Trump Spending Priorities Would Fray Social Safety Net Programs

Published in the Woonsocket Call on March 16, 2019

Last Monday, President Donald Trump released his proposed FY 2020 budget request to Congress. Lawmakers, who rejected many of these budgetary spending requests in the president’s previous two submitted budgets proposals, consider his latest to be “dead-on-arrival.”

But, Trump’s $4.7 trillion fiscal blueprint, outlined in the 150-page “Budget for a Better America,” gives us a clear picture of his spending priorities and policies he seeks to implement through executive orders and regulator changes.

Trump’s FY 2020 spending plan proposes funding increases for combating the opioid epidemic, improving veteran’s health care, fixing the nation’s crumbling infrastructure ($200 billion increase), even giving the Pentagon a 5 percent increase in spending exceeding what the military asked for. White House senior advisor Ivanka Trump successfully pushed for the FY 2020 budget to include $750 million to establish a paid parental leave program and a $1 billion one-time fund to provide childcare to under served populations.

Trump’s budget proposal makes a commitment of $291 million to eliminate the spread of HIV within a decade, it slashes the National Institutes of Health’s funding by 12 percent, and the budget for the Centers of Disease Control and Prevention by about 10 percent.

Trump does not back away from his controversial stance of building a wall, putting in an additional $8.6 trillion for the construction of a U.S. Mexico border barrier. Congress had earlier opposed his demand for $5.7 billion for the construction project.

Trump Budget Proposal Puts Senior’s Earned Benefits at Risk

In 2016, Presidential candidate Trump had pledged not to cut Medicare, Medicaid or Social Security, but he does in his submitted FY 2020 budget proposal.

Trump calls for a 5 percent cut in non-defense federal agencies, including a whopping $ 1.5 trillion in Medicaid over 10 years. The budget plan instead allocates $1.2 trillion to create “market-based health care grants,” (a.k.a block grants) for states that would start in 2021. This gives states the power to set their own rules for this program.

Medicaid expansion under the Affordable Care Act (ACA) would be eliminated by Trump’s FY 2020 budget proposal by ending ACA’s protections for people with pre-existing conditions and causing millions of people to join the ranks of the uninsured. About 15 million more Americans have joined Medicaid since the ACA expansion was enacted.

Trump’s budget proposal also cuts Medicare by $845 billion over the next decade by cutting payments to hospitals and physicians, rooting out fraud and abuse, and by lowering prescription drug costs.

Meanwhile, the Social Security Disability Insurance program takes a huge budgetary cut of $25 billion and the Social Security Administration’s (SSA) operating budget is slashed by 1 percent, at a time when the agency is working hard to ratchet up its customer service provide to SSA beneficiaries.

Trump’s budget proposal would cut $220 billion from the Supplemental Nutrition Assistance Program (SNAP), popularly referred to as the food stamp program. The program currently serves 39 million people. Under this budget, beneficiaries would be required to be employed for 20 hours a week to be eligible for assistance and replacing the EBT-debit card used to purchase groceries with the delivery of a “Harvest Box” filled with non-perishable foods like cereal and pasta, canned goods and surplus dairy products.

Housing and Urban Development’s 202 housing program for seniors and people with disabilities takes a $36 million hit, says long-time aging advocate Bill Benson, principal of Washington, D.C.-based Health Benefits ABC, in the March 15th issue of Aging Policy and Public Health News.

According to Benson, several Older Americans Act programs including the Family Caregiver Support program would be cut in Trump’s budget proposal. The Long-Term Care Ombudsman Program would be cut by $1 million. Elder Justice Programs would also be cut under the President’s budget including a $2 million cut to the Elder Justice Initiative at Administration for Community Living.

” Cruelest of all [budgetary cuts] is the proposed out-right elimination of the Social Services Block Grant (SSBG) which is the only source of sustained federal funding to states for Adult Protective Services (APS),” says Benson. Some 37 states use SSBGs to support their APS programs. SSBG is also used by states for a number of other services benefiting older adults including home-delivered meals and case management.

Shortchanging Seniors

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM) warns that Trump’s budget proposal shortchanges seniors. “In combination with 2017’s tax cuts for the wealthy and the administration’s failure to allow Medicare to negotiate with Big Pharma, the Trump budget shows that his administration is not plugged into the realities of being elderly in America,” he says.

Richtman says that Trump’s budget plan also proposes to eliminate federal grants that help pay for programs under the Older Americans Act, such as Meals on Wheels and home heating assistance for the elderly poor.”

According to Richtman, the 116th Congress gives seniors hope with introduced legislation that would boost Social Security benefits and expand Medicare coverage to include dental, hearing and vision services, changes that an overwhelming majority of Americans support. He calls on Congress to “quickly reject this callous budget proposal — and take decisive action to enhance the well-being of older Americans.

Robert Greenstein, president of the Center on Budget and Policy Priorities, sees Trump’s newly released budget proposal as very troubling, too. “It sharply cuts funding in the part of the budget that invests in future economic growth through education and training, scientific research, infrastructure, and the like,” he says.

