Roughly 1.2 million children in the United States currently receive Supplemental Security Income (SSI) benefits through the Social Security Administration — yet advocates estimate that hundreds of thousands more eligible children go unenrolled every year, their families simply unaware the program exists for them.
Marlene O’Brien almost became one of those statistics. I met her on a cold Tuesday evening in February 2026, at a Medicare enrollment event hosted by the Enoch Pratt Free Library branch in Baltimore’s Hampden neighborhood. She had squeezed herself into a folding chair near the back, still in her FedEx uniform, a spiral notebook open on her knee. She wasn’t there because she needed Medicare — at 29, she was decades away from eligibility. She was there because she had heard the word “Medicaid” and needed someone to explain the difference.
When I introduced myself and mentioned I covered Social Security and government benefits, she looked at me like I had announced I covered golf. “No offense,” she said, uncapping her pen, “but that stuff is for people with accountants. Not people like me.”
By the end of that evening, her notebook was full. We exchanged numbers, and two weeks later I sat down with her at a diner near her apartment in the Waverly neighborhood to hear the whole story.
A Raise That Made Things Harder
Marlene has driven delivery routes for FedEx since she was 22. In March 2025, she got a raise — from $19.50 an hour to $23.75 — the first meaningful bump in three years. She was proud of it, and for a few months, it felt like breathing room. Then the spending expanded to fill the space.
“We got a bigger apartment,” she told me. “My husband started ordering groceries delivered, which I know is ironic because I do deliveries. We just started spending like people who made more money, without actually becoming those people.”
Her husband, Darnell, works part-time as a warehouse associate while serving as the primary caregiver for their four-year-old son, Marcus, who was diagnosed with autism spectrum disorder at age three. The diagnostic process — two specialists, a neuropsychological evaluation, and a six-month stretch of early intervention therapy not covered by their insurance — cost the family roughly $8,400, all of it charged to two credit cards that were still sitting at combined balances of $6,200 when I met her.
Their combined household income sits at approximately $54,000 a year — enough to feel stable some months and precarious in others. Marlene has no 401(k) enrollment at work, a fact she mentioned with a shrug that didn’t quite conceal the anxiety underneath it. “I keep saying I’ll do it when things calm down,” she said. “But things don’t calm down.”
The Question She Didn’t Know to Ask
What brought Marlene to that library event was a specific, practical problem: Marcus’s speech therapist had recommended a new provider whose services weren’t covered under the family’s current insurance plan. Marlene had heard that Medicaid might cover the gap. She came looking for a workaround, not a revelation.
A benefits navigator at the event — a woman named Tanya who worked with a local nonprofit — was the one who first said the letters “SSI” to Marlene in the context of children. Marlene told me she had assumed SSI was only for adults who couldn’t work. “I thought it was like, for someone who got hurt on the job and couldn’t drive anymore,” she said. “I had no idea kids could get it.”
Under SSA’s rules for child SSI, a child under 18 can qualify if they have a medically determinable physical or mental impairment that results in marked and severe functional limitations — and if the family’s income and resources fall below certain thresholds. Autism spectrum disorder, depending on severity and documented functional limitations, can qualify. The maximum federal SSI benefit in 2025 is $967 per month, though the actual payment amount is reduced by a portion of parental income.
The Application — and the Waiting
Marlene submitted Marcus’s SSI application through the SSA’s online portal in early March 2026, about three weeks after the library event. She had spent the intervening weeks gathering documentation: Marcus’s autism diagnosis records, his therapy notes, school evaluation reports from the early intervention program, and two years of the family’s tax returns. “It felt like doing taxes and a college application at the same time,” she told me, laughing without much humor.
As of the day we spoke, the application had been submitted but not yet processed. SSA processing times for initial SSI decisions have stretched significantly in recent years — the agency’s own data shows average processing times hovering near five to seven months for initial disability determinations. Marlene is waiting. She checks the SSA portal most mornings before her route starts at 6 a.m.
“I don’t want to count on it,” she told me. “Because what if they say no? I don’t want to be sitting here thinking I had money and then it turns out I don’t.”
What She Stands to Gain — and What She’s Still Sitting With
The benefit amount Marcus might receive, if approved, depends entirely on the income-deeming calculation applied to Marlene and Darnell’s combined earnings. At their income level, an SSA eligibility worker would subtract allowable deductions from parental income and deem a portion of what remains to Marcus. Based on publicly available SSA deeming worksheets, a rough estimate — and it is only an estimate — puts Marcus’s potential monthly benefit somewhere in the range of $400 to $600 per month, substantially less than the federal maximum.
That Medicaid connection is what Tanya, the benefits navigator, called the “second story” inside every child SSI case. For Marlene, Medicaid coverage for Marcus would potentially eliminate the out-of-pocket therapy costs that drove her family into credit card debt in the first place. It would not erase the $6,200 already owed, but it could stop the bleeding.
“Honestly, at this point, the Medicaid might matter more than the check,” Marlene said. “Marcus has appointments every week. Every week. If I could stop putting those on the card, that changes things.”
But Marlene is not celebrating yet. Her stubborn practicality — the same quality that made her dismissive of “rich people’s” financial talk — keeps her expectations guarded. She has read enough online about SSI denials to know that a first application for a child with autism is not guaranteed approval, even with strong documentation. Approximately 60 percent of initial SSI disability claims are denied, according to SSA data, though many are approved on appeal.
A Reluctant Reckoning With Retirement
Near the end of our second conversation, I asked Marlene about something she had mentioned briefly at the library — her worry about outliving her retirement savings. It came out almost apologetically. She has roughly $2,100 in a savings account, no employer-sponsored retirement enrollment, and a general belief that Social Security would be gone by the time she needed it.
That last point is more complicated than the common narrative suggests. According to the SSA’s 2025 Trustees Report, the combined Social Security trust funds are projected to be able to pay full scheduled benefits through 2035, after which — without legislative changes — benefits could be reduced to approximately 83 percent of scheduled amounts. Not eliminated. Reduced. For a 29-year-old, the program’s future depends heavily on Congressional decisions that have not yet been made.
Marlene listened when I relayed that, her pen moving across the notebook again. “Okay,” she said slowly. “So it’s not gone. It’s just… uncertain.” She thought about that. “That’s basically my whole life, so.”
There was no triumphant resolution at the end of my reporting on Marlene’s story. Her son’s SSI application is pending. Her credit card debt is real and present. Her retirement account remains unenrolled. What shifted, she told me, was something smaller and harder to quantify — the sense that these programs were not designed for some other, more deserving category of person. “I always thought you had to be a certain kind of desperate, or a certain kind of together, to use any of this,” she said. “I didn’t think I was either one.”
She is neither, and both. She is a delivery driver in Baltimore who almost never asked the question that might change her son’s trajectory — not because she was careless, but because nobody told her the question existed. That gap between eligibility and enrollment is where a lot of families live, quietly, without knowing what they’re missing.
Leave a Reply