Old Assumptions, New Realities

The foundation for much of the U.S. social, health and employment benefit system was created in 1935 with the passage of the Social Security Act (SSA). The SSA authorized a national social insurance program for retired workers, established joint federal-state unemployment insurance programs, and created a modest program of cash assistance for lone mothers to be financed jointly by the federal and state governments. Soon after passage the SSA was amended to cover some initially excluded occupations and to extend benefits to the survivors of covered workers. Coverage for permanently disabled workers was added in 1956. In the 1960s lawmakers created the federal Medicare program for Social Security recipients and the federal-state Medicaid program for families receiving public assistance.

For over seventy years, the SSA has provided the foundation for incremental expansion of national social insurance programs. These programs were aimed primarily at previously employed adults unable to work due to age or disability, and they have greatly improved the economic security of these adults and their dependents.

The original provisions of SSA did much less to protect working-age adults and their children. Over the years, federal, state and local governments have addressed this and other gaps in the initial SSA provisions by developing a large and largely uncoordinated array of programs targeted on specific populations and needs – from health and nutritional assistance for low-income pregnant women to public and publicly subsidized housing, means-tested child care subsidies, public preschool services, specialized social and mental health services, employment preparation and vocational training programs, and many more. Less visibly, federal and state lawmakers have used specialized tax deductions and credits to create incentives for employer-provided benefits, to subsidize individual expenditures for home mortgages, retirement and college savings, and other expenses, and to provide refundable tax credits for low income workers. The original programs of the SSA have also been pressed to respond to other service needs. The means-tested Medicaid health insurance program, for example, is now the primary public funder for long-term care for the elderly and disabled. Medicaid dollars are also used in many states to provide therapeutic, rehabilitative and personal assistance services for mentally ill and disabled individuals. The SSA authorized public assistance program (TANF) is used to provide child care subsidies and job preparation services and the same title of the Act funds state child welfare, foster care and adoption services.

Over the past 70 years, U.S. social benefits and employment supports have been built, piecemeal, over, on and around the foundation of the SSA – a foundation that did little to address the needs of working age individuals and that reflected depression-era social, economic and population characteristics. Even a brief comparison of these conditions to 21st century realities suggests how much has changed over time and how much these change matter for contemporary social benefit and employment policies.

When the SSA was passed in 1935…

• Families functioned as an economic and home production unit in which a male breadwinner earned a 'family wage' sufficient to support himself and dependents and a female homemaker provided full-time, uncompensated carework in the home. more
  
  
• Most nuclear families remained together and were able to pool income and share caregiving labor across the lifecycle. more
  
  
• An expanding economy promised to absorb new workers with the returns from increasing prosperity shared proportionately across all income levels. more
  
  
• Individuals expected to have stable and continuous employment throughout their working years. more
  
  
• Employment was expected to be the primary mechanism for securing health and retirement benefits. more
  
  
• The U.S. population was distributed in an age pyramid with a small dependency ratio, i.e. a large working-age population was available to support a small elderly population. more
  
  
• Restrictive immigration policies limited the diversity of claimants for social benefits. more
  
  
• The government, particularly at the federal level, played a limited role in social and health policy. more
  
  
• Government and private charities played distinct roles in social welfare and health provision. more

The profound transformation of work and family life, the structure of employment opportunities, and the roles of government and private charities have been extensively documented elsewhere. Less systematic attention has been given to the implications of 70 years of change for the financing and delivery of social and health benefits and employment policies in the U.S.

The Old Assumptions, New Realities: Economic Security and Social Policy in the 21st Century conference will bring together leading scholars and prominent policy practitioners in an engaged dialogue about contemporary social, economic, and demographic realities and their implications for social, health and employment policies with a particular emphasis on working-age adults and their children. The conference organizers will author an introductory essay summarizing underlying old assumptions of the U.S. social benefit and employment support systems and new realities or ‘facts on the ground’ in the 21st century.