Published in Woonsocket Call on June 4, 2017

Last month, President Donald Trump submitted his Fiscal Year 2018 budget proposal to a GOP controlled Congress. Critics of the Republican president and Democratic lawmakers called the 62-page budget proposal, “Dead on Arrival.” Now, with Congressional recess over, look for the House and Senate to begin drafting their own fiscal blueprint.

Massive Cuts to Entitlements and Discretionary Spending

Trump’s $4.1 trillion spending plan proposes historic, massive cuts by eliminating funding for 19 federal agencies to offset the cost of $54 billion to increase defense spending, to pay for infrastructure and the construction of a border wall between Mexico and the U.S., and to fund school voucher programs and a new paid leave initiative. The Trump budget also slashed funding from the budgets of other executive departments and agencies as well. The Environment Protection Agency, the State Department and Agriculture Department took the biggest funding cuts.

The core philosophy of Trump’s first full budget request, “A New Foundation for American Greatness,” can be described as “Taxpayer First,” says Director Mick Mulvaney, of the Office of Management and Budgets.

Mulvaney, a former Republican Congressman now serving as Trump’s budget director, told reporters one day before the release of Trump’s budget, “This is, I think, the first time in a long time that an administration has written a budget through the eyes of the people who are actually paying the taxes.”
We’re not going to measure our success by how much money we spend, but by how many people we actually help,” added Mulvaney.

Many aging advocates fear that Trump’s budget proposal will fray the nation’s social safety net forcing seniors to fall into poverty.
With the release of the Trump Budget proposal, the Washington, DC-based AARP, representing over 38 million members was quick to issue this statement. Executive Vice

President Nancy LeaMond said “AARP opposes the budget proposed today because it explicitly harms the very people we are counting on the President to protect. Today’s budget proposes to cut Social Security benefits, as well as funding for critical health, hunger, housing, and transportation assistance to low and middle-income seniors. This budget sends a powerful message to older Americans and their families that their health and financial security is at risk.”

“We do want to acknowledge the Administration’s paid leave proposal. Although it must be improved so that it addresses the workplace needs of all family caregivers, we hope that it leads to a national conversation about ways to support family caregivers in the workplace,” adds LeaMond.
The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM), believes Trump’s released budget proposal “literally leaves seniors in the cold.”

“This heartless budget does not reflect true American values,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare in a statement. “In our America, we do not cast seniors into the cold. We do not take food out of their mouths or make it harder to get the healthcare they so desperately need. In short, we do not cut off our most vulnerable citizens at the knees to pay for a massive tax break for the wealthy and big corporations.”

“This budget undermines the President’s promises to seniors. It guts Medicaid, which he promised to protect. The cuts to Social Security Disability Insurance (SSDI), [a program that helps disabled beneficiaries to say at work or return to work] violates his pledge not to tamper with Social Security. It also casts into serious doubt his pledge as a candidate to defend Medicare. No one who is serious about protecting these vital programs would propose a budget so harmful to seniors,” says Richtman.

Richtman says, “Make no mistake: the $64 billion in SSDI cuts are very real – and would cause real pain for Americans with severe disabilities. These are people deemed by the Social Security Administration to be too disabled to work. The qualification requirements are stringent, and the cases dire. Though SSDI helps younger Americans, too, most of its beneficiaries are 55 or over – meaning any cuts to the program will hit older Americans particularly hard. In fact, an average 1 in 6 men on SSDI die within 5 years of claiming benefits. For women, the figure is 1 in 7.”

Trump Budgetary Cuts Hurt Seniors, Poor

According to NCPSSM’s Government Relations and Policy staff, Trump’s budget proposal would drastically slash or eliminate funding for programs that benefit America’s seniors. Here is a sampling of budgetary cuts they identified.

Trump’s budgetary cuts of SSDI has an impact on older disabled persons. It would limit the retroactivity of applications for disability benefits from 12 months to six months and denies unemployment compensation payments to certain SSDI beneficiaries. Finally, it unreasonably caps the amount of payable to individuals who receive SSDI while living with other Supplemental Security Income recipients.

