President Trump’s initial budget framework would slash programs for seniors and younger people with disabilities, especially those aiming to remain at home rather than move to a nursing home or other residential care. Combined with the House GOP’s proposed health plan, it may severely limit access to federally-funded medical care, personal assistance, and other supports and services.
The Trump fiscal plan leaves out many key details. However, the message is clear: Frail elders and younger people with disabilities should not count on the federal government to provide them with anything close to current levels of services. Programs such as energy and legal assistance, Meals on Wheels, a public service jobs program for low-income seniors, and National Institutes of Health research are specifically targeted for cuts. Trump has not yet identified other programs he’d trim, but he’s proposing major spending reductions for the federal departments that fund them. So they could well be in jeopardy.
Here are some of his proposed cuts:
- He’d eliminate two major block grant programs to state and local governments: the Community Development Block Grant and the Community Services Block Grant. Among other services, CDBG helps fund Meals on Wheels.
- He’d cut spending for the Department of Health and Human Services by $15.1 billion, or 17.9 percent (excluding any additional reductions in payments for Medicare or Medicaid, which Trump did not identify).
- The HHS cuts include a 22 percent reduction in the NIH budget and a major—but mostly unspecified—reorganization of the institute.
- He’d eliminate the HHS office of community services, which includes an energy assistance program for low-income families, including seniors.
- The budget outline does not describe most other specific HHS cuts, but it is all-but-certain that critical programs for seniors and people with disabilities, including the Older Americans Act (OAA), will face big reductions. The OAA helps fund senior nutrition programs, caregiver support, respite care, information services, elder abuse prevention, and dozens of other programs.
- He’d cut spending at the Department of Housing and Urban Development by $6.2 billion or more than 13 percent. While the budget outline identifies some relatively small programs on the chopping block, it is silent on major housing subsidies, including the Sec. 202 program that helps fund commercial development of supportive housing for low-income seniors. However, cuts of the magnitude that Trump is proposing are likely to hit those programs as well.
- He’d eliminate the Senior Community Service Employment Program (SCSEP), which helps older adults get public service jobs.
- He’d reduce spending at the Department of Transportation by $2.4 billion or 12.7 percent. Trump did not say which programs he’d cut, but senior transportation will almost certainly be targeted.
Trump says he’ll release a more complete budget in May. Meanwhile, this one is already facing withering criticism on Capitol Hill, including from Republicans. But Trump wants to boost spending for defense and homeland security and backs major, multi-trillion dollar tax cuts. He will not be able to do all those things and keep an already-troublesome budget deficit under control. My best guess is that many of the programs Trump has targeted—both those he named and those he did not—will face big reductions for next year, even if they are not as big as Trump requested yesterday. Federal funding for senior services will be much lower in 2018 than it is today.