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

House Finance Committee’s FY 26 Budget boosts support for older Rhode Islanders

Published in RiNewsToday on June 16, 2025

Last Wednesday evening, the House Finance Committee voted 11–3 to approve a balanced $14.33 billion budget for fiscal year 2026—approximately $500 million less than the current year’s budget.

Lawmakers were tasked with closing a $250 million deficit without resorting to broad tax hikes or cuts to essential services. Faced with a slowing state economy and looming federal funding reductions, they focused squarely on bridging the budget gap while improving access to health care, increasing reimbursement rates for primary care providers, nursing homes, and hospitals, and addressing the state’s housing crisis.

The budget proposal also boosts funding for housing and homelessness services, supports municipalities through increased revenue sharing, expands Rhode Island Public Transit Authority (a.k.a. RIPTA) funding, invests in education, imposes new EV registration fees, restores highway tolls, and extends childcare subsidies while setting distinct rates for toddlers and infants.

“Despite the very significant challenges we face in this fiscal year, this budget reflects our commitment to our priorities: not only protecting, but strengthening the vital Medicaid programs that provide health and safety to Rhode Island’s seniors, children, individuals with disabilities, and working families; supporting our health care system, particularly the hard-working primary care providers and frontline caregivers; and addressing our housing crisis,” said House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick), in a statement announcing the budget’s passage by the House Finance Committee.

Vote Set

According to House Communications Director Larry Berman, the 435-page budget proposal (2025-H 5076A) now moves to the full House for a vote scheduled for Tuesday, June 17, at 3:30 p.m. If passed, the budget will be sent to the Senate, where action is expected by the end of next week as the legislative session concludes.

If the Senate makes no changes, the bill will go directly to Governor Dan McKee for his signature. However, if revisions are made, it must return to the House for final approval before being sent to the Governor.

Berman and his Senate counterpart, Greg Paré, Director of Senate Communications, do not anticipate any major issues—but note that nothing is ever guaranteed.

Funding Aging Programs and Services

The Senior Agenda Coalition of Rhode Island (SACRI) and its allied aging advocacy groups didn’t get everything they lobbied for —but they made progress, according to SACRI Executive Director Carol Anne Costa, who praised the proposal as a “moral budget.”

“This budget represents a moral compass pointing toward a healthier, more equitable Rhode Island,” said Costa, crediting the group’s advocacy efforts, particularly those of SACRI Policy Advisor Maureen Maigret.

Costa highlighted new language in Article 8 that expands the Medicare Savings Programs, enhancing healthcare access for vulnerable older adults and individuals with disabilities. The House Finance Committee recommended adding $7.1 million—$700,000 of that from general revenues—for this critical expansion.

Unlike a narrower 2024 Assembly proposal that faced implementation barriers, the FY 2026 budget expands eligibility to 125% of the federal poverty level for the Qualified Medicare Beneficiary (QMB) group and up to 168% for the Qualified Individuals (QI) group.

“This crucial change is estimated to assist thousands of Medicare enrollees, helping them cover burdensome co-payments and deductibles, and potentially saving them at least the $185 monthly Part B premium—which can now go toward food and other essentials. For many, this means the difference between delaying care and receiving timely treatment,” Costa noted.

Strengthening Primary Care Access

“The state’s primary care system is at a crisis point. We’ve heard that our reimbursement rates are low, and that’s the main cause of the health care shortage. We wanted to address that immediately,” said Speaker Shekarchi.

SACRI applauded the Speaker’s efforts to address both the shortage of primary care physicians and the funding shortfall for direct-care staff in nursing homes. “This budget recognizes the critical importance of primary care—especially for older adults and those managing chronic conditions—and addresses provider rate increases through several key initiatives,” said Costa.

The proposal includes over $40 million—$15 million from the state and the rest from federal funds—to increase Medicaid reimbursement rates for primary care providers, currently lower than in neighboring states.

Additionally, the budget proposes a new healthcare assessment similar to the state’s immunization program assessments. This broad-based assessment, applied per member per month to all covered lives (including self-insured plans), is expected to raise $30 million annually to support primary care and related services. The estimated state cost is $1.4 million, including $800,000 in general revenues.

