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Impact Of The Fy 18 Trump Budget On Massachusetts Aging

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Mass Home Care, the statewide elder rights group, said this morning that the FY 18 budget released yesterday by President Trump is “no path for Congress to follow,” and said it will oppose the elimination of several key programs that are key to the economic security of seniors.

The President’s budget outright eliminates several key programs:

  • Low-Income Home Energy Assistance Program (LIHEAP). The President eliminates funding for a fuel assistance, a reduction of $3.9 billion that helps low-income households and families, including many older adults, with heating and energy bills throughout the year. Especially critical in New England.
  • State Health Insurance Assistance Program (SHIP). The President’s budget zeroes-out the $52.1 million for State Health Insurance Assistance Program, known in Massachusetts as SHINE (Serving the Health Insurance Needs of Everyone), which provided 76,000 Massachusetts seniors last year with free health insurance counseling for Medicare and Medicaid needs. SHINE is a cost-effective, volunteer-driven counseling services that is the only source of counseling that is not tied to insurance providers.
  • Senior Corps: The President eliminates the Older Americans Act Senior Community Service Employment Program (SCSEP), administered by the Department of Labor (DOL), and the Senior Corps programs (RSVP, Foster Grandparents and Senior Companion) under the Corporation for National community Service (CNCS). The President’s budget cuts $400 million in FY 2018. SCSEP is the only workforce development program that specifically targets older adults in or near poverty. Many of these jobs supplement workforce needs at Area Agencies on Aging and other community-based organizations serving seniors.
  • Community Services Block Grant (-$715 million)
  • Social Services Block Grant (-$1.7 billion)
  • Community Development Block Grant (-$615 million).
    These programs fund state and local community and economic development efforts that provide key services to older adults.

Unhealthy Medicaid and Food Stamp Cuts

The President’s makes deep cuts to domestic and safety-net programs, increases in defense spending and tax cuts for higher-income earners and corporations. The $4.1 trillion budget request includes proposals to cut federal spending by $3.6 trillion over ten years through massive cuts to Medicaid, nutrition and income assistance programs for low-income Americans. The budget spares Medicare, Social Security and most Older Americans Act (OAA) programs from cuts, but the request would propose eliminating many other key programs that supplement and support the capacity of the Aging Network to serve older adults and caregivers. Key safety-net programs including Medicaid, the Supplemental Nutrition Assistance Program (SNAP) and the Temporary Assistance for Needy Families (TANF) would see major reforms.

These changes and cuts would reduce assistance for low-income Americans by nearly $1 trillion over 10 years, over half of which would come from Medicaid. Under the budget proposal, states would have a choice to either block grant or per-capita cap their Medicaid programs. The Administration would further cut Medicaid by allowing states to block grant the Medicaid program for all eligibility categories, including for the older adults and people with disabilities who make up the bulk of Medicaid spending. The Administration estimates these reforms would result in a $610 billion reduction in Medicaid spending over 10 years on top of the $840 billion cut assumed in the American Health Care Act.

The Trump budget makes deep cuts to SNAP (Food Stamps). SNAP benefits support 4.8 million adults age 60 and over every year, but still only reach three out of five seniors who qualify for this support. The budget proposal would cut SNAP by 25%, or $193 billion over 10 years. SNAP cuts could put pressure on other nutrition assistance programs, like Meals on Wheels, which currently aren’t meeting existing need due to stagnant funding.

Additionally, the budget would cut spending on domestic programs by a total of $57 billion to $479 billion in FY 2018, which is $37 billion below “sequester-level” caps established in the Budget Control Act (BCA) for this coming fiscal year. (Unless Congress passes another bipartisan agreement this year to ease the budget caps established under the BCA, they will again kick in at the start of FY 18.)
 
Older Americans Act Spared Deep Cuts

.The Trump budget preserves all the Older Americans Act programs administered by the Administration on Aging/Administration for Communithy Living. Funding for OAA Title III B Home and Community-Based Supportive Services ($347 million), III C Nutrition Services ($447 for Congregate and $226 for Home-Delivered Nutrition Services), and III E Family Caregiver Support ($150 million) was flat. Unfortunately, the budget request does not reflect the ultimate increases for III B and III C services that were included in the final FY 2017 funding bill, as mentioned above, but that should not be read as a cut.