The president’s budget proposal also slashes more than $600 billion from the Medicaid program, which undermines seniors’ access to long-term care. It also eliminates the Community Services Block Grant ($715 million), the Community Development Block Grant ($3 billion) and the Social Service Block Grant ($1.7 billion) which helps fund some Meals-on-Wheels program, delivering hot meals to needy seniors.

Trump calls for eliminating the Low Income Home Energy Assistance Program (LIHEAP) which assists seniors with heating costs. LIHEAP received $3.39 billion in President Obama’s Fiscal Year 2017 budget. Of the 6.8 million household’s assistance, it is estimated that 2.26 million are over age 60.
Federal funding is also reduced for the National Institutes of Health (NIH) by $5.67 billion (including nearly $300 million for the National Institute on Aging), which will negatively impact research into cancer, Alzheimer’s, Parkinson’s and other diseases affecting older Americans.

With flat-line funding in the president’s budget proposal, we can expect longer waits at the local offices of Social Security Administration (SSA) and even extended waits when calling SSA’s telecommunication centers. The agency has been critically underfunded since 2010 – reducing the quality of service to SSA beneficiaries. This will continue.

Finally, Trump’s budget proposal eliminates funding for the Senior Corps programs, including the Retired and Senior Volunteer Program, Foster Grandparents and Senior Companions. These programs enable older adults to remain act in their homes.

Rhode Island Lawmaker Gives His Two Cents

U.S. Rep. David N. Cicilline notes, who serves as Co-Chair of the House Democratic Policy and Communications Committee “If a budget is a statement of your priorities and values, then Donald Trump’s budget shows he doesn’t understand the challenges facing Rhode Island seniors. This budget would cut Medicaid by up to $1.3 trillion over the next decade, jeopardizing health coverage that more than 18,000 Rhode Island seniors rely on to access high-quality affordable care.”

“Additionally, despite the President’s campaign promise not to touch Social Security, this budget carves out tens of billions in cuts to SSDI. That would have a devastating impact on SSDI recipients – most of whom are over the age of 55 – who have worked their entire lives and are physically unable to earn additional income,” says the Democratic lawmaker.

Cicilline warns, “Trump’s proposal to slash $193 billion – over 25 percent of total funding – over a decade to the Supplemental Nutrition Assistance Program (SNAP) would undermine the health and well-being of more than 16,300 Rhode Island seniors who receive assistance for their basic food and nutrition needs every month.”

“This budget would eliminate the Low Income Home Energy Assistance Program (LIHEAP), which helps low-income people, including thousands of seniors, pay their heating and cooling bills. It also eliminates the Social Services Block Grant and State Health Insurance Program, both of which provide critical federal support to help states meet the individualized needs of their seniors,” adds Cicilline.

“Plain and simple, this is a budget written by the wealthiest Americans for the benefit of the wealthiest Americans. But it’s a setback for the middle class and millions of seniors who have worked hard and played by the rules for their entire lives. Along with my colleagues in the House Democratic Leadership, I will do everything I can to reverse these devastating cuts and shape a budget that invests in the future of our country and puts honest, hardworking families first,” says Cicilline.

AARP, NCPSSM and aging advocates, now turn their attention to the House and Senate to keep Trump’s draconian budgetary vision out of the final FY 2018 budget. But, voters must also oppose huge cuts in Medicare, Medicaid and Social Security entitlement programs and discretionary funding for programs for older Americans at town meetings held by their Congressman and Senators.

Midterm elections will take place on Tuesday, November 6, 2018, All 435 seats in the House and 34 of the 100 senate will be up for grabs. Maybe GOP lawmakers will craft a budget proposal that will benefit their constituents, not support their political party’s policy positions.

