Tag Archives for Katie Smith Sloan

Trump’s Big Bill, Big Promises – But a Bust for Seniors

Pubished in Blackstone Valley Call & Times on July 8, 2025

After 48 relentless days of political maneuvering—marked by cajoling, backroom bargaining, strategic threats, and last-minute incentives to win over stubborn holdouts—President Donald Trump finally got his wish: Congress passed his prized “One Big Beautiful Bill” (H.R. 1), which he triumphantly signed into law on July 4, 2025.

On May 22, 2025, the House narrowly approved the sweeping 900-page bill by a vote of 215–214–1. Every House Democrat opposed the measure. Two Republicans, Reps. Thomas Massie (R-KY) and Warren Davidson (R-OH), joined the opposition, while Freedom Caucus Chair Andy Harris (R-MD) voted “present.” Two GOP lawmakers did not vote.

What’s In the Bill: Tax Breaks Up, Safety Nets Down

The legislation extends the 2017 individual tax cuts and adds new deductions for tips, overtime pay, auto loan interest, and “Trump Accounts” for children. It raises the SALT deduction cap to $40,000 for five years, increases the child tax credit, imposes a remittance levy, and taxes college endowment income.

On the spending side, H.R. 1 raises the debt ceiling by $5 trillion, slashes over $1 trillion from Medicaid and Medicare, expands work requirements for  Supplemental Nutrition Assistance Program (SNAP) recipients, and allocates $150 billion each to defense and border enforcement—boosting ICE funding to over $100 billion by 2029.

Senate Republicans spent more than five weeks reviewing the House bill’s provisions to comply with the Byrd Rule, walking a tightrope between deficit hawks and moderates. After a marathon “vote-a-rama” that saw 46 amendment votes (only six of which passed), the Senate approved the bill 51–50 on July 1, with Vice President J.D. Vance casting the tie-breaking vote.

The reconciliation process allowed the Senate to pass the bill with a simple majority rather than the standard 60-vote threshold. When the bill returned to the House Speaker Mike Johnson and President Trump personally lobbied holdouts, linking support to other legislative priorities and negotiating procedural rules. Early on July 3, the House adopted the Senate version in a 218–214 vote, with only Reps. Brian Fitzpatrick (R-PA) and Thomas Massie (R-KY) voting with Democrats. The bill was sent to the White House and signed into law the following day.

Despite Republican praise, public reaction to Trump’s “One Big Beautiful Bill” has been largely negative. A KFF Health Tracking Poll found that 64% of Americans view H.R. 1 unfavorably, compared to 35% in support.

President Trump and GOP leaders hailed the bill as a historic conservative win that fulfills “America First” promises—cutting taxes, slashing regulations, boosting border security, promoting energy independence, and reducing federal spending. “This is a major victory for hardworking families,” said Rhode Island GOP Chair Joe Powers in a statement, praising the bill for delivering middle-class tax relief and real border control.

But Congressman Gabe Amo (D-RI), representing Rhode Island’s 1st Congressional District, sees it differently and warns of the devastating consequences to aging programs and services.

“Trump’s big, ugly bill” shows that Republican lawmakers, following Trump’s marching orders, voted for “the largest theft in American history to further enrich the richest among us,” he says.

“Simply put, because of this horrific legislation, Americans will be poorer, sicker, hungrier, and further away from economic opportunity,” says the Rhode Island Congressman.

Deep Cuts and Dire Warnings from Aging Advocates

SACRI Policy Advisor Maureen Maigret emphasized the need for swift action in Rhode Island, stating, “It is crucial for the Secretary of the Executive Office of Health and Human Services to promptly convene the advisory group outlined in Section 8 of the state’s FY 2026 budget bill.”

“For years, SACRI has worked to ensure a balanced system of long-term services—supporting quality nursing home care, expanding access to affordable home and community-based services, and collaborating with the Office of Healthy Aging and other aging advocacy groups to promote healthy aging,” says Maigret.