The committee also recommended $26.4 million ($8.3 million in general revenue) to raise Medicaid primary care rates to 100% of Medicare rates beginning Oct. 1, 2025. This significant increase aims to incentivize providers to serve more Medicaid patients and improve access to foundational care.

Furthermore, the Office of the Health Insurance Commissioner (OHIC) must submit a one-time report by September 2026 to recommend further adjustments to primary care reimbursement rates.

“To address fiscal challenges facing our community health centers, the budget also includes $10.5 million—$4 million of that from general revenues,” Costa added.

Attacking Persistent Staffing Issues in Rhode Island’s Nursing Homes

SACRI, the Rhode Island Health Care Association (RIHCA), SEIU 1199NE, and the state’s Long-Term Care Ombudsman praised the House Finance Committee’s decision to allocate funds aimed at addressing persistent staffing issues in Rhode Island’s 73 nursing homes. The committee approved a $12 million funding package—including $5 million from general revenues—for a base rate staffing adjustment to improve compensation, wages, benefits, and employer costs for direct-care staff. These investments are designed to enhance the quality of resident care and improve workforce stability.

According to John E. Gage, President and CEO of RIHCA, following months of negotiations, RIHCA and SEIU 1199NE reached a compromise to amend the 2021 nursing home staffing law. The revised agreement establishes a more achievable staffing target of 3.58 hours of care per resident per day and adjusts penalties to support facilities in reaching consistent compliance. It also introduces flexibility for high-performing facilities and those with site-specific challenges. “The state budget passed by the House Finance Committee invests $5 million, which unlocks an additional $7 million in federal matching funds,” noted Gage.

“On behalf of RIHCA and its members, we are pleased that the Speaker and House Finance Committee members recognized the dire conditions facing the industry,” Gage added. “We are encouraged that their actions will help stabilize Rhode Island’s nursing facilities and ensure access to high-quality care and services.”

Rhode Island currently ranks second in the nation for “Immediate Jeopardy” violations—the most serious federal nursing home deficiencies. Both SEIU 1199NE and RIHCA believe the budget provisions will help reverse this alarming trend.

SEIU 1199NE’s Patrick Quinn and SACRI’s Costa praised the inclusion of the $12 million investment in the FY 2026 budget, viewing it as a crucial step in helping nursing homes recruit and retain essential staff.

Lori Light, Rhode Island’s State Long-Term Care Ombudsman, also commended House lawmakers for allocating new funding to improve pay and staffing levels—critical measures for enhancing care quality and creating safer, more stable environments for vulnerable residents. “These are issues our office has consistently advocated for, and we’re encouraged to see real movement in the right direction,” she said.

Finally, the budget proposal also includes an increase of $1.86 million for the Office of Healthy Aging, raising its funding from $37,091,920 to $38,948,518. This includes:

  • A $200,000 boost for Senior Services Support (from $1.4 million to $1.6 million)
  • A $50,000 increase for Meals on Wheels (from $630,000 to $680,000)
  • $325,000 to provide elder services, including respite care, through the Diocese of Providence
  • $40,000 to fund ombudsman services provided by the Alliance for Long Term Care

The Missing Millionaire’s Tax

SACRI and progressive advocacy groups had hoped the budget would include HB 5473, introduced by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls) on Feb. 12, 2025 and S329 introduced on by Sen. Melissa Murray (D-Dist. 24, Woonsocket, North Smithfield, on February 21, 2025. The bill proposed a 3% surtax on taxable income above $625,000—on top of the existing 5.99% rate—targeting the top 1% of Rhode Island filers. The tax was projected to raise roughly $190 million annually and impact only 5,700 of the state’s 500,000 taxpayers.

But the surtax didn’t make it into the final budget.

Asked why, Speaker Shekarchi explained: “There is still a great deal of uncertainty at the federal level. We don’t know what changes are going to be made in the federal tax code. We felt comfortable enough to move forward with the non-owner-occupied property tax on homes valued at over $1 million, and we will revisit the millionaire’s tax when we have more clarity from Washington.”

While Costa wished the surtax had been included to fund additional initiatives, she said, “The bottom line is the budget is balanced and people-focused. In particular, older adult concerns were seriously considered.” As the session winds down, SACRI will continue to monitor remaining legislative proposals that affect Rhode Island’s older residents.