Published in the Woonsocket Call on May 28, 2017

Weeks ago, the Trump Administration and GOP House leadership mended fences with GOP moderates and conservatives to hammer out a new version of the introduced legislation, the American Health Care Act (AHCA) of 2017 and replace the Affordable Care Act, called Obamacare Care. The GOP health care proposal with its last-minute changes passed on May 4 by a razor-thin vote of 217-213, a slim margin of four votes. All 193 Democrats opposed passage, along with 20 Republican lawmakers.

With passage, AHCA moved to the Senate for deliberation. Senators considered the House passed health care bill “Dead on Arrival.” But, Senate Majority Leader Mitch McConnell (R-Ky.) quickly appointed 13 Republican Senators to hammer out their chamber’s health care bill. Political observers doubt whether McConnell has enough votes to pass legislation this year.

Democratic lawmakers and critics of the House’s passed AHCA legislative proposal expressed outrage that House Speaker Paul Ryan (R-WI) called for a vote, not even waiting for the nonpartisan Congressional Budget Office (CBO) to provide an updated financial analysis of the new version of AHCA. The CBO’s cost analysis of the original bill, pulled moments before a scheduled vote on March 24, 2017, found that the GOP health care bill estimated that if passed 24 million or more Americans could be uninsured by 2026.

Now the long-awaited CBO new numbers are finally in for the House GOP passed health care bill.

According to the CBO analysis released on May 24, 2017, 23 million people will lose health insurance in the next decade under the House GOP’s recently passed health care proposal. The CBO analysis concludes that the AHCA benefits the young and healthy at the expense of older and sicker Americans. The report indicates that “near seniors” (aged 50-64) will be hit particularly hard by the GOP healthcare bill. Specifically, net insurance premium costs for low-income seniors would rise by 700 to 847 percent over the next 10 years under House-passed bill. A 64-year-old with an income of $26,500 per year who paid $1,700 annually for an Obamacare policy would now pay a whopping $13,600 under the Republican plan.

Aging Groups Rally Against Flawed GOP Fix to Nation’s Health Coverage

Aging advocates says that CBO’s analysis of the newer version of AHCA again brings to the forefront the flaws of the GOP’s health care coverage fix.

In a statement, AARP Executive Vice President Nancy LeaMond says the new CBO analysis serves as another example that the House legislation would make harmful changes to the nation’s current health care system. The bill would also hurt older Americans by decreasing the solvency of Medicare, hiking costs for those who can least afford them, eroding seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies, she said.

“AARP reiterates our strong opposition to the harmful bill passed by the House and calls on the Senate to take action by starting a bill from scratch. The CBO analysis found that premiums would go up to unaffordable levels by inflicting an Age Tax and removing current protections for people with common conditions including diabetes and weight gain. Putting a greater financial burden on older Americans is not the way to solve the problems in our health care system,” says LeaMond.

“The CBO report was no surprise to those of us who are looking out for the best interests of older Americans. The GOP leadership was so focused on passing repeal and replace legislation that they failed their due diligence by ignoring an ominous flaw: their bill will drive up seniors’ out-of-pocket costs by repealing subsidies that help defray the cost of premiums,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare in a statement.

The report also confirms that the House bill will only compound the problems faced by near seniors with pre-existing conditions. While an amendment by Rep. Fred Upton (R-MI) adds $8 billion over five years to fund high-risk pools for patients with pre-existing conditions, that will not be nearly enough to offset the extra costs to seniors, warns Richtman.

According to CBO, “People who are less healthy (including those with pre-existing or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all.”

Seniors who rely on Medicaid will suffer under the GOP’s passed health care bill, said Richtman, noting that the CBO report calculates that the AHCA slashes Medicaid spending by $834 billion. Medicaid currently helps pay for long term care for millions of seniors nationwide.

The CBO estimates that some 14 million Medicaid recipients would lose coverage under the AHCA – or not be able to attain it in the first place – within the next 10 years. In fact, more than half of the increase in uninsured Americans under the AHCA would come from this vulnerable population. In addition, changes to the ACA’s individual market reforms will increase the number of uninsured Americans age 50 to 64 from just over 10 percent under current law to nearly 30 percent, says Richtman.

