (a)
                                                            2,110
                                                                0
                                                              (a)
                                                            2,315


Food Stamps

Social  security  offices to complete  a  short-form  food  stamp
application for all interested SSI claimants.Program
Admin.
FdStamps
                                                        Medicaid0
                                                              (b)
                                                                1
                                                               00
                                                              (b)
                                                                1
                                                               00
                                                              (b)
                                                                1
                                                               00
                                                              (b)
                                                                1
                                                               00
                                                              (b)
                                                                1
                                                                0
Eliminate categorical  eligibility  for  food stamps when the SSI
benefit standard equals or exceeds the poverty line.Program
Admin.
FdStamps
                                                        Medicaid0
                                                              (a)
                                                            (870)
                                                               00
                                                              (a)
                                                           (1300)
                                                               00
                                                              (a)
                                                            (710)
                                                               00
                                                              (a)
                                                            (740)
                                                               00
                                                              (a)
                                                            (780)
                                                                0
PROGRAM REVIEW ISSUES





An Advisory Council Level of Review
Establish a separate Advisory Council on SSI.Program
Admin.
                                                        Medicaid0
                                                              (a)
                                                               00
                                                              (a)
                                                               00
                                                              (a)
                                                               00
                                                              (a)
                                                               00
                                                              (a)
                                                                0

FOUR TOP PRIORITY ISSUES
Increase Staffing; Increase Federal Benefit  Standard;  Eliminate
In-Kind  Support  and Maintenance; Increase Resource Limits  With
Fewer Exclusions Program
Admin.
                                                    Medicaid3,539
                                                              610
                                                              610
                                                            9,391
                                                            1,237
                                                            2,490
                                                           15,711
                                                              855
                                                            3,870
                                                           23,346
                                                              885
                                                            5,545
                                                           32,507
                                                              946
                                                            7,615
ALL ISSUES COMBINED

Estimate of combined  SSI  costs, program and administrative, for
all preceding options to which  specific dollar amounts have been
attributed.


                                                            5,281

                                                           13,258

                                                           19,635

                                                           28,539

                                                           38,844

                                               NUMBER    OF   NEW
BENEFICIARIES (IN THOUSANDS)

Estimate of total number of people added to the Federal SSI rolls
by  all  preceding options to which specific dollar amounts  have
              been attributed.  Annual numbers are cumulative.489


                                                            1,527


                                                            2,240


                                                            2,965


                                                            3,607