Elder Justice and Adult Protective Services

The budget request also level funds OAA Title VII Long-Term Care Ombudsman ($15.8 million) and Prevention of Elder Abuse and Neglect ($4.8 million) programs. Additionally, Elder Rights Support Activities, including the Elder Justice Initiative—an ACL priority under the Obama Administration—are level funded at $11.9 million. Again, President Trump’s budget request does not factor in the $2 million increase to the Elder Justice Initiative in FY 2017 to continue developing a national Adult Protective Services (APS) data system and to continue APS research. This is the first budget request in several years that does not include a significant increase in funding for Elder Justice and APS activities.
 
Senior Housing

The Trump budget increases funding for Section 202 Housing for the Elderly to $510 million—a massive $77 million increase (18 percent) increase over FY 2017. This request includes $90 million to renew service coordinator/congregate housing services grants. Section 202 Housing provides funding to create and support multifamily housing for very low-income elderly people. However, this increase also includes policy changes that would give the Department of Housing and Urban Development (HUD) authority to not increase rental payments; to transfer money between housing programs serving both seniors and people with disabilities; and to increase cost-sharing requirements for beneficiaries. Nearly 400,000 units for low-income senior households have been produced to date, and Section 202 is currently the only federal program that expressly addresses this need for affordable senior housing.

Transportation
The President’s FY 18 budget request for the Department of Transportation (DOT) includes a $2.4 billion cut (13 percent) over FY 2017 funding. Funding for the Federal Transit Administration (FTA), would fall $500 million below last year, including a $49 million (15 percent) cut to FTA Section 5310, transportation programs focusing on serving seniors and people with disabilities. The request also includes $5 million in funding for the n4a and Easterseals–led National Aging and Disability Transportation Center (NADTC), as part of the Federal Transit Administration’s technical assistance program to assist local communities and states in the expansion and provision of transportation services for older adults and people with disabilities.
Prevention and PublicHealth Funding 

The Administration eliminates the Prevention and Public Health Fund (PPHF), which was created in 2010 via the Affordable Care Act (ACA). PPHF provides a source of mandatory funding for activities devoted to boosting public health and using proven prevention strategies to reduce Americans’ rates of illness and disability. Because the budget request would, like the House health care reform bill recently passed, eliminate the PPHF, several disease prevention and health promotion initiatives targeting older adults would shift from being mandatorily funded to the discretionary side of the federal leger. The Trump Administration proposes discretionary funding for the Chronic Disease Self-Management Program (CDSMP) at $3 million below FY 2017 levels, which amounts to a 38 percent cut for these activities. Elder Falls Prevention would be level-funded at $5 million under the budget request, but because this funding would come out of the ACL/AoA discretionary budget, it puts pressure on other discretionary programs. Funding for Alzheimer’s Disease Program, which provides funding for Alzheimer’s outreach and awareness campaign activities and long-term services and caregiver support programs, would also move to the discretionary side of the ledger (and receive a boost in funding).

“The people who are disproportionately impacted by all these budget cuts are poor people,” said Mass Home Care Executive Director, Al Norman. “The people at the bottom of the economic ladder will feel the weight of the loss of Medicaid health care, food stamps, and fuel assistance. The Trump budget make the daily lives of the Americans more difficult. And this is where our advocacy must begin.”

Budget analysis assistance provided by tne National Association of Area Agencies on ‘Aging (n4a)

One Response to “Impact Of The Fy 18 Trump Budget On Massachusetts Aging”

  1. Elise Beaulieu says:

    These cuts are not off-set by the promised jobs. Folks who are blinded by the notion that “jobs” will make up the different in these situations are misled. Jobs may work for those who are in the age bracket of working, but the working poor, those with disabilities, or aged workers cannot take advantage of these promises. A free swinging economy serves the capitalistic concept, but leaves behind those who have, or will have to face misfortune. Health costs are the leading cause of bankruptcy, by gutting health care, we put people even at more risk of bankruptcy. The arms sale just negotiated will certainly provide jobs, but these weapons products make an assumption that they will be used, and folks will want more, hence employment? Would it not be better to have intellectual ideas, products to be used for the benefit of individuals rather than for the extinction of them? Do we leave our vulnerable, sick citizens behind to further the arms manufacturing?

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