The other day, Rand Paul stirred controversy when he had this to say about the looming debate over what to do about funding shortfalls in the Social Security Disability Insurance program, which is set to become a major flashpoint in the weeks ahead:

“If you look like me and you hop out of your truck, you shouldn’t be getting a disability check. Over half of the people on disability are either anxious or their back hurts — join the club. Who doesn’t get a little anxious for work and their back hurts?  Everybody over 40 has a back pain. And I am not saying that there are not legitimately people who are disabled.  But the people who are the malingerers are the ones taking the money away from the people who are paraplegic, quadriplegic.”

Now Senator Paul’s office has offered a new clarification of what he meant. But it appears to only dig the Senator in deeper.

Glenn Kessler has a great piece today laying out the broader set of facts in this debate. Kessler gives Paul’s comments Three Pinocchios, but also notes that they highlight “an important issue that will have a central role in the political debates this year as the program faces a serious funding crunch.”

But there is a nugget in there that is worth a look. A Paul spokesman offered Kessler the following explanation of the Senator’s comment:

Paul spokesman Brian Darling pointed to two data points — 27.7 percent of disabled beneficiaries are diagnosed as having ailments related to “Musculoskeletal system and connective tissue” and that 14 percent have “mood disorders.” That adds up to 42 percent, he noted.

In other words, when Paul said folks getting disability are merely “anxious,” he was talking about a specific category of people — those with “mood disorders.” But as Kessler notes, it turns out that, according to Social Security Administration spokesman William Jarrett, in the SSDI’s classification of beneficaries, those with “mood disorders” include the following:

Jarret noted that the “mood disorders” category includes conditions like bipolar disorder, major depressive disorder, and dysthymia (persistent depressive disorder).

According to the National Alliance on Mental Illness, which has tracked the debate over Paul’s initial comments, this actually makes them more serious, because his office has confirmed that his reference to those who are “anxious” but seemingly undeserving of benefits applied to actual categories of people with serious medical conditions.

“It was bad enough, frankly, when he seemed to trivialize anxiety disorders,” Ron Honberg, the legal and policy director for NAMI, told me. “But if he was referring to mood disorders, we know they can be very disabling. Unfortunately these kinds of comments really do trivialize very serious conditions, and perpetuate the stigmas and misinformation that oftentimes serve as barriers to people seeking help when they need it. It is very disturbing.”

Look, in fairness to Senator Paul, all politicians make off the cuff remarks that they probably regret, and for which they probably shouldn’t be pilloried too harshly. And no doubt the Senator is absolutely sincere in saying that he recognizes that many people are legitimately disabled and that he worries fraud hurts those who genuinely deserve disability support.

But there is an actual policy argument that is set to unfold here, and this opens a window on it. The House passed a rule early in the new Congress that, to oversimplify, will make it a lot harder to use routine funding transfers to fund the disability program with money from the broader Social Security program, even though this method had previously been used routinely many times. Democrats and outside advocates believe that, with the disability program set to start running low in money in 2016, this will set the stage for Republicans to use the program’s travails as leverage to force broader entitlement reform on their own terms, i.e., benefits cuts that Democrats oppose. Senator Sherrod Brown has called on fellow Democrats to gird for a very tough battle ahead.

Some Republicans are openly targeting the disability program for “reform.” As Ryan Cooper explains, it’s very hard politically for Republicans to target Social Security benefits overall, so disability benefits make a potentially “easier” target, providing a route into broader “reform” of entitlements. (Senator Brown has described this as an effort to divide “good” Social Security from “bad” Social Security, the latter falling into the waste and fraud category.)

The argument over whether the disability program’s beneficiaries actually deserve benefits obviously has political ramifications for this debate. Senator Paul’s trivializing of the “anxious” and those with “back pain” is occurring in that context. But as Kessler’s piece shows, the rate of disability fraud is relatively low, and doesn’t usually involve non-deserving layabouts in any case. And Paul’s clarification confirms that making broad claims about those who are supposedly undeserving of disability benefits is a lot harder than he thought.


UPDATE: Senator Sherrod Brown responds to Senator Rand Paul’s latest, in a statement sent over by his office:

“We know that Republicans are trying to dismantle Social Security for all Americans by first picking off support for SSDI. We saw an opening salvo last week when House Republicans changed longstanding rules to demand benefit cuts for all Americans in exchange for reallocation of the Social Security trust fund – a non-controversial procedure that has been used by both parties for decades. It seems that the next step in this cynical playbook is branding disabled Americans as lazy cheats. This not only insulting to them, but should put all Americans who count on Social Security on notice.”