Need-Tested Benefits: Who Receives Assistance?

Need-Tested Benefits: Who Receives Assistance?

Need-Tested Benefits: Who Receives
June 30, 2021
Assistance?
Gene Falk
The COVID-19 pandemic has highlighted the financial insecurity faced by some families. For
Specialist in Social Policy
some, these insecurities are related to the economic impact of the pandemic; for others, financial

insecurity preceded the pandemic. Congress responded to the economic fall-out from the
Karen E. Lynch
pandemic through providing ad-hoc assistance to families, and making (mostly) temporary
Specialist in Social Policy
changes to existing assistance programs.

Before the pandemic, benefits from selected need-tested programs were received by one-third of
Paul D. Romero
the population, or approximately 111 million people. However, individuals were more likely to
Research Assistant
receive some forms of benefits versus others. Figure S1 shows that a comparatively large

number of people received medical assistance (Medicaid/CHIP), nutrition assistance (SNAP), or
refundable tax credits (EITC or ACTC). In contrast, fewer people received housing assistance,

monthly cash benefits from SSI, monthly cash benefits from the TANF block grant, and child
care subsidies.
Figure S1. Receipt of Selected Need-Tested Benefits
(Pre-pandemic)

Source: Congressional Research Service (CRS) analysis of data from the U.S. Census Bureau Annual Social and Economic
Supplement (ASEC) and the U.S. Department of Health and Human Services (HHS)-funded TRIM3 data maintained at the Urban
Institute. Medicaid enrol ment estimates were developed by CRS and represent noninstitutionalized enrol ees.
While the need-tested programs are targeted to low-income families and individuals—and these groups had the highest rate
of benefit receipt—the majority of individuals who were recipients of need-tested aid had pre-assistance incomes above the
poverty level. Medical assistance and the refundable tax credits were the least targeted to lower-income families and
individuals, while food assistance, housing assistance, monthly cash benefits, and child care were more targeted to these
recipients.
Many of the need-tested programs also target their benefits to families with children, those aged 65 and older, or individuals
with work-limiting disabilities. Children and adults (age 18 or older and of any disability status) in families with children
accounted for 76 million of the 111 million people who received need -tested benefits prior to the pandemic. Most families
with children had at least one adult who had some work during a year. For adults without children, those aged 18 to 64, with
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Need-Tested Benefits: Who Receives Assistance?

work-limiting disabilities (and often not working) had the highest incidence of need-tested benefit receipt. However, this was
a relatively small group. Adults without children aged 65 and older and those adults aged 18 to 64 without disabilities or
children were the least likely to receive benefits.
Figure S2. Receipt of Need-Tested Benefits, Individuals by Family Category, Age,
and Disability Status (Pre-pandemic)

Source: CRS analysis of data from the U.S. Census Bureau’s ASEC and the HHS-funded TRIM3 data maintained at the Urban
Institute. Medicaid enrol ment estimates were developed by CRS and represent noninstitutionalized enrol ees.
The emphasis of need-tested benefits on aiding families with children and workers is the cumulative effect of policy changes
and the pre-pandemic high work rate of at least one adult in families with children. Most of the pre-pandemic program
expansions since the mid-1980s supplement a parent’s earnings and benefits from employment, and some were explicitly
designed to encourage parents to work. Monthly cash aid for families with children but without earnings was scaled back.
Thus, most low-income families’ benefits comprised noncash (or in-kind) medical and food assistance, or refundable tax
credits paid once a year, not monthly cash.
For 2020 and 2021, years when work was limited by the pandemic, Congress enacted policies to expand food, housing, and
child care assistance as well as to inject cash into households. For 2021, the child tax credit was made available to non-
earners and a portion of the expected credit amount is to be periodically advanced during the last six months of the year.
President Biden’s “American Families Plan” would continue some of the policies enacted during the pandemic, such as
allowing the child credit to be advanced and paid periodically and expanding other programs further such as child care
assistance.

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Contents
Introduction ................................................................................................................... 1
Programs Examined in This Report .............................................................................. 1
Data Used in This Analysis ......................................................................................... 5
Need-Tested Benefits Receipt ........................................................................................... 5
Need-Tested Benefit Receipt by Pre-assistance Income ................................................... 7
Need-Tested Benefits by Family Category, Age, and Disability Status ............................. 10
Need-Tested Benefits by Work Status ......................................................................... 14
Conclusion................................................................................................................... 17

Figures
Figure 1. Estimated Number of Persons Receiving Benefits from Selected Major Need-
Tested Programs at Any Time During a Year ..................................................................... 7
Figure 2. Need-Tested Benefits Receipt, by Pre-assistance Income Poverty Status..................... 9
Figure 3. Number of People Receiving Selected Need-Tested Benefits and Percentage of
Recipients with Pre-assistance Incomes Below the Poverty Threshold ................................ 10
Figure 4. Receipt of Need-Tested Assistance: Individuals by Family Category, Age, and
Disability Status ......................................................................................................... 13
Figure 5. Receipt of Need-Tested Assistance: Individuals by Whether or Not a Family
Had an Adult Worker .................................................................................................. 14
Figure 6. Receipt of Need-Tested Assistance: Individuals by Family Category, Age, and
Disability Status and Whether or Not a Family Had an Adult Worker ................................. 16

Tables
Table 1. Key Characteristics of Selected Need-Tested Programs ............................................. 4

Contacts
Author Information ....................................................................................................... 18