SACRI, a statewide coalition advocating for older Rhode Islanders, has partnered with other organizations to make significant strides in these areas, according to Executive Director Carol Anne Costa. “We cannot allow this progress to be reversed, especially as older adults are the fastest-growing segment of the state’s population,” Costa says.

“We have sent a letter to Secretary Charest requesting that SACRI be included in the advisory group established by Article 8 of the state’s FY 2026 budget bill.”

Now accounting for nearly 20 percent of the total population, the number of Americans age 65 and older is steadily increasing.

“Make no mistake: this harmful, cold-hearted bill will wreak havoc on our country’s fragile aging services infrastructure—at a time when demand for the Medicare and Medicaid-supported services it delivers is growing,” warns Katie Smith Sloan, president and CEO of LeadingAge.

“This legislation deals a significant blow to a core element of our country’s social safety net: Medicaid,” adds Sloan, emphasizing that the consequences “will not be pretty.”

She further warns, “Due to the level of deficit this bill will create, Medicare payments to providers may be reduced by 4% for the next ten years.”

According to Sloan, the bandaids included in H.R. 1—such as freezing (but not reducing) nursing home provider taxes and creating a rural health transformation fund, both touted as protections for older adults and aging services providers—will soon prove ill-equipped to prevent the bill’s damage. As states begin to grapple with budget shortfalls caused by reduced federal Medicaid contributions, the suffering, she says, will begin.

Max Richtman, President & CEO of the National Committee to Preserve Social Security and Medicare, warned that 16 million Americans may lose health coverage, and millions more could lose access to food assistance. He stressed the bill’s devastating effects on the 7.2 million seniors dually enrolled in Medicare and Medicaid and the 6.5 million older adults who rely on SNAP benefits.

“These beneficiaries are some of the most vulnerable members of our society — and Republicans have put them at risk in order to pay for another tax cut mainly for the rich,” he says.

AARP: Safety Nets Shredded, Protections Undermined

Although AARP expressed strong opposition to many provisions in the reconciliation bill, the organization did support several key measures. These included increased investment in affordable housing through the Low-Income Housing Tax Credit, raising the additional senior standard deduction to $6,000, and expanding the Section 45S tax credit for paid family and medical leave.

Executive Vice President Nancy LeaMond criticized the bill’s cuts to Medicaid, ACA Marketplace coverage, and food assistance, calling them particularly harmful to older adults, rural residents, and family caregivers. She emphasized that over 17 million Americans aged 50 and older rely on Medicaid to remain in their homes and manage chronic health conditions.

“This is a moment to strengthen—not weaken—the supports that help people stay in their homes, access needed health care, and live with dignity and independence,” said LeaMond, representing nearly 38 million members nationwide.

She stressed that AARP remained strongly opposed to Senate provisions that would slash Medicaid, Marketplace coverage, and food assistance, making it harder for older adults to get by.

“More than 17 million Americans age 50 and older rely on Medicaid as a critical safety net to stay in their homes, manage chronic conditions, and afford long-term care,” says LeaMond. “By limiting how states fund their Medicaid programs, the new law threatens health care access—particularly for people in rural and underserved areas and through safety-net providers,” she adds.

LeaMond also expressed concern over delayed implementation of nursing home staffing standards, which are estimated to save 13,000 lives annually, and provisions allowing drug companies to continue charging high prices for certain orphan drugs—even while selling the same medicines overseas at far lower costs.

AARP opposes H.R. 1’s new burdens that could cost people their health care or food assistance when they are unable to work due to age discrimination, caregiving responsibilities, or chronic illness. “This will only make it harder for many older adults to access needed health care and to put food on the table,” she says.

She also warns that the new SNAP cost-sharing formula could shift billions in expenses to state budgets, forcing states to restrict eligibility, reduce benefits, or withdraw from the program entirely.

Finally, AARP strongly opposed the bill’s 10-year moratorium on state and local regulation of artificial intelligence (AI), arguing that it undermines consumer protections in employment, housing, and health care—leaving older adults more vulnerable to harm from biased or untested AI systems.