Senior Agenda Coalition of RI pushes wealth tax to fund programs for older residents

Published in RINewsToday on June 2, 2025

With the recent passage of the House Republican budget—which cuts some programs and services for seniors, veterans, people with disabilities, and families with children—Sulma Arias, Executive Director of Chicago-based People’s Action (PA), is calling on billionaires and large corporations to finally pay their fair share of taxes.

Senator Bernie Sanders has echoed similar sentiments on the national stage, urging lawmakers to ensure that ultra-wealthy individuals and powerful corporations contribute more equitably to the nation’s economic well-being, rather than shifting the burden to everyday Americans by cutting essential services.

In Rhode Island, Democratic lawmakers are advancing legislation this session that would increase taxes on the state’s highest earners to generate vital revenue for public programs and services.

Proposed Legislation Targets Top Earners

HB 5473, introduced on February 12, 2025, by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls), was referred to the House Finance Committee. The bill proposes a 3% surtax on taxable income above $625,000—on top of the existing 5.99% rate—targeting the top 1% of Rhode Island tax filers. The surtax is projected to raise approximately $190 million annually and would affect about 5,700 of the state’s more than 500,000 filers. If enacted, the tax would apply to income earned in tax years beginning in 2026 and would not be retroactive.

As of the May 6 House Finance Committee hearing, about 140 pieces of written testimony had been submitted on HB 5473. The committee held the bill for further study, with no additional action yet taken. The proposal remains under consideration as part of ongoing budget negotiations.

A companion bill, S. 329, was introduced in the Senate by Sen. Melissa Murray (D-Dist. 24, Woonsocket, North Smithfield) and referred to the Senate Finance Committee. A hearing on the measure was held last Thursday, and the bill was also held for further study.

As the volume of testimony indicates, the battle lines are clearly drawn. Progressive groups and unions support the legislation, while businesses and business organizations, such as the Greater Providence Chamber of Commerce and the Northern Rhode Island Chamber of Commerce, have voiced strong opposition. Governor Dan McKee has not yet taken a public position on the bills.

The Pros and Cons

Supporters argue that with Rhode Island facing a $220 million budget deficit, HB 5473 and S. 329 could raise nearly $190 million annually to fund critical services, including: K-12 and higher education; health care; housing; public transportation; affordable child care; infrastructure, and programs for older adults

They contend that the proposals would bolster the state’s safety net, particularly in light of uncertain federal funding. A more progressive tax structure, they argue, would make the system fairer by reducing the burden on middle- and lower-income residents. Currently, the top 1% of Rhode Island taxpayers control a disproportionate share of the state’s wealth but, when accounting for sales and property taxes, pay a smaller share of their income than lower-income households.

Opponents, however, warn of unintended consequences. They claim the bills would drive wealthy residents and businesses out of the state, eroding the tax base.Supporters dispute this, pointing to IRS and Stanford University studies indicating that wealthy individuals typically relocate for family or climate-related reasons—not for tax considerations. States like California and New Jersey, they note, have implemented similar surtaxes without experiencing significant outmigration.

Morally, proponents argue, those with more resources have a responsibility to help those with less—especially in a post-COVID era when many low-income families continue to struggle.

Yet critics, including the Rhode Island Public Expenditure Council (RIPEC) along with the Greater Providence Chamber of Commerce, Northern Rhode Island Chamber of Commerce and businesses, warn that such a tax could signal to entrepreneurs and investors that Rhode Island is “business unfriendly.” They contend that higher income taxes might discourage business investment and hiring, harming the state’s long-term economic prospects.

Some opponents cite Connecticut’s experience in the early 2010s, when a handful of wealthy taxpayers reportedly relocated after tax hikes, resulting in noticeable revenue loss. Given that a small number of high earners contribute a significant share of state income tax revenue, even limited outmigration could have an outsized fiscal impact, critics argue.

Skeptics also question whether new revenue will be reliably dedicated to education, infrastructure, and social programs. They point out that in the past, even funds placed in restricted accounts were sometimes redirected to fill budget shortfalls.

