Federal senior services programs are in for another very difficult year. In the 2015 budget he released yesterday, President Obama proposed freezing or even cutting spending for many key programs. And Obama’s blueprint may be the highwater mark for many initiatives, which are likely to see even deeper cuts as the budget works its way through Congress. Key House Republicans have already signaled that several programs are on their chopping block.
Obama proposed to reduce overall funding for the Administration for Community Living (ACL), the federal office that oversees most–though not all–senior services programs. He’d trim the agency’s budget to $2.062 billion, about $35 million below last year’s spending level. The National Council on Aging has a nice table here describing the budget numbers.
Among key programs, the news ranged from it-could-be-worse to downright bad. Funding for home delivered nutrition programs such as Meals on Wheels, supportive services, family caregiver support, and feeding programs for people in congregant care would all be frozen at 2014 levels even though the aging population is growing rapidly. Serious budget wonks may remember that Congress increased 2014 spending levels when it reached its budget deal last fall and temporarily eased the sequester.
For programs outside of the ACL, the news is more mixed. Obama would slash funding for the popular The Low-Income Home Energy Assistance program (LIHEAP) by nearly 20 percent to $2.8 billion. However, he’s proposing increases for Sec. 202 elderly housing and for housing counseling, including reverse mortgage counseling.
The White House would also continue funding for the Money Follows the Person demonstration program until 2020. This program is aimed at moving people from nursing homes back into their communities but has had limited success, especially for elders. In one important change, states could use funds to help people stay in their community, not just help them return after a nursing home stay.
The president would cut and restructure the Community Services Block Grant program, an important source of funding for local senior service initiatives. The program would be competitive so funding would go to the most successful agencies. However, Obama would only make about $350 million available, far less than the $650 million the program is getting this year.
Another program taking a big hit: The Senior Community Service Employment Program (SCSEP) that helps prepare unemployed seniors to go back to work. Obama would slash funding from $434 million this year to $380 million in 2015. One bit of good news: He’s once again proposing to shift the program from the Labor department, where it is something of an orphan, to the ACL.
Obama’s budget also includes a range of premium increases for Medicare recipients. It would phase-in income-related premium hikes for Part B and D (drug benefits). Eventually, about one-quarter of beneficiaries would pay these higher premiums. It would boost copayments for brand name prescription drugs for those getting Part D low-income subsidies. It would require all new enrollees to pay higher Part B deductibles and higher premiums for the most generous Medicare supplement (Medigap) policies. New enrollees would have to make a copayment for Medicare home health (that’s Medicare post-acute care, not Medicaid long-term care). And many Medicare providers would be paid less.
Until Congress and the president break their impasse over raising taxes and fundamentally restructuring costly entitlement programs such as Medicare and Social Security, there is no chance that spending for federal senior services will increase. The money just won’t be there.
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