For additional information on H.R. 1’s impact on senior programs and service, visit: aarp.org/advocacy/fight-senate-cuts-medicaid-snap
aarp.org/advocacy/support-budget-bill-tax-proposals

HHS Shake-Up Sends Shockwaves Through Aging Network

Published on April 31, 2025

Taking a page from President Donald J. Trump’s to “Make America Great Again,” last week the U.S. Department of Health and Human Services (HHS) announced a major restructuring of the federal agency to “Make America Healthy Again.” The dramatic restructuring in accordance with Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”

The U.S. Department of Health and Human Services (HHS), under management of HHS Secretary Robert F. Kennedy, Jr., last week announced a major restructuring and renaming of the federal agency under the initiative “Make America Healthy Again.” This dramatic reorganization follows Trump’s Executive Order, Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” said HHS Secretary Robert F. Kennedy, Jr. in a statement announcing the massive overhaul. “This Department will do more—much more—at a lower cost to taxpayers.”

“Over time, bureaucracies like HHS become wasteful and inefficient, even when most of their staff are dedicated and competent civil servants,” Kennedy added. “This overhaul will be a win-win for taxpayers and those HHS serves. That’s the entire American public, because our goal is to Make America Healthy Again.”

During the Biden administration, HHS’s budget increased by 38%, and its staffing grew by 17%, prompting the new HHS chief to place the federal agency on the budgetary chopping block.

According to HHS, this restructuring will not impact critical services while saving taxpayers $1.8 billion per year through a reduction of approximately 10,000 full-time employees. When combined with other cost-cutting initiatives, including early retirement, and the Fork in the Road program, the total downsizing will reduce HHS’s workforce from 82,000 to 62,000 employees.

HHS also plans to streamline departmental functions. Currently, the agency’s 28 divisions contain redundant units. Under the restructuring plan announced on March 27, 2025, these units will be consolidated into 15 new divisions, including a newly created Administration for a Healthy America (AHA). Additionally, core organizational functions—such as Human Resources, Information Technology, Procurement, External Affairs, and Policy—will be centralized. The number of regional offices will be cut from 10 to five.

As part of the restructuring, several agencies will see workforce reductions. The U.S. Food and Drug Administration (FDA) will cut approximately 3,500 full-time employees, focusing on streamlining operations and centralizing administrative functions, though HHS asserts these reductions will not affect drug, medical device, or food reviewers, nor inspectors.

Similarly, the U.S. Centers for Disease Control and Prevention (CDC) will downsize by approximately 2,400 employees, refocusing its efforts on epidemic and outbreak response. The National Institutes of Health (NIH) will eliminate 1,200 positions by centralizing procurement, human resources, and communications across its 27 institutes and centers. Meanwhile, the Centers for Medicare and Medicaid Services (CMS) will cut around 300 positions, targeting minor duplication within the agency. HHS insists these changes will not impact Medicare or Medicaid services, but improve them.

Restructuring HHS to Focus on Chronic Illness Prevention

HHS’s overhaul aligns with the agency’s new priority of ending America’s chronic illness epidemic by focusing resources on ensuring safe, wholesome food, clean water, and the elimination of environmental toxins.

The Administration for a Healthy America (AHA) will consolidate five agencies—the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health—into a single entity. This unification aims to enhance health resource coordination for low-income Americans, emphasizing primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development.

Additionally, the Administration for Strategic Preparedness and Response, responsible for national disaster and public health emergency response, will be transferred to the CDC to strengthen its core mission of protecting Americans from health threats.

To combat waste, fraud, and abuse, HHS will create a new Assistant Secretary for Enforcement, overseeing the Departmental Appeals Board, the Office of Medicare Hearings and Appeals, and the Office for Civil Rights.

Furthermore, HHS will merge the Assistant Secretary for Planning and Evaluation with the Agency for Healthcare Research and Quality to form the Office of Strategy, enhancing research to inform policy decisions.
Critical programs under the Administration for Community Living (ACL), which supports older adults and people with disabilities, will be integrated into other HHS agencies, including the Administration for Children and Families, the Office of the Assistant Secretary for Planning and Evaluation, and the Centers for Medicare and Medicaid Services (CMS). HHS assures that these changes will not impact Medicare or Medicaid services.