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Introduction
Need-tested benefits programs provide financial or other forms of assistance to or on behalf of
families and individuals based on their economic need. Before the COVID-19 pandemic and its
economic fal out, an estimated one-third of al persons in the United States, about 111 mil ion
individuals, benefitted from at least one of the selected, major need-tested programs discussed in
this report.
The pandemic has highlighted the financial insecurity faced by some individuals and families. For
some, the insecurity is related to the economic impact of the pandemic; for others, financial
insecurity preceded the pandemic. The economic impact of the pandemic prompted a number of
temporary changes to augment certain government programs that provide economic assistance to
households, including unemployment insurance and some need-tested programs. Under current
law, most of these policy changes will expire.
This report examines need-tested programs as they operated prior to the pandemic. This provides
a picture of how need-tested programs would operate once the temporary measures expire and
should the economy continue to recover. It is based on income and employment from 20171, the
eighth full year of an economic expansion, with an unemployment rate that averaged 4.4%. In
contrast, the unemployment rate for 2020 averaged 8.1% and the Congressional Budget Office
(CBO) forecasts that the unemployment rate for 2021 wil be 5.7%.2
Estimates Based on 2017, With Caveat for Tax Benefits
The estimates in this report are based on income reported for 2017. For most of the programs examined in the
report, the estimates of program receipt are also for 2017. However, the estimated total number of recipients
across al programs is technical y not the estimated number of recipients that received benefits in 2017. This is
because this report uses a simulation of federal income tax policy under the Tax Cuts and Jobs Act of 2017 (TCJA,
P.L. 115-97), which was not effective for tax year 2017 but was effective in 2018. The report estimates receipt of
the refundable tax credits as if TCJA were in effect in 2017. This is to provide a better sense of how policies
would affect incomes once the temporary measures adopted to respond to the COVID-19 pandemic expire.
Programs Examined in This Report
The major need-tested programs examined in this report are government programs that condition
their benefits on financial need, and two refundable tax credits in the federal income tax code that
are targeted to low-income taxpayers. The report distinguishes these programs from social
insurance programs, such as Social Security, Medicare, and Unemployment Compensation. Those
social insurance programs primarily base eligibility for their benefits on past work and an event
(e.g., old age, unemployment) that interrupts or ends working careers rather than low income or
assets. Need-tested programs general y take into account income from cash-based social
insurance programs, and social insurance benefits often raise incomes so that their beneficiaries
are financial y ineligible for need-tested benefits.

1 T his report uses the year 2017 because as of June 2021 it was the latest year for which data were available to the
Congressional Research Service (CRS) t hat corrected for the under-reporting of benefit receipt in selected need-tested
benefit programs using the T RIM3 microsimulation model. See discussion in the “ Data Used in T his Analysis” section.
2 T he unemployment rate forecast for 2021 is based on the Congressional Budget Office’s economic projections made
in February 2021; see https://www.cbo.gov/about/products/budget-economic-data#4.
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The selected, major need-tested programs (or groups of programs) discussed in this report
represent a subset of al need-tested programs.3 They were selected for inclusion largely on the
basis of available data. The programs are the following:
 Medicaid and the State Children’s Health Insurance Programs (CHIP)
provide grants to states to help them finance the delivery of medical services as
wel as long-term care services and supports. Medicaid provides health coverage
to a diverse low-income population, including children, pregnant women, adults,
individuals with disabilities, and people aged 65 and older. Historical y, Medicaid
eligibility general y has been limited to low-income children, pregnant women,
parents of dependent children, individuals aged 65 and older, and individuals
with disabilities. However, since 2014 states have had the option to cover
nonelderly adults with income up to 133% of the federal poverty level (FPL)
under the Affordable Care Act (ACA) Medicaid expansion. In FY2017, Medicaid
enrollment for children, non-expansion adults, and expansion adults comprised
77% of Medicaid enrollment, but 46% of total benefits. Individuals with
disabilities and those aged 65 and older represented 23% of Medicaid enrollment,
but 54% of Medicaid spending. State CHIP al ows states to provide health care
coverage to low-income children and pregnant women without other health
insurance who have incomes above Medicaid’s eligibility thresholds.
 The Supplemental Nutrition Assistance Program (SNAP, formerly known as
food stamps) provides low-income families with an in-kind income supplement
to enable them to purchase a minimal cost, nutritious diet. SNAP is available to
al low-income households regardless of their demographic composition, though
benefits for able-bodied adults without dependents and who are not working are
time-limited. SNAP benefits are uniform nationwide for families of a given size
except in Alaska, Hawai , and the participating territories.4
 Housing assistance programs support below-market rent for low-income
households through subsidized apartments (public housing, project-based Section
8 rental assistance) and rental vouchers (Section 8 Housing Choice voucher
program). These programs are funded annual y through discretionary
appropriations, are 100% federally funded, and are administered by local public
housing authorities and private property owners under contract with the federal
government.
 The Earned Income Tax Credit (EITC) provides an earnings supplement for
low-wage earners, with the size of the credit dependent on family type and
earnings. The bulk of EITC dollars have historical y been delivered through tax
refund payments and go to families with children.
 The Additional Child Tax Credit (ACTC) represents the refundable portion of
this tax credit. It assists eligible parents of children who have earned income
above a certain threshold but whose tax liability is too smal to fully benefit from
the regular nonrefundable child tax credit. It is delivered to families through
refund payments when they file their taxes.

