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The nation's two primary disability programs - Social Security Disability Insurance (DI) and Supplemental Security Income (SSI) disability - today provide vital income support for about 10 million individuals. These programs have grown rapidly in recent years to the point where in fiscal year 2001 they are expected to account for about $90 billion in Federal spending, or nearly five percent of the Federal budget. In 2001, about two-thirds of the Social Security Administration's $7.1 billion administrative budget, nearly $5 billion, is expected to be spent on disability work. As the baby boomers reach the age of increased likelihood of disability the growth in these programs will accelerate. This projected growth threatens to overwhelm a policy and administrative infrastructure that is already inadequate to meet the needs of the public. Long-standing problems are growing more acute and new ones are emerging. The purpose of this report is to provide the new Administration and the new Congress with a framework for considering the fundamental changes that need to be made if the disability programs are to meet the challenges they are facing. Some of these changes would require Congressional action. Others would require at least the implicit concurrence of the Congress because they are likely to require additional administrative resources. We believe that, taken together, these changes would accomplish fundamental reform.