Richtman charges that the GOP healthcare bill also weakens Medicare by repealing a tax on high wage earners, which would decrease the solvency of the Medicare Part A Trust Fund by three years. Accelerating the exhaustion of the Part A trust fund would likely lead to cuts in Medicare, including privatizing the program, that would be detrimental to current and future beneficiaries.

“The amended American Health Care Act is an assault on the health care of all seniors,” says Richtman. “We can only hope that the Senate will take the CBO’s new figures into consideration – and reverse the provisions that are so demonstrably harmful to our nation’s seniors.”

GOP Defends its Health Care Coverage Fix

As expected, with the release of CBO’s new numbers, the GOP moved quickly to dispute the federal agency’s findings. Republican National Committee Chairwoman Ronna McDaniel stated “The CBO has a history of being way off in their predictions, often giving a different forecast from actual reality.”

Even former House Speaker Newt Gingrich (R-GA) got into the verbal fray, blasting the new CBO analysis on FOX Business’ Lou Dobbs Tonight, calling for “the abolishment of the federal agency.” Gingrich called CBO “a dishonest bureaucratic organization,” suggesting that money might be saved by hiring “outside professional firms, get three to five major scores on bills.”

The Battle on Health Care Reform Moves to the Upper Chamber

On May 22, 2017, more than 75 national organizations recently sent a letter to Senate Majority Leader Mitch McConnell and Ranking Minority Leader Chuck Schumer, calling on the Senators to reject AHCA and to engage in “a transparent, bipartisan dialogue on needed reforms to enhance health care access and affordability.” The correspondence gave notice that these organizations strongly opposed provisions in the AHCA that undermined Medicare’s financing and risk access to essential care for Medicare and Medicaid recipients.

The correspondence cosigners noted that Obamacare imposed a small tax increase on the highest earners that helped” put Medicare on stronger financial footing. The GOP health care bill’s repeal of this tax would result in lost revenues, causing the Medicare Hospital Insurance (Part A) Trust Fund to become insolvent two years earlier than anticipated. The correspondence also expresses alarm that Congress would knowingly vote to undercut the Trust Fund.

The correspondence also charges that the GOP’s AHCA advances devastating Medicaid cuts—per-capita caps—that threaten access to needed care for the 11 million people with Medicare who also depend on Medicaid. One in five people with Medicare rely on Medicaid to cover vital long-term home care and nursing home services, to help afford their Medicare premiums and cost-sharing, and more.

“Federal cuts to Medicaid…would drive states to make hard choices, likely leading states to scale back benefits, impose waiting lists, implement unaffordable financial obligations, or otherwise restrict access to services,” says the correspondence.

Joe Baker, president of the Medicare Rights Center, said, “A Medicaid cut is a Medicare cut. One in five people with Medicare rely on Medicaid to access home and community-based services and nursing home care that they would otherwise go without. Medicaid is also the lifeline that helps millions of older adults and people with disabilities afford their Medicare premiums and cost-sharing. Per-capita caps are not a viable path forward to support our aging nation; the Senate must start from scratch.”

Adds, Kevin Prindiville, executive director of Justice in Aging. “The AHCA risks the health and financial security of millions of older adults in our families and communities. Slashing the program’s funding by over $800 billion eliminates Medicaid’s 50-year guarantee that older adults can count on Medicaid when they need it the most. We call on the Senate to protect seniors and Medicaid.”

“Simply put, this legislation is not a health care bill,” says Judith Stein, executive director of the Center for Medicare Advocacy. “A health care bill would strengthen coverage and delivery programs. AHCA gratuitously weakens Medicare, decimates Medicaid, and guts insurance for 24 million people. We urge the Senate to reject this charade and develop a real health care bill that improves coverage and enhances the Affordable Care Act.”