Tag Archives for Nancy LeaMond

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

It’s now time for Congress to give tax credits to America’s caregivers

Published in RINewsToday on February 24, 2025

Just a few days after the 119th Congress was sworn in on Friday, January 3rd, AARP, along with 94 organizations, sent a letter to Congress urging lawmakers to enact legislation to provide financial relief for America’s caregivers. This could be accomplished by including the bipartisan bicameral Credit for Caring Act of 2024 (S. 3702/H.R. 7165 introduced in the 118th Congress) in any tax legislation that is advanced during the new Congress, says the joint letter.    

S. 3702/H.R. 7165, introduced during the last session of Congress by Sen. Michael Bennett (D-Colorado) and House lawmakers Mike Carey (D-Ohio), would allow an eligible caregiver a tax credit of up to $5,000 for 30% of the cost of long-term care expenses that exceed $2,000 in a taxable year. The bills defined eligible caregiver as an individual who has earned income for the taxable year in excess of $7,500 and pays or incurs expenses for providing care to a spouse or other dependent relative with long-term care needs. 

The joint letter, dated Jan. 7, 2025, stressed that family caregivers make it possible for older adults, people with disabilities, and veterans, to live independently in their community and age in place at home.  It also cited an AARP study that found caregivers provided $600 billion annually in unpaid labor in 2021 to care for their loved ones. (This figure is based on about 38 million caregivers providing an average of 18 hours of care per week for a total of 36 billion hours of care, at an average value of $16.59 per hour). 

Caregivers take a hefty financial hit, too, having to cover out-of-pocket expenses associated with caregiving and losing income by cutting back on work hours or leaving the workforce entirely. When this occurs these individuals would see reduced Social Security and retirement savings by receiving reduced Social Security and other retirement benefits, noted the organizations in the correspondence. 

The joint letter also mentioned an AARP study that reported family caregivers spend on average, 26 percent of their income on caregiving expenses or over $7,200 annually. The uncompensated care saves taxes payers billions of dollars by delaying or even preventing admission to costly nursing home care and unnecessary hospital stays.  

The joint letter suggested that any tax legislation consider include a new, non-refundable tax credit of up to $ 5,000 for eligible working family caregivers would reduce the significant financial impact of caregiving.  Eligible caregivers caring for loved ones of all ages could receive the credit if the care recipient meets certain functional or cognitive limitations or other requires.  This tax credit would help working family caregivers regardless of whether they live with their loved one or if their loved one is a dependent. 

Overwhelmingly support for tax relief for caregivers 

A newly released AARP poll findings indicate that voters in competitive congressional districts want Congress to give financial relief to America’s family caregivers. The poll, conducted in late Jan. 2025, highlights a “clear, bipartisan mandate” say prominent pollsters from Fabrizio Ward and Impact Research. 

The bipartisan polling team conducted this survey of 3,000 registered voters nationally and 1,000 voters in the 28 most competitive House districts between January 27 and February 1, 2025. According to AARP, the districts chosen were the 15 Republican-held districts won by <5% of the vote in 2024, and the 13 Democratic-held districts that were also won by President Trump in 2024. The margin of sampling error for the national survey is ±1.8% and ±3.1% for the congressional districts survey.

The AARP poll findings reveal overwhelming voter support (84%) for Congress and the Trump Administration to act this Congress on a caregiver tax credit. Among various tax proposals currently being considered by Congress — including eliminating income taxes on Social Security, tips, and overtime pay—voters ranked passing a caregiver tax credit as their top priority. 

“America’s family caregivers put family first, helping their parents, spouses and others stay at home. They spend thousands of dollars every year on this care, while juggling work and family responsibilities,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer in a statement released on Feb. 11, 2025 announcing the results of AARP’s poll. “Without them, millions of older Americans would be forced into costly nursing homes—many at taxpayer expense. As Congress debates tax policy, the message from voters is clear: lawmakers must prioritize financial relief for hardworking Americans who are caring for their aging family members. AARP urges Congress to put money back into the pockets of hardworking family caregivers by passing a tax credit,” she says.  

Bipartisan

The poll findings indicate that support for the caregiving tax credit spans party lines, with strong majorities of Republicans (84%), Independents (82%), and Democrats (87%) in favor.  And support for a caregiver tax credit (84%) outpaces support for continuing the 2017 tax cuts (51%).  

Seventy-six-percent of voters agree that “Before Congress extends any tax breaks for the wealthy and corporations, it should support working Americans with a tax credit to help cover the expenses of taking care of a loved one.”  

Family caregiving crosses party lines, with nearly two-thirds of voters (63%) serving as family caregivers at some point in their lives—many of whom struggle financially. 

Most voters (63%) say they are worried about their personal financial situation.  Family caregivers nationwide, many of whom face financial struggles, spend an average of $7,200 in out-of-pocket expenses each year—making it harder to afford essentials like groceries and bills.

“Voters over the age of 50 are a critical voting bloc that all candidates should compete for every election cycle,” adds Tony Fabrizio, partner at Fabrizio Ward. “Our poll found that Americans of all political stripes want leaders to support family caregivers. Candidates looking ahead to the 2026 midterms should pay attention to this issue if they want to win,” he said.

Could tax credits for caregivers become a reality?

Maybe.  During the 118th Congress, Republican and Democratic lawmakers came together to cosponsor legislation that called for federal tax credits for caregivers. S. 3702, with 11 Democrats, 3 Republicans and 3 Independents, was referred to the Senate Finance Committee.  Its companion measure in the lower chamber, H. R. 7165, with 81 cosponsors (72 Democrats and 9 Republicans), was referred to House Ways and Means Committee.  Both bipartisan bills never made it to mark up or even to the House floor for vote. 

Tax Notes reporter Alexander Rifaat, who covers the White House and Treasury, reported in a web article posted on Oct. 29, 2024 that Presidential Republican candidate Donald Trump supported tax relief for caregivers. Rifaat noted that during his 2024 presidential election, at a campaign event held at New York’s Madison Square Garden on Oct. 27, Trump called for a national tax credit for caregivers who are “never spoken of” and stay at home. 

At the campaign event,  Rifaat noted that Trump told the crowd:  “I will support a tax credit for family caregivers who take care of a parent or a loved one. And it’s about time they were recognized, right?” 

Now, as President Trump has an opportunity to keep this campaign promise by calling on the Republican-controlled Congress to work with Democratic lawmakers to give America’s caregivers financial relief, through the passage of a national tax credit legislation that will benefit them.  It’s time to work together and put caregivers before partisan politics.

For a copy of the National Legislative Priorities Survey, Feb. 2025, go to www.aarp.org/content/dam/aarp/research/topics/voter-opinion-research/politics/federal-tax-package-legislative-priorities.doi.10.26419-2fres.00921.001.pdf.

For a listing of organizations urging Congress in Jan. 7, 2025 correspondence to provide financial tax relief to caregivers, go to www.nase.org/sf-docs/default-source/advocacy-documents/financial-relief-for-family-caregivers-credit-for-caring-act-sign-on-letter-january-2025-(1).pdf?sfvrsn=e6b0e0f0_1

www.bls.gov/blog/2023/celebrating-national-family-caregivers-month-with-bls-data.html

To read AARP’s Research Insights into Caregiving, go to www.aarp.org/pri/topics/ltss/family-caregiving/aarp-research-insights-caregiving/.