3 For a more comprehensive discussion of assistance for low-income individuals and families, see CRS Report R46214,
Federal Spending on Benefits and Services for People with Low Incom e: FY2008 -FY2018 Update.
4 T he participating territories are the U.S. Virgin Islands and Guam. Note that the estimates in this report are limited to
the 50 states and the District of Columbia and do not include the program participation population in the territories.
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 Supplemental Security Income (SSI) provides a federal y funded cash income
floor for low-income persons or couples who are aged 65 and older, blind, or
disabled. Federal SSI benefits are based on uniform nationwide eligibility and
benefit rules, and they are paid with federal funds. States may supplement SSI
with their own funds.
 Temporary Assistance for Needy Families (TANF) provides monthly cash
assistance to low-income families with children whose incomes are below state-
determined eligibility thresholds. Benefits are financed from the TANF block
grant to the states and associated state funds. States also determine benefit
amounts. (TANF may also be used to provide other types of services, such as
child care or training services, but for the purposes of this report, TANF receipt
and benefit amounts are limited to the monthly cash assistance caseload.)
 Child Care and Development Fund (CCDF) provides grants to states to help
subsidize child care for low-income parents and caretakers of children who are
either working or in training. The subsidies are general y provided in the form of
vouchers so that parents have a choice of child care providers and settings.
Table 1 summarizes selected characteristics across each program. As the table shows, these
programs provide varied benefits, ranging from monthly or annual lump sum cash benefits to
non-cash benefits that fully finance or partial y subsidize costs of specific goods or services (e.g.,
medical care, food, housing, child care). Each program limits eligibility to those meeting a need
test based on income or other resources (e.g., assets), but actual income limits vary widely across
programs. The programs tend to set income limits using different metrics (e.g., relationship of
income to the federal poverty level or to a state’s or local area’s median income) and complex
program rules (e.g., income limits for tax benefits may vary by filing status). In some cases,
income limits may vary by state or locality (e.g., for Medicaid/CHIP, TANF). Funding can play a
significant role in how widely program benefits are received. Programs with open-ended
mandatory spending (e.g., SNAP, tax credits) are typical y able to serve al who are eligible and
want to participate, whereas programs with discretionary or capped mandatory spending (e.g.,
housing, CCDF) may or may not have sufficient funding to serve al who are eligible and want to
participate.
Need-tested benefits are often limited to families with children, persons aged 65 or older, or
individuals with a disability. Many of the programs that target benefits to families with children
also require that the families have workers. The refundable tax credits, the EITC and the ACTC
(before the ACTC’s temporary expansion to nonearners for 2021), require earnings and hence
work to qualify for benefits. CCDF child care subsidies are general y limited to children who are
in families where a parent or other legal guardian is either working or in training.
In addition, program rules or other laws often restrict eligibility for need-tested benefits in other
ways. For instance, noncitizen eligibility for need-tested benefits is often restricted.5 Some
programs also restrict benefits for those with past criminal convictions.
The data in this report provide a national picture of need-tested benefits receipt. However, these
programs—except the federal income tax benefits—are at least partial y administered and often

5 See CRS Report RL33809, Noncitizen Eligibility for Federal Public Assistance: Policy Overview; CRS Report
R46697, Noncitizen Eligibility for Supplem ental Security Incom e (SSI) ; CRS Report R46462, Noncitizen Eligibility for
Federal Housing Program s; and CRS Report RL34500, Unauthorized Aliens’ Access to Federal Benefits: Policy and
Issues.
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have their eligibility and benefits determined by states or localities. Therefore, the picture in any
given state might differ from the national picture.
Table 1. Key Characteristics of Selected Need-Tested Programs
Funding
Program
Benefit Type
Income Limit
Populations
Category
Medicaid/
Medicaid: Pays for
Medicaid: Thresholds vary by
Medicaid: Covers a diverse
Medicaid:
CHIP
primary and acute
population, and by state.
low-income population,
Mandatory
medical services, as
including children, pregnant
(open-ended
wel as long-term
women, caretaker adults,
for states)
services and supports.
persons aged 65 and older,
individuals with disabilities,
and, at state option,
nonelderly adults.

CHIP: Pays for
CHIP: Eligibility begins for
CHIP: Covers low-income
CHIP: Capped
primary and acute
those with incomes above
uninsured children and
entitlement to
medical services.
regular Medicaid levels up to
pregnant women.
states
a percentage of the federal
poverty level (FPL). That
percentage varies by state.
SNAP
Electronic benefits
100% of the FPL (net income)
General y available to al
Mandatory
provided on a debit-
or 130% of the FPL (gross
household types, but adults
(open-ended)
like card that may be
income); may vary by state
aged 18 to 49 without
redeemed for food at
(but may not exceed 200% of
disabilities or dependent
retailers authorized to
the FPL for gross income)
children may participate
accept SNAP.
under broad-based
only for 3 months in a 36-
categorical eligibility rules.
month period if not
working or participating in
an employment program for
20 hours per week.
Housing
Subsidized apartments
50% to 80% of local area
General y available to al
Discretionary
(public housing,
median income in general,
household types, although
project-based Section
with assistance targeted to
some units or subsidies are
8 rental assistance)
those with income at or
earmarked for special
and rental vouchers
below 30% of local area
populations, including
(Section 8 Housing
median income.
persons who are aged 65
Choice Voucher
and older or have
program)
disabilities.
EITC
Refundable tax credit
Varies annual y by number of
Taxpayers must have
Mandatory
(annual lump sum)
children and tax filing status
earned income. Those
(open-ended)
(in 2020, the eligibility
without dependent children
threshold ranged from
must be between the ages
$15,820 for an unmarried
of 25 and 64. (This is
taxpayer with no qualifying
modified for 2021.)
children to $56,844 for a
married taxpayer filing jointly
with three or more qualified
children).
ACTC
Refundable tax credit
Depends on overal tax
Limited to taxpayers with
Mandatory
(annual lump sum)
liability and receipt of other
dependent children.
(open-ended)
tax credits.
Taxpayers must have
earned income (except in
2021).
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Funding
Program
Benefit Type
Income Limit
Populations
Category
SSI
Monthly cash benefit
Equal to the maximum
Limited to persons aged 65
Mandatory
monthly payment, adjusted
and older, blind or disabled
(open-ended)
annual y for inflation (in 2021,
adults, and blind or disabled
the income limit is general y
children.
$794 a month for an

