The huge 2018 budget bill Congress passed last week includes significant new money for dementia research and modest additional funding for many programs aimed at assisting frail older adults. The final $1.3 trillion bill was a dramatic about-face for President Trump and House Republicans, whose own budget plans would have slashed or even eliminated funding for many seniors’ programs.
The biggest winners were Alzheimer’s researchers. The budget increases the National Institute of Health’s dementia research budget by a staggering 30 percent, or $414 million. The Sec. 202 housing program for low-income seniors was also a big winner: Congress raised its budget from $502 million to $678 million.
Other programs that will see big funding increases include home delivered nutrition such as Meals on Wheels that got an additional 9 percent or $19 million; family caregiver supports that got a 20 percent boost to nearly $181 million; and aging and disability resource centers that saw their funding rise from $6.1 million to $8.1 million.
The National Council on Aging has a nice summary of some budget highlights here. If you’d like to explore the budgets in more detail, here is a detailed description of the Department of Health & Humana Services budget.
Other programs whose funding was frozen or received modest increases include state health insurance assistance programs (SHIP) that got about $2 million more than last year, and chronic disease self-management and falls prevention programs whose budgets remain the same as in 2017.
Saving programs marked for repeal
In many cases, senior services programs received their biggest funding increases in years. Many have been operating on the same budgets for a decade, constrained by tight spending caps, President Obama’s reluctance to ask for new domestic funding, and the reluctance of a GOP-controlled Congress to give it to him, even when he did request new money.
Strikingly, several programs that Trump and House Republicans wanted to kill survived and, in every case, did so without suffering any budget cuts. For example, funding was frozen for the social services and community services block grant programs that support local initiatives for seniors and other high-need populations. But both programs survived.
The Senior Community Service Employment Program (SCSEP) that helps unemployed seniors find jobs in government or with non-profits also kept its funding of $400 million. The Low Income Home Energy Assistance Program that helps needy families pay fuel bills got a modest budget hike as well. Lawmakers have been trying to kill both programs for years, but they somehow survive every budget battle.
Overall, the budget increased domestic spending by $52 billion, and defense spending by $66 billion. This, of course, came on top of a huge tax cut that Congress passed last December that is projected to reduce federal revenues by $1.5 trillion over the next decade.
The only real disappointment for seniors and their advocates was Congress’ failure to extend the Money Follows the Person program. MFP helps move seniors and younger people with disabilities from nursing homes back into their communities. While it has been more successful for younger people, it has also helped some seniors get home. The federal program expired in 2016, and many of the 47 states that operate programs are running out of funding to continue it.
With that exception, Congress was more than willing to open its checkbook for seniors’ programs. The problem: All of this new spending, coupled with large tax cuts, is ultimately unsustainable. The US now has a $21 trillion national debt and will, at some point, face a fiscal crisis. When it does, Congress will have to either cut spending, raise taxes, or both. But, for now, Trump and Congress are playing Santa, giving nearly all constituencies both tax cuts and new spending.
And, like the rest of government, senior services programs are benefitting from this largess. Enjoy it while it lasts.