Sounding the Alarm

Following the announcement of HHS’s restructuring plans, which would broad without a lot of detail, aging advocacy groups quickly released statements to voice strong concerns.

“For decades, the federal health programs that retirees and people with disabilities depend on have been ably administered under both Democratic and Republican administrations. However, the radical cutbacks proposed by the Trump administration place the delivery of these programs in jeopardy,” warned Dan Adcock, Director of Government Relations & Policy at the National Committee to Preserve Social Security and Medicare (NCPSSM).

Adcock also noted that HHS plans to eliminate the ALC and divide its responsibilities between two offices with no prior experience in this area. “This administration has already demonstrated a reckless disregard for public interests in favor of slashing operations and staff under the guise of ‘efficiency,’” he added. “So far, all they have done is create chaos and confusion, disrupting essential programs for seniors and the disabled. We view Secretary Kennedy’s plans with alarm.”

Nancy LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer at AARP, also urged HHS to prioritize older Americans’ health needs. “HHS must ensure access to senior centers, community health centers, nutritious meals, Medicare assistance, and other vital services that countless older Americans rely on. Health is central to the lives, well-being, and financial security of AARP’s members and the more than 100 million Americans over age 50,” she emphasized.

Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, echoed these concerns. “The announcement of workforce cuts at HHS comes at a time of unprecedented growth in America’s aging population. The proposed reorganization of ACL and its integration into other agencies requires careful consideration.”

Fulmer stressed that ACL administers programs essential to older adults’ daily lives, such as meal delivery, transportation to medical appointments, and chronic disease management. Absorbing these functions with far fewer staff demands careful planning. The government’s commitment to older adults requires a cautious approach, she said.

The Center for Medicare Advocacy also expressed deep concerns, particularly regarding plans to restructure ACL and consolidate oversight of Medicare appeals. “Given what we have seen with Social Security Administration cuts and restructuring, HHS’s claim that these changes won’t impact critical services rings hollow,” said Co-Director David Lipschutz.

LeadingAge, a national association representing nonprofit aging services providers, called for HHS to ensure older adults and their caregivers are not overlooked. “Cutting staff responsible for critical agency functions raises serious concerns. How will the work our members rely on get done? How will this impact quality care for older adults?” asked President and CEO Katie Smith Sloan.

Sloan also cautioned that reducing HHS’s field offices from 10 to five could impact CMS’s ability to oversee nursing home surveys and provider compliance. “A 25% workforce reduction must be undertaken with extreme care—especially given the millions of older adults who depend on these services,” she emphasized.

For a fact sheet on the HHS restructuring, visit https://www.hhs.gov/about/news/hhs-restructuring-doge-fact-sheet.html

Older Americans Month: great time to bring back House Aging Committee

Published in RINewsToday on May 9, 2022

On April 29, President Joe Biden proclaimed the month of May, Older Americans Month for 2022 to honor the nation’s 54.1 million Americans aged 65 and over “who contribute their time and wisdom to make our communities stronger, more informed, and better connected.”

“Older adults have always been a vital source of strength and resilience in America,” stated Biden in the proclamation.  During the pandemic, many seniors came out of retirement to serve their communities in health care and education roles, filling job vacancies in critical shortage areas. Moving forward, we must ensure that older Americans have the appropriate resources to maintain their independence and stay connected to their communities,” he said.

The proclamation also noted that the nation is celebrating the 50th anniversary of the Older Americans Act Nutrition Program — the first federal program to support the well-being of older Americans through meal deliveries, nutrition services, educational programs, and counseling. This year is also the 10th anniversary of the nation’s National Plan to Address Alzheimer’s Disease and recommit to building upon this important work being done.