individual and $1,191 a month
for a couple, but limits may
be higher in states that
provide supplementary
payments).
TANF
Monthly cash benefit
Varies by state.
Limited to families with
Mandatory
children.
(capped)
CCDF
Subsidized child care,
85% of state median income
Limited to families with
Discretionary
most often provided
under federal law, but most
children. Parents general y
and mandatory
by certificates
states set the income limit
must be working or in
(capped)
(vouchers)
lower.
training.
Source: CRS analysis of program rules and financing. Income limits are summarized broadly. Countable income
and applicable asset/resource tests may vary by program. Programs may have other restrictions or eligibility rules
not addressed here.
Notes: CHIP = State Children’s Health Insurance Program. SNAP = Supplemental Nutrition Assistance
Program. EITC = Earned Income Tax Credit. ACTC = Additional Child Tax Credit. SSI = Supplemental Security
Income. TANF = Temporary Assistance for Needy Families. CCDF = Child Care and Development Fund.
Data Used in This Analysis
The information in this report is based on income as reported by the U.S. Census Bureau for
2017. It was the eighth full year of economic growth following the 2007 to 2009 recession, with a
relatively low unemployment rate averaging 4.4% per month.
The estimates in this report are based on the 2018 U.S. Census Bureau’s Annual Social and
Economic Supplement (ASEC) to the Current Population Survey (CPS), augmented by computer
simulations from the Transfer Income Model 3 (TRIM3) microsimulation model. The ASEC is a
survey of households in the 50 states and the District of Columbia; it excludes persons in the
territories as wel as those who are institutionalized. The TRIM3 microsimulation model is
funded primarily by the Department of Health and Human Services (HHS) and maintained at the
Urban Institute.
TRIM3 is used to address the under-reporting of benefits receipt by respondents to the ASEC. It
also provides estimates of tax liabilities. However, readers should note that models like TRIM3
may not perfectly correct for the inaccurate information sometimes reported in survey data. For
example, receipt of refundable tax credits is underestimated even when using the TRIM3 model.
Thus, this report’s estimates of how many individuals receive these tax credits– and hence receive
at least one benefit—are underestimated.
For further information on the data and methods used in this report, see CRS Report XXXXXX.
Need-Tested Benefits Receipt
Before the economic impact of the COVID-19 pandemic, an estimated one in three persons
received benefits from at least one of the major need-tested programs examined in this report.
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This totals to an estimated 111 mil ion individuals. This share of the population, and number of
people, is based on income data for 2017.
Figure 1 shows the estimated number of persons benefitting from each of the need-tested benefits
examined in this report. It reveals that some benefits are comparatively widely received, while
others aid smal er populations. Medicaid/CHIP assistance reached the largest number of people
(77 mil ion). This number excludes Medicaid recipients who have their long-term care services
and supports financed in an institutional setting. In addition to Medicaid/CHIP, the programs that
benefit a comparatively large number of individuals are SNAP and the two refundable tax credits
(the ACTC and the EITC).
In contrast, fewer people are recipients of housing assistance, SSI, TANF cash, and child care
subsidies. A comparatively large share of the population is eligible for housing assistance, but the
number of housing units that are subsidized is limited by funding and thus there are waiting lists
that ration housing assistance. SSI eligibility is limited to the needy persons who are aged 65 and
older, or have a disability (including blindness). While TANF has limited funding, federal and
required state contributions for TANF were theoretical y sufficient in 2017 to assist al eligible
families.6 However, about one-quarter of those eligible for TANF received assistance. TANF is
not an entitlement to individuals and state work requirements (including those for applicants) and
other restrictions can function as costs to participation (e.g., a person’s time and attention).
Potential recipients might decide that the TANF cash benefit is not large enough to merit applying
for given these requirements. CCDF funding is limited and many states or sub-state areas
maintain waiting lists of those eligible for child care as wel .
The benefits that reached the greatest number of people were either noncash medical and food
assistance, or refundable tax credits that provide their benefits once a year through federal income
tax refunds. The population receiving ongoing (mostly monthly) cash assistance from SSI and
TANF was smal compared to the number receiving the major noncash benefits or refundable tax
credits.

6 According to estimates from the T RIM3 microsimulation model, if 100% of all those eligible for T ANF assistance
received it, benefits would have totaled approximately $18 billion. Federal funding from the basic T ANF block grant
was $16.5 billion, and states were required to contribute an additional $10.4 billion from their own funds under the
T ANF maintenance of effort (MOE) requirement. T hus, states, in total, had more than sufficient funds to pay these
benefits. However, states may, and have, used T ANF funds for a wide range of benefits and services related to
childhood economic disadvantage aside from assistance, and for a broader population than those receiving T ANF
assistance. See CRS In Focus IF10036, The Tem porary Assistance for Needy Fam ilies (TANF) Block Grant.
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Figure 1. Estimated Number of Persons Receiving Benefits from Selected Major
Need-Tested Programs at Any Time During a Year
Based on 2017 Income Data