Aging Programs and Services at a Crossroads

“Rhode Island stands at a crossroads,” warns Carol Anne Costa, Executive Director of the Senior Agenda Coalition of Rhode Island (SACRI). With a projected $220 million deficit and potential federal cuts to programs such as Medicaid, SNAP, and services provided by the Office of Healthy Aging, Costa insists that passing HB 5473 and S. 329 is essential to preserve and expand supports for older adults and people with disabilities.

“Most of our state’s older residents are not wealthy,” Costa notes, citing Census data showing that one in four older households earns less than $25,000 annually, and 45% earn less than $50,000. Only about 8% of older households earn more than $200,000.

In FY 2023, 27,535 Rhode Islanders aged 65 and older were enrolled in Medicaid, which funds the majority of long-term services not covered by Medicare. In addition, 14% of older adults in the state relied on SNAP benefits to help cover food costs.

Costa argues that revenue from the proposed surtax could ensure continued funding for these essential programs and expand the Medicare Savings Program. Such an expansion could save low-income seniors and adults with disabilities up to $185 per month in Medicare Part B premiums—money they need for food, housing, and transportation.

While critics warn of wealthy residents fleeing Rhode Island if taxes increase, Costa cites a comprehensive report by the Economic Progress Institute refuting this claim. “In fact, the data suggests the opposite,” she says. “Higher-income tax filers are moving into Rhode Island more than they are leaving.”

Costa also points to Massachusetts as a real-world example. After voters approved a 4% surtax on income over $1 million in 2022, the number of Massachusetts residents with a net worth over $1 million increased from 441,610 to 612,109 by 2024, according to an April report from the Institute for Policy Studies and the State Revenue Alliance.

Business Community Pushes Back

At the House Finance Committee hearing, Laurie White, President of the Greater Providence Chamber of Commerce, voiced strong opposition to the proposed tax.

“Our views reflect those of thousands of local businesses statewide,” she said. “Rhode Island is already in fierce competition with neighboring states to attract and retain businesses, residents, and talent.”

White warned that the surtax would send the wrong message, particularly as Rhode Island invests in high-wage sectors like life sciences and technology. “Tax burden is a key factor in business decisions, and an increase in personal income tax would significantly reduce Rhode Island’s appeal,” she stated.

House GOP Minority Leader Michael W. Chippendale (R-Dist. 40, Coventry, Foster, Gloucester) echoed White’s sentiments: “Taxing people who have worked hard and become prosperous is an insult to the American dream. We shouldn’t be punishing success—we should be creating an economic environment where everyone can thrive. Driving away high-income residents with more taxes is backward thinking.”

Chief of Staff Sue Stenhouse confirmed that the entire 10-member House Republican caucus stands united in opposition to the surtax.

The Washington, DC-based Tax Foundation also weighed in. In written testimony on S. 329, Senior Policy & Research Manager Katherine Loughead stated that if the surtax were enacted, Rhode Island would move from having the 14th-highest to the 8th-highest top marginal state income tax rate in the nation—excluding the District of Columbia. She warned that this could make Rhode Island less attractive to high-income earners than even Massachusetts.

So What’s Next?

Costa maintains that taxing the wealthiest residents may be both a necessary and viable solution to protect the state’s safety net amid budget shortfalls and looming federal cuts.

However, with HB 5473 and S. 329 still being held for further study, it remains unclear whether they will be included in the final state budget.

“As we approach the final weeks of the session, there is no shortage of meritorious proposals that affect state resources,” said House Speaker Joseph Shekarchi (D-Dist. 23, Warwick). “The uncertainty of the federal funding picture and the numerous holes in the Governor’s proposed budget complicate both balancing this year’s budget and planning for the unknown. I continue to keep many options on the table for this challenging task.”

Stay tuned—SACRI and other aging advocacy groups are watching closely to see what options will be considered by the House Speaker when he releases FY 2026 state budget to address funding for programs and services that support Rhode Island’s growing older population in this difficult fiscal year.

To read submitted emails and testimony on S. 329, go to https://www.rilegislature.gov/senators/SenateComDocs/Pages/Finance%202025.aspx.

To read written testimony submitted on HB 5473, go to https://www.rilegislature.gov/Special/comdoc/Pages/House%20Finance%202025.aspx.