Biden recognizing this month in honor of seniors follows the footsteps of 11 presidents, beginning with President John F. Kennedy in 1963, when only 17 million Americans had reached their 65thbirthday. At that time,  about a third of America’s seniors lived in poverty and there were only a few federal programs to meet their needs. A meeting in April 1963 between Kennedy and the National Council of Senior Citizens led to designating May as “Senior Citizens Month,” later renamed “Older Americans Month.”

Over the years, OAM is a time the nation acknowledges the contributions of past and current older persons to our country, in particular those who defended our country. Communities across the nation pay tribute at ceremonies, events, and fairs, or in other ways to older persons in their communities.  

OAM – a great time to bring back the House Aging Committee

As the nation celebrates OAM, an eblast to over 90,000 seniors by the National Committee to Preserve Social Security and Medicare (NCPSSM) urged these older voters to call their congressmen to request them to cosponsor Rhode Island Congressman David Cicilline’s H. Res. 583, to reestablish the House Select Committee on Aging (HSCoA). “It couldn’t be a better time to highlight the urgent need to reinstate this investigative committee which would help restore Congressional focus on key policy issues [Social Security, Medicare, housing, prescription drugs, and long-term care] impacting the nation’s seniors says the Benefits Watch newsletter.   

“Today, with seniors representing a growing portion of the U.S. population and several federal programs that seniors rely on at an inflection point, there is an increasing need for a House committee that advocates for older Americans,” says NCPSM’s email, noting that’s why the Washington, DC-based advocacy group has signed onto the Leadership Council on Aging Organization’s (LCAO) letter calling on the House to pass H. Res. 583. 

“While there are other committees with jurisdiction over seniors’ programs, there is no single committee dedicated to keeping an eye on the big picture for seniors.  Fortunately, the Senate Special Committee on Aging has continued to operate in the absence of a House counterpart,” notes NCPSSM’s email, noting that “seniors would benefit from a reinstated and robust HSCoA, whose sole mission would be to look out for older American’s needs.

National Aging Groups, former Pepper staffer weighs in

“Older Americans month would be the perfect time to bring back the Aging Committee,” says Bob Weiner, former Chief of Staff under chairman Claude Pepper of the House Select Committee on Aging. “It’s sorely missing now. With Pepper’s legacy as the guide, pandemic deaths, nursing homes, home health care, Social Security, and Medicare would be improved by the sunlight of oversight. Seniors are now vulnerable and threatened by what could happen and having the Aging Committee back would reinstate the wall of protection that Pepper gave them,” he says. 

“The LCAO supports the establishment of HSCoA to provide an important forum for discussion, debate and exploration of issues impacting an aging society,” says Katie Smith Sloan, chair of the Leadership Council of Aging Organizations (LCAO), a coalition of 69 Washington, DC-based aging organizations. “Addressing the needs of older adults and families, which are increasingly prevalent with our population shifts, now, as we celebrate Older Americans Month, is appropriate – and urgent,” says Sloan. LCAO sent a letter to members of Congress on March 4, 2022, urging them to cosponsor H. Res. 583. 

“Passing H Res 583 in May to coincide with it being Older Americans month would make eminent policy and political sense.  It is an investment in having a stronger and dedicated advocacy voice for older adults in the House which has been missing for almost 20 years,” says Robert B. Blancato, National Coordinator of the Elder Justice Coalition, who was the longest serving staff person on the original House Aging Committee, from 1977 to 1993.

“As our country’s older adult population continues to grow each day, so does the urgency with which we need to pursue effective solutions to myriad aging issues,” says Erika Kelly, Chief Membership and Advocacy Officer of Meals on Wheels America. “To see the House pass this resolution to reestablish the HSCoA during Older Americans Month would be a tremendous step forward,” she says.

“Older Americans Act programs, like Meals on Wheels, will undoubtedly face the lingering impact of the pandemic and other challenges for years to come. Having this HSCoA come [back] to life again, especially during this celebratory month, would provide critical leadership and attention when it’s needed most and make a difference in the lives of tens of millions of older adults,” says Kelly.