Source: CRS, based on data from the U.S. Census Bureau’s ASEC to the CPS and the TRIM3 microsimulation
model, primarily funded by HHS and maintained at the Urban Institute. Medicaid/State Children’s Health
Insurance Program (CHIP) enrol ment estimates were developed by CRS and include only noninstitutionalized
enrol ees (excludes enrol ees residing in nursing homes).
Notes: CHIP=State Children’s Health Insurance Program; SNAP=Supplemental Nutrition Assistance Program;
ACTC=Additional Child Tax Credit; EITC=Earned Income Tax Credit; SSI=Supplemental Security Income;
TANF=Temporary Assistance for Needy Families; and CCDF=Child Care and Development Fund. Recipients are
people receiving benefits at any time during the year. For the refundable tax credits, this represents tax credits
earned during the year. Recipient counts for tax credits represent the tax filer, spouse, and dependents of the
tax filer. For subsidized child care, the number of people represents children who received subsidized care at any
time during the year. For other programs, the number of people represents the individuals in units defined for
the program for which needs and resources are measured and benefits are provided.
Need-Tested Benefit Receipt by Pre-assistance Income
Al the programs discussed in this report restrict eligibility to those who meet a test of low
income. Some programs also require that individual and family assets (e.g., bank accounts,
automobiles) be valued below a certain dollar value to qualify for benefits. The financial
eligibility thresholds vary among the programs, as noted in Table 1. Some are expressed as a
multiple of the FPL. However, not al major need-tested programs measure income limits as a
multiple of the FPL. For instance, income limits for housing programs and the CCDF are
typical y set, respectively, at a percentage of local area or state median income.
Medicaid and CHIP benefits are often available at income levels above the poverty thresholds.
States are required to cover children under Medicaid who are at or below 133% of the FPL. States
may cover children at higher income levels, and CHIP coverage kicks in for children in families
above the income threshold for regular Medicaid. The refundable tax credits are tied to earnings,
and provide benefits to families above the poverty line as wel . Some programs may also reduce
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benefits at a modest, rather than rapid, rate as participants’ earnings increase to avoid
discouraging work, resulting in some benefits going to families above the poverty line even when
programs primarily target families below the poverty line.
Figure 2 shows the share and number of individuals who received at least one need-tested benefit
by poverty status. The poverty status of persons is determined by their pre-assistance income—
income before the receipt of need-tested benefits—relative to their family’s poverty threshold.
For this analysis, it uses income and need concepts of the research Supplemental Poverty
Measure (SPM), a measure developed for research purposes that can be used to assess the effects
of benefits receipt on poverty.7 The figure shows that 83% of persons who lived in families with
pre-assistance income below the poverty threshold received at least one of the need-tested
benefits discussed in this report. That percentage drops to 52% for those with incomes between
100% and 199% of the poverty threshold, 21% for those with incomes between 200% and 299%
of the threshold, and 6% for those with incomes of 300% or more of the threshold. Families
receiving benefits with pre-assistance income at 300% or more of the poverty threshold might
receive benefits for only a few months during the year in which they were needy, or they may be
families with special circumstances (e.g., non-parent relative caregivers of children they are not
financial y responsible for).
The figure also shows that while those with pre-assistance incomes below the poverty threshold
had the highest rate of need-tested benefit receipt, they comprised less than half of al those who
received benefits.

7 Note that the poverty concepts used to count people by poverty status differs from the concepts used for determining
program eligibility. For example, the health care programs (Medicaid and CHIP) and nutrition programs often
determine eligibility using the FPL or a mult iple of the FPL. T he countable income of applicants, based on each
program’s rules for counting income, is compared to the FPL to determine eligibility for these programs. On the other
hand, for determining the poverty status of the population and the shar e of the population above or below the poverty
line, other poverty concepts are used. T his report uses the concepts of the research SPM in determining poverty status.
For an overview of poverty concepts used in determining program eligibility versus those used for statistical purposes,
see CRS Report R44780, An Introduction to Poverty Measurem ent.
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Figure 2. Need-Tested Benefits Receipt, by Pre-assistance Income Poverty Status
Based on 2017 Income Data; Poverty Status Determined Using the Supplemental Poverty Measure (SPM)

Source: CRS, based on data from the U.S. Census Bureau’s ASEC to the CPS and the TRIM3 microsimulation
model, primarily funded by HHS and maintained at the Urban Institute. Medicaid/State Children’s Health
Insurance Program (CHIP) enrol ment estimates were developed by CRS and include only noninstitutionalized
enrol ees (excludes enrol ees residing in nursing homes).
Notes: Percentages calculated based on unrounded numbers. Recipients are people receiving benefits at any
time during the year for at least one the programs: Medicaid/State Children’s Health Insurance Program (CHIP),
Supplemental Nutrition Assistance Program (SNAP), the Earned Income Tax Credit (EITC), the Additional Child
Tax Credit (ACTC), housing assistance, cash from Temporary Assistance for Needy Families (TANF),
Supplemental Security Income (SSI), or Child Care and Development Fund (CCDF) child care subsidies. For the
refundable tax credits, this represents tax credits earned during the year. Recipient counts for tax credits
represent the tax filer, spouse, and dependents of the tax filer. For subsidized child care, the number of people
represents children who received subsidized care at any time during the year. For other programs, the number
of people represents the individuals in units defined for the program for which needs and resources are
measured and benefits are provided.
As discussed previously, some programs are more targeted than others toward the lowest income
groups. This can result from either statutory eligibility rules or how programs ration aid among
eligible individuals and families. Figure 3 shows the percentage of those receiving benefits from
each of the eight programs who had pre-assistance incomes below the poverty threshold. The
programs that had the highest share of their benefits going to families with pre-assistance incomes
below the poverty line were SNAP, housing assistance, SSI, TANF, and child care. Except for
SNAP, these were also the programs that benefitted comparatively fewer individuals (Figure 1).
In comparison, more than half of ACTC (the refundable portion of the child tax credit) recipients
had incomes above the poverty threshold. For Medicaid/CHIP and the EITC, about half of al
persons receiving benefits had incomes below the poverty threshold.
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Figure 3. Number of People Receiving Selected Need-Tested Benefits and
Percentage of Recipients with Pre-assistance Incomes Below the Poverty Threshold
Based on 2017 Income Data; Poverty Determined Using the Supplemental Poverty Measure (SPM)

