Perceptions of Deservingness and the Politicization of Social Insurance: Evidence From Disability Insurance in the United States

Date01 September 2020
Published date01 September 2020
Subject MatterArticles
American Politics Research
2020, Vol. 48(5) 543 –559
© The Author(s) 2019
Article reuse guidelines:
DOI: 10.1177/1532673X19863439
How do citizens form opinions about the merits of benefit
provision under social insurance programs? In contrast to
universalistic redistributive social assistance programs,
most social insurance programs require potential beneficia-
ries to contribute ahead of time to be eligible to receive ben-
efits in specific, defined circumstances. These programs
therefore pool risk among a contributing population and are
generally popular relative to redistributive programs that
also serve individuals who are in need.1 However, there is
little scholarship examining whether the basis on which
social insurance beneficiaries are eligible for and receive
assistance affects perceptions of their deservingness. Such
concerns are particularly important for understanding the
contemporary politics of those social insurance programs
where individuals receive benefits only after discretionary
determination of the merit of their claim (as compared with
programs where eligibility is determined by formal objec-
tive criteria like age, as in the case of Social Security and
Medicare). As the size and cost of these “discretionary”
social insurance programs (often involving case-by-case
determinations of the merits of each claim for benefits) have
grown over time, new efforts to scale back these programs
have emerged and appear, in part, to be motivated by con-
cerns that these programs increasingly pay benefits to those
who should not receive them.
Prior work argues that support for redistributive welfare
programs is governed by a “deservingness heuristic,” in
which the willingness to support programs or benefits for
particular beneficiaries is shaped by beliefs about whether
beneficiaries demonstrated they warrant care.2 Perceptions
of the deservingness of welfare beneficiaries in general are
correlated with support for welfare (i.e., cash assistance), and
differences in perceptions of deservingness across individu-
als (e.g., across beneficiaries of different races) are corre-
lated with differences in support for providing benefits to
those individuals (e.g., Appelbaum, 2001; Gilens, 1999).
This raises the question of whether, despite key differences
in program design, the psychological processes explaining
mass attitudes toward program beneficiaries are similar for
social assistance and discretionary social insurance pro-
grams. Specifically, are beneficiaries of discretionary social
insurance programs evaluated on the basis of the same
863439APRXXX10.1177/1532673X19863439American Politics ResearchFang and Huber
1Independent Scholar, Seattle, WA, USA
2Yale University, New Haven, CT, USA
Corresponding Author:
Gregory A. Huber, Forst Family Professor of Political Science,
Department of Political Science and Institution for Social and Policy
Studies, Yale University, New Haven, CT 06520, USA.
Perceptions of Deservingness and
the Politicization of Social Insurance:
Evidence From Disability Insurance in
the United States
Albert H. Fang1 and Gregory A. Huber2
Concerns about the deservingness of policy beneficiaries appear to explain skepticism about redistributive social assistance
programs. Many social insurance programs, despite requiring beneficiaries to pay in ahead of time, require discretionary
evaluations of the merits of claims for benefits. Do perceptions of deservingness also affect attitudes toward these
discretionary social insurance programs? Examining the politics of Social Security Disability Insurance (SSDI), a program
whose size and beneficiaries have been increasingly politicized, we investigate these questions by analyzing novel survey data
and two experiments conducted on national surveys. We show that people use information about a beneficiary’s eligibility-
determining impairment—but not their race, which prior work argues is a key heuristic—to infer their deservingness.
Moreover, support for SSDI is responsive to policy arguments emphasizing the program’s social insurance features and
potential abuse. Our findings demonstrate important psychological processes relevant to the contemporary politicization of
social insurance programs involving discretionary eligibility rules.
public opinion, policy attitudes, social insurance, deservingness, disability insurance
544 American Politics Research 48(5)
“deservingness heuristic” that prior work shows is a power-
ful predictor of attitudes toward those receiving welfare and
other social assistance programs? And do perceptions of the
race of program beneficiaries, which prior work shows is a
key predictor of attitudes toward support for redistributive
spending (Gilens, 1999), also affect beliefs about the deserv-
ingness of Social Security Disability Insurance (SSDI) recip-
ients? In this regard, SSDI is a useful case for study because
it is not an overtly racialized policy domain, although indi-
viduals may perceive it as such.