Finally, Cicilline, H. Res. 583’s sponsor and the NCPSSM tells us why it is important for House Speaker Nancy Pelosi and her Democratic leadership colleagues to support and bring H. Res. 583 to the House Rules Committee for a vote during Older Americans Month.

“With Older Americans Month upon us, this is an important moment to underscore how the pandemic has disproportionately impacted seniors. Now, with growing concerns about inflation, seniors on fixed incomes will bear the burden of the rising cost of prescription drugs, food, housing, and other essentials. A House Permanent Select Committee on Aging would help Congress focus on, study, and address the issues that affect seniors to make sure they can live the rest of their lives with dignity and security,” says Cicilline.

“When there was a HSCoA before it was abolished in 1995, the investigative House committee held hearings on aspects of the Older Americans Act leading up to the 1992 reauthorization of the law,” noted NCPSSM’s Dan Adcock, Director of Government Relations and Policy. “The findings of these hearings were helpful to the House Committee on Education and Labor which had legislative jurisdiction over the Older Americans Act.  The Subcommittee on Human Resources [now called the Civil Rights and Human Services Subcommittee] under the full Education and Labor Committee held several of its own hearings on the OAA, too – including field hearings held across the country — leading to the enactment of the 1992 reauthorization., he said. 

According to Adcock, during that period of time, there was significant communication between the House Aging Committee staff and the Ed and Labor Committee and Human Resources Subcommittee staff.  But the legislative language was written and marked up by the latter. “A reestablished HSCoA could play a similar role in the future, but the panel’s ability to have an impact on legislation drafted by the authorizing committees would depend on the cooperation between the respective committee chairs and staff and the degree of relevancy of the hearings held by a reconstituted House Aging Committee,” he says. 

Over 400 senior groups support H. Res. 583

While LCAO is a pretty diverse group of national aging organizations – each with their own policy priorities, the coalition of 69 members, representing over 100 million over 50, and 50 million over 65 came together to endorse and affirm their support of Cicilline’s resolution.  

Ms. Nancy Altman, President of Social Security Works and Chair of the Strengthen Social Security Coalition, strongly supports the passage of H. Res. 583 and that her coalition of 350 national and state organizations representing 50 million Americans endorses Rep. Cicilline’s resolution.  

As we celebrate OAM, it is key to House Speaker Nancy Pelosi, Majority Leader Steny Hoyer (D-MD) and Whip James Clyburn (D-SC) to join Cicilline along with Congresswomen Jan Schakowsky (D-IL) and Doris Matsui (D-CA), cochairs of the Task Force on Aging and Family and 43 cosponsors of H. Res 583, giving the green light to the House Rules committee to vote, and if approved send it quickly to the floor.

H. Res. 583 does not require Senate consideration and only requires a House Rules and floor vote for passage.  Passing the reestablishment of an investigative committee in the House would send a powerful message to older Americans that Congress following in Pepper’s footsteps will again get serious in addressing aging issues. 

As mentioned in previous commentaries, bringing back the HSCoA is a winning federal policy to positive impact America’s seniors and this group.  It’s the  right thing to do especially at a time when seniors have been a disproportionately impacted by the continuing COVID-19 pandemic.    

Over 450 national and state aging organizations representing conservatively over 150 million seniors, support the enactment of H. Res. 583. That’s a great reason for the lower chamber to strongly support.

To see the LCAO’s letter sent to Congress on March 4, 2022, endorsing H. Res. 583, go to https://www.lcao.org/wp-content/uploads/2022/03/House-Aging-Committee-LCAO-Letter-3-4-22.pdf.

For a historical background of the HSCoA and details about H. Res. 583, go to https://rinewstoday.com/congressman-cicilline-poised-for-legacy-as-next-fiery-advocatsie-on-aging/.

For details about Congressman Claude Pepper (D-FL) Congressman, during his six-year serving as chair of the HSCoA, go to https://rinewstoday.com/congressman-cicilline-poised-for-legacy-as-next-fiery-advocate-on-aging/.