Source: CRS, based on data from the U.S. Census Bureau’s ASEC to the CPS and the TRIM3 microsimulation
model, primarily funded by HHS and maintained at the Urban Institute. Medicaid/State Children’s Health
Insurance Program (CHIP) enrol ment estimates were developed by CRS and include only noninstitutionalized
enrol ees (excludes enrol ees residing in nursing homes).
Notes: CHIP=State Children’s Health Insurance Program; SNAP=Supplemental Nutrition Assistance Program;
ACTC=Additional Child Tax Credit; EITC=Earned Income Tax Credit; SSI=Supplemental Security Income;
TANF=Temporary Assistance for Needy Families; and CCDF=Child Care and Development Fund. Percentages
calculated based on unrounded numbers. Recipients are people receiving benefits at any time during the year.
For the refundable tax credits, this represents tax credits earned during the year. Recipient counts for tax
credits represent the tax filer, spouse, and dependents of the tax filer. For subsidized child care, the number of
people represents children who received subsidized care at any time during the year. For other programs, it
represents the individuals in units defined for the program for which needs and resources are measured and
benefits are provided.
Need-Tested Benefits by Family Category, Age, and Disability
Status
In addition to tests of financial need, many need-tested programs also restrict eligibility to
persons of a certain age, of a certain disability status, or in a certain type of family. Cash
assistance from SSI is restricted to needy persons who are aged 65 and older or disabled
(including blindness). Cash assistance from TANF is limited to families with children. Of the
benefits discussed in this report, CHIP, the ACTC, TANF, and CCDF are general y targeted to
families with children.
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Needy individuals and couples who are neither aged 65 and older nor disabled nor have children
are often ineligible for benefits or might receive them under more restrictive circumstances.
Medicaid coverage for this group is provided at state options. Additional y, SNAP restricts
benefits for people aged 18 to 49 who do not have children and are not disabled to those either
working or participating in an employment program for at least 20 hours per week. EITC for
childless workers is provided only at lower earnings levels and in smal er amounts. Such
individuals are ineligible for ongoing cash assistance from SSI or TANF.
This report classifies individuals into the following groups:
 children (individuals under the age of 18),
 adults (of any age or disability status) in families with children, and
 adults in families without children who are
 aged 18 to 64 and have a work-limiting disability,8
 aged 18 to 64 and do not have a work-limiting disability, or
 aged 65 and older.

Overlap in Family and Individual Groupings
For the purposes of the estimates in this report, these categories are treated as mutual y exclusive, with
individuals assigned to a single category based on “adults in families with children” having first order of
precedence. This is general y because many of the benefits discussed in this report are either targeted toward
families with children or require that a family have a child to qualify (CHIP, ACTC, TANF, CCDF). Families with a
parent with disabilities or with an adult aged 65 or older may themselves qualify or have a spouse that qualifies for
these benefits based on the presence of a child, rather than disability status or age. Assigning individuals to
mutual y exclusive groups creates overlap between populations—specifical y, there are people classified as “adults
in families with children” who either have a severe work-limiting disability or are aged 65 and older.
In 2017, 8.7% of adults in families with children overlapped with other categories: 4.9% of these adults were aged
18 to 64 and had a severe work disability and 3.8% were aged 65 and older. Despite this overlap, each adult was
assigned to only one group based on the rank order listed above (e.g., adults who are age 65 and in a family with
children were classified as “adults in families with children”).

Number
Percentage of

(in thousands)
Total
Adults in families with children (total)
84,046
100.0
Adult aged 18 to 64 without a disability
76,775
91.3

8 T his report uses a definition of an individual with a work-limiting disability that is based on a method developed by
the U.S. Census Bureau. An individual is considered to have a work -limiting disability if any of the following is true:
(1) responded “Yes” to an ASEC question asking whether the individual has a health problem or disability that prevents
working, (2) responded “Yes” to an ASEC question asking whether the individual retired or left a job for a health
reason, (3) responded that the individual did not work in the month of the survey because of a disability, (4) responded
to an ASEC question that the individual did not work in the prior year because of a disability, (5) was a recipient of
Medicare and under age 65, or (6) was a recipient of SSI and under age 65. T his corresponds to the definition of
“severely” work disabled in the document found here: https://www2.census.gov/programs-surveys/demo/guidance/
disability/cpstableexplanation.pdf.
Note that this report uses T RIM3 information about receipt of SSI rather than the information in the ASEC.
Additionally, if an adult was in a family with a child, that individual would have been classified as an adult in a family
with a child; and all individuals under 18 were classified as children, including those who might have a work -limiting
disability as described above.
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Adults aged 18 to 64 with a severe work
4,099
4.9
disability
Adults aged 65 and older
3,172
3.8
Source: CRS, based on data from the U.S. Census Bureau’s ASEC to the CPS and the TRIM3
microsimulation model, primarily funded by HHS and maintained at the Urban Institute.
Figure 4 shows receipt of benefits from any of the need-tested programs discussed in this report
by family category, age, and whether an individual in a family without a child had a disability. It
shows the rate of receipt in each category in the context of the broader population within that
category. For the purposes of this figure, the broader population represents al the individuals in
each of these groups (not the number of eligible individuals within the group).
Individuals with severe work disabilities without children had the highest rate of benefit receipt
among the five groups (65%). However, this group is also the smal est in terms of number of
people. The largest group in terms of population is nondisabled adults under age 65 without
children under age 18. Of the persons in this group, 19% received need-tested benefits.
Individuals aged 65 and older without children had the lowest rate of receipt of need-tested
benefits (14%). Most persons aged 65 and older do receive government benefits, but in the form
of Social Security and Medicare social insurance rather than need-tested aid. Additional y, the
population aged 65 and older and individuals with disabilities captured here exclude those who
receive care in institutionalized settings (e.g., nursing homes, institutions for mental disease,
institutions for individuals with developmental disabilities). Medicaid finances a large share of
expenditures for long-term services and supports, and those provided in institutionalized settings
are not captured in either the population or Medicaid enrollment statistics in this report.
Figure 4 also shows that many of the recipients of need-tested aid are in families with children—
they are either the children themselves or adults in families with children. These two groups have
a high rate of need-tested benefits receipt, with more than half of al children (57%) being a
recipient of benefits. Together, 76 mil ion children and adults in families with children received a
need-tested benefit, representing 68% of al persons receiving need-tested aid.
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Figure 4. Receipt of Need-Tested Assistance: Individuals by Family Category, Age,
and Disability Status
Based on 2017 Income Data