We investigate this question using the case of support for
the SSDI program. SSDI is a large and growing social insur-
ance program in the United States that provides cash assis-
tance to individuals who have a severe, long-term disability
that interferes with work.3 Theoretically, SSDI combines a
social insurance program design with support for individuals
who have been determined to have a health-driven disability
that prevents work. It is therefore an ideal case for under-
standing the interplay of these two factors—the requirement
to pay in ahead of time and discretionary determination of
the merit of a claim for receiving benefits—in shaping pro-
gram support. The program is funded by worker payroll
taxes and provides benefits only to those who have met
recent work and earnings requirements. Because of the pro-
gram’s social insurance features such as prior contribution
requirements and the limited basis for claiming benefits,
SSDI (and SSDI recipients) may be broadly popular. In
recent decades, however, the number of individuals success-
fully obtaining SSDI has increased substantially, accompa-
nied by changes in who is participating (increasingly
working-age men) and the basis for being declared disabled
(increasingly certain musculoskeletal and mood disorders)
(Autor & Duggan, 2003). To some observers, these changes
show that the core function of the program has changed from
being last-resort social insurance to a subsidy for individuals
who choose not to work.4 What is unknown, however, is
whether these changes have had any effect on support for
SSDI. Is support for SSDI beneficiaries, or for the program
more generally, related to beliefs about whether those seek-
ing benefits are in fact unable to work, or do the program’s
social insurance features blunt these concerns about deserv-
ingness? Relatedly, if support for SSDI beneficiaries is partly
a function of their perceived deservingness, what are relevant
markers of beneficiaries that people use to form perceptions
of their deservingness? Is beneficiary race a relevant factor
in shaping opinions toward the program despite its social
insurance features and lack of past history of racialization?
A nascent line of political science research examines sup-
port for government-provided health care benefits for sick
individuals and finds that those with diseases that are less
controllable (e.g., due to a pathogen or genetics rather than
failure to exercise) warrant greater support (Jensen &
Petersen, 2017). That research has not examined willingness
to provide cash assistance to individuals with health impair-
ments, which may differ in important respects from the
provision of health care because of the greater possibility of
misuse of cash. Nor has that work examined how determina-
tions of merit are affected by different models for eligibility
for government benefits (e.g., in the case of medical care,
social insurance [like Medicare], means-tested redistributive
programs [like Medicaid], universalistic government provi-
sion, etc.). Finally, whereas the source of an illness may be
an important basis for deciding about the merits of providing
government health care, SSDI is designed to compensate
individuals not for lost health directly, but instead for the
labor income that is lost because an impaired individual is
unable to work. The critical question in adjudicating the
merit of an SSDI claim, therefore, is whether the claimant is
able to work, which, in addition to evaluating whether the
person is sick, requires determining whether or not they
could work. Thus, even if one broadly believe that sick indi-
viduals are deserving of government health care, we do not
know if the basis on which one claims medical impairment
affects perceptions of deservingness in the social insurance
In particular, building on prior theoretical work on deserv-
ingness perceptions, we expect that individuals combine
cues about beneficiary-level attributes (such as the impair-
ment they have) and group stereotypes (about beneficiaries
possessing specific attributes) to form judgments about their
deservingness as a function of those attributes. We focus on
ease of diagnosis, by which we mean the degree to which an
impairment is readily verifiable as preventing work, as a key
measure of deservingness (e.g., the true merit of a claim). We
expect increased perceptions of undeservingness to be asso-
ciated with reduced support for a social insurance program
like SSDI and its beneficiaries. The need for a discretionary
evaluation of the merit of a person’s claim may therefore
counteract the general popularity that accompanies social
insurance programs where beneficiaries pay into those pro-
grams ahead of time. In addition, we compare the effect of
beneficiary impairment with another possible marker of
deservingness, beneficiary race, to understand the similarity
between SSDI and more traditionally racialized policy
domains such as welfare. Finally, in light of these counter-
vailing forces and prior research on policy framing effects
and historical accounts of the politicization of social insur-
ance in the United States, we test whether public support for
social insurance programs is also responsive to policy argu-
ments emphasizing the program’s social insurance features
and potential abuse.
To investigate these expectations, we analyze both obser-
vational and experimental data from a novel nationally rep-
resentative survey, supplemented with additional analysis
from online convenience samples. Specifically, we begin by
measuring knowledge and perceptions of those receiving
disability benefits. We find that, on average, individuals
report being uncertain about whether those who receive dis-
ability could have worked. Thus, despite the social insurance
features of the SSDI program, individuals do have beliefs

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