Source: CRS, based on data from the U.S. Census Bureau’s ASEC to the CPS and the TRIM3 microsimulation
model, primarily funded by HHS and maintained at the Urban Institute. Medicaid/CHIP enrol ment estimates
were developed by CRS and include only noninstitutionalized enrol ees (excludes enrol ees residing in nursing
homes).
Notes: Adults in families with children may be of any age (18 or older) or disability status. Percentages
calculated based on unrounded numbers. Categories are mutual y exclusive. Recipients are people receiving
benefits at any time during the year for at least one the programs: Medicaid/State Children’s Health Insurance
Program (CHIP), Supplemental Nutrition Assistance Program (SNAP), the Earned Income Tax Credit (EITC), the
Additional Child Tax Credit (ACTC), housing assistance, cash from Temporary Assistance for Needy Families
(TANF), Supplemental Security Income (SSI), or Child Care and Development Fund (CCDF) child care subsidies.
For the refundable tax credits, this represents tax credits earned during the year. Recipient counts for tax
credits represent the tax filer, spouse, and dependents of the tax filer. For subsidized child care, the number of
people represents children who received subsidized care at any time during the year. For other programs, the
number of people represents the individuals in units defined for the program for which needs and resources are
measured and benefits are provided.
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Need-Tested Benefits: Who Receives Assistance?

Non-resident Parents
This report—and the rules of many programs—define a family with children as one where a child lives (or usual y
lives) in the same household as the parent or caretaker. However, an individual in a family without a child can stil
be a parent and stil be financial y responsible for the wel -being of a child. A non-resident parent may be one who
is divorced from the other parent or never married the other parent. Non-resident parents may stil owe child
support for the care of a child.
It is estimated that in 2017, among the 104 mil ion adults aged 18 to 64 without disabilities in childless families
shown in this report, 5.4 mil ion were non-resident parents.9 Such adults are often excluded from programs that
are targeted toward families with children. As shown in Figure 4, 19% of adults aged 18 to 64 without disabilities
in families where a child did not live received benefits from at least one of the need-tested programs, compared
with 40% of adults in families where a child lived in the same household.
Need-Tested Benefits by Work Status
Most persons other than those aged 65 and older or individuals with a work disability were in a
family with an adult worker—either they worked themselves or another adult (e.g., spouse, adult
child, grandparent) in the family worked. The work test used in this analysis is any work during
the year. While this includes families where there is only weak attachment to the workforce, it
does differentiate between those families where the withdrawal from the workforce is total and
those where there is some work activity.
Most need-tested benefit recipients are in families with an adult worker: in 2017, of the 111
mil ion recipients of need-tested benefits, 91 mil ion (81%) were in such families (Figure 5).
Figure 5. Receipt of Need-Tested Assistance: Individuals by Whether or Not a Family
Had an Adult Worker
Based on 2017 Income Data

Source: CRS, based on data from the U.S. Census Bureau’s ASEC to the CPS and the TRIM3 microsimulation
model, primarily funded by HHS and maintained at the Urban Institute. Medicaid/CHIP enrol ment estimates
were developed by CRS and include only noninstitutionalized enrol ees (excludes enrol ees residing in nursing
homes).

9 Estimate is based on a statistical imputation of noncustodial parents as part of the T RIM3 microsimulation model.
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Notes: Percentages calculated based on unrounded numbers. Totals may not sum due to rounding. Recipients
are people receiving benefits at any time during the year for at least one the programs: Medicaid/State Children’s
Health Insurance Program (CHIP), Supplemental Nutrition Assistance Program (SNAP), the Earned Income Tax
Credit (EITC), the Additional Child Tax Credit (ACTC), housing assistance, cash from Temporary Assistance for
Needy Families (TANF), Supplemental Security Income (SSI), or Child Care and Development Fund (CCDF)
child care subsidies. For the refundable tax credits, this represents tax credits earned during the year. Recipient
counts for tax credits represent the tax filer, spouse, and dependents of the tax filer. For subsidized child care,
the number of people represents children who received subsidized care at any time during the year. For other
programs, the number of people represents the individuals in units defined for the program for which needs and
resources are measured and benefits are provided.

Figure 6 shows that the high rate of need-tested benefit receipt among families with workers is
attributable primarily to the large share of recipients in families with children. The figure shows
that most families with children had an adult worker, and most families with children receiving
need-tested benefits had an adult worker (31 mil ion out of 34 mil ion). Only among individuals
aged 65 and older with no children or those aged 18 to 64 with a work-limiting disability and no
children were the majority of people overal —and of people receiving need-tested benefits—in
families without an adult worker.
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Figure 6. Receipt of Need-Tested Assistance: Individuals by Family Category, Age,
and Disability Status and Whether or Not a Family Had an Adult Worker
Based on 2017 Income Data

Source: CRS, based on data from the U.S. Census Bureau’s ASEC to the CPS and the TRIM3 microsimulation
model, primarily funded by HHS and maintained at the Urban Institute. Medicaid/CHIP enrol ment estimates
were developed by CRS and include only noninstitutionalized enrol ees (excludes enrol ees residing in nursing
homes).
Notes: Adults in families with children may be of any age (18 or older) and disability status. Percentages
calculated based on unrounded numbers. Categories are not mutual y exclusive. Recipients are people receiving
benefits at any time during the year for at least one the programs: Medicaid/State Children’s Health Insurance
Program (CHIP), Supplemental Nutrition Assistance Program (SNAP), the Earned Income Tax Credit (EITC), the
Additional Child Tax Credit (ACTC), housing assistance, cash from Temporary Assistance for Needy Families
(TANF), Supplemental Security Income (SSI), or Child Care and Development Fund (CCDF) child care subsidies.
For the refundable tax credits, this represents tax credits earned during the year. Recipient counts for ta x
credits represent the tax filer, spouse, and dependents of the tax filer. For subsidized child care, the number of
people represents children who received subsidized care at any time during the year. For other programs, the
number of people represents the individuals in units defined for the program for which needs and resources are
measured and benefits are provided.
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Conclusion
Need-tested aid is often thought of in the context of families and individuals not engaged in work.
For two populations, individuals aged 65 and older and individuals with work-limiting
disabilities, aid is often provided to those in families without a worker. For individuals aged 65
and older, social insurance benefits such as Social Security and Medicare are received more often
than need-tested aid and help them achieve their standard of living. (Note that the analysis in this
report does not capture need-tested benefits provided to those in nursing homes, which means that
it likely underestimates benefits receipt and benefit amounts among individuals age 65 and older.)
Few adults aged 18 to 64 without disabilities living in families without children receive need-
tested aid compared to those in families with children or adults with disabilities.
For families with children, need-tested aid is commonly received by families with an adult
worker. This is the cumulative result of policy changes to aid needy families with children made
since the mid-1980s. It is also the result of the high work rates among adults in families with
children observed before the COVID-19 pandemic. Most of the need-tested program expansions
since the mid-1980s—the expansion of the EITC, the enactment of the child tax credit (and the
ACTC) and its expansions, Medicaid expansions covering children based on their poverty status
rather than their family’s receipt of cash assistance, and the establishment of federal child care
subsidies—were al put in place to supplement parents’ earnings and benefits from work, and
some were explicitly designed to encourage parents to work. The Personal Responsibility and
Work Opportunity Act of 1996 (P.L. 104-193) ended the entitlement to monthly cash assistance
for needy families with children and replaced that program with a broad-purpose block grant
(TANF) that helps fund monthly cash assistance to fewer families than were provided benefits in
the early and mid-1990s under the predecessor entitlement programs, as states shifted block grant
funds to other activities.10
Before the pandemic, the bulk of need-tested aid was provided either in the form of noncash
benefits (e.g., Medicaid/CHIP, SNAP), or refundable tax credits that were received in a lump-sum
form once a year. Housing assistance and child care subsidies were received by comparatively
fewer persons than the other benefits. Monthly cash benefits—which can be used to pay rent and
other bil s—were received by relatively few families with children before the pandemic. In 2017,
the 4 mil ion people who received TANF assistance at some point in the year represented one-
quarter of al individuals who met eligibility requirements.
For 2020 and 2021, years when work was limited by the pandemic and economic insecurities
faced by some households were highlighted, Congress enacted policies to increase food aid
(SNAP), provide additional rental assistance, and appropriate additional funding for child care. It
also enacted policies to inject cash into households, including providing most households with
“stimulus checks” and (for 2021) altering the child tax credit to make it available to non-earners
and to periodical y advance a portion of the expected credit amount during the last six months of
the year.
Under current law, many pandemic-related policies wil expire by the end of 2021. Thus, policies
would general y revert back to those that were in place before the pandemic, providing the bulk
of aid to families with children in the form of noncash benefits or refundable tax credits provided
once a year.

10 For more information, see CRS In Focus IF10889, Temporary Assistance for Needy Families: The Decline in the
Cash Assistance Caseload.
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President Biden’s “American Families Plan” would extend some of the policies enacted in
response to the economic impact of the pandemic into the post-pandemic period. In particular, the
proposal to continue periodic cash payments of the child tax credit would bring to the fore the
policy tradeoff between economic security for those working irregularly or not working, versus
conditioning benefits on work and earnings and thus providing incentives to work and labor force
participation.
The President’s plan would also expand some of the existing work-based policies, such as child
care assistance. Thus, it would retain some of the character of pre-pandemic, need-based aid by
further expanding earnings supplements to families with children. This may raise questions about
how much is spent to supplement earnings and whether there are alternatives (e.g., wage and
labor market policies) that could be pursued to reduce reliance on need-tested benefits more
broadly.

Author Information

Gene Falk
Paul D. Romero
Specialist in Social Policy
Research Assistant

Karen E. Lynch

Specialist in Social Policy

Acknowledgments
This report benefitted from the contributions of Evelyne Baumrucker, Randy Alison Aussenberg, Jameson
Carter, Paul Davies, Maggie McCarty, and Will Morton of the Congressional Research Service. CRS
Graphics Specialist Amber Wilhelm helped produce the data visualizations in the report’s summary.

Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and
under the direction of Congress. Information in a CRS Report should n ot be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in
connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not
subject to copyright protection in the United States. Any CRS Report may be reproduced and distributed in
its entirety without permission from CRS. However, as a CRS Report may include copyrighted images or
material from a third party, you may need to obtain the permission of the copyright holder if you wish to
copy or otherwise use copyrighted material.

Congressional Research Service
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