“It reverses progress in making affordable health care available to people who don’t have employer coverage or can’t afford private coverage. It cuts basic assistance substantially for families, children, and elderly and disabled people who are in need and struggle to get by. And, it doubles down on policies that take away health care, food, and housing when adults aren’t able to meet a work requirement,” says Greenstein.
“Despite bemoaning deficits, it calls for making the costly 2017 tax cuts — which largely benefit those who already have high incomes and wealth — permanent,” he adds.

Richtman believes that Trump’s 2020 spending proposal serves as a warning of what the administration would do if it were not for the firewall known as the Democratic-led House of Representatives. “These draconian ideas – though rejected by voters in the 2018 mid-terms – remain in the conservative political bloodstream, requiring continued advocacy on the part of seniors and their champions in Congress,” he says.

The release of Trump’s FY 2020 budget program begins the Democratic party’s efforts to retake the White House and Senate in the 2020 presidential election, just over 598 days away. By making major cuts in Social Security and Medicare and turning Medicaid into a state block grant program, Trump is giving Democratic challengers in the 2020 presidential election fodder to create politically-charged themes for ads to turn senior voters against him for seeking cuts in these popular domestic programs.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, healthcare, and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Older Americans to Benefit from Bipartisan Budget Act

Published in the Woonsocket Call on February 11, 2018

While many were sleeping, funding to operate the federal government expired midnight Thursday, though it was restored about eight and a half hours later with action from Congress to end the brief government shutdown, when President Donald Trump signing the 652-page Bipartisan Budget Act of 2018 early Friday morning.

The $400 billion budget agreement funds the federal government through March 23 to give lawmakers time to pull together the details needed to craft full appropriations bills that become the official federal budget.

Lawmakers had expected the massive budget bill to pass before the midnight deadline to avoid a government shutdown but Sen. Rand Paul (R-Ky.), delayed the Senate vote past midnight to protest the additional billions of dollars being added to the federal budget deficit by the legislation.

Ultimately the House approved the bill by 240 votes to 186, almost four hours after the Senate had passed the budget bill by 71 to 28 three hours earlier. The GOP-controlled House needed the help of 73 Democratic lawmakers to pass the budget bill because 67 House Republicans voted against the legislation.

The Nuts and Bolts

The two-year budget deal eliminates strict budget caps that were set in 2011 to reduce the federal deficit and allows Congress to increase military and domestic spending by $300 billion, along with adding another $90 billion for emergency disaster aid for Texas, Florida and Puerto Rico and throws in billions more for infrastructure, the opioid epidemic and health programs. It also suspends the debt limit for one year – until after the upcoming midterm elections.

Specifically, the newly enacted Bipartisan Budget Act of 2018, would allocate $165 billion to the Pentagon and defense spending while $131 billion would be directed to domestic programs. In addition, $20 billion would be spent on infrastructure programs such as surface transportation, rural water and wastewater systems, $ 7 billion in community health centers to provide care to low-income people, $6 billion to fight the opioid crisis, and $4 billion directed to veteran’s health care.

The budget agreement also repeals the controversial Obamacare’s Independent Payment Advisory Board (IPAB), which was designed to limit Medicare costs. It also gives a ten-year extension to the Children’s Health Insurance Program (CHIP), which is four years longer than the previous spending bill passed last month. Finally, the legislation did not address the dilemma of 700,000 “Dreamer immigrants who are in the United States illegally after being brought here as children and who” are enrolled in the Deferred Action for Childhood Arrivals program, set to expire on March 5, nor did it provide funding for President Trump’s proposed southern border wall.

“A Pretty Good Deal for Seniors”

Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, sees the Bipartisan Budget Bill of 2018 “a pretty good deal for seniors.”

“Seniors will feel these changes in their pocketbooks and even in the way they feel physically,” says Richtman, in a released statement. “We have been fighting for these measures for quite some time and are happy to see Congress take action on a bipartisan basis.”

According to Richtman, the Bipartisan Budget Act of 2018 closes Medicare Part D “donut hole” in 2019. The prescription drug coverage gap embedded in the original law, which the Affordable Care Act has been gradually closing, will be altogether eliminated one year early. This will save seniors thousands of dollars in out-of-pocket prescription drug costs., he says.

Richtman says that the enacted Budget agreement also repeals Medicare therapy caps. The bill scraps arbitrary caps on physical, speech, language and occupational therapies that have cost senior’s money – or delayed care at crucial times. Beneficiaries will now find it easier – and more affordable – to get the therapies they need without undue interruption, he notes.

The Bipartisan Budget Act of 2018 also lifts non-defense domestic spending caps, allowing Congress to appropriate more adequate funding for the Social Security Administration’s (SSA) operating budget, says Richtman, noting that the federal agency has suffered from draconian budget cuts since 2011 which have impinged on customer service, even as 10,000 Baby Boomers retire every day. He notes that “this badly-needed (but yet unspecified) higher level of funding should allow SSA to improve customer service for the program’s 67 million beneficiaries.”
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But, on the negative side, says Richtman, the new law increases Medicare premiums for some individuals by further expanding Medicare means-testing. “Congress continues to expand Medicare means-testing, and they will not stop until middle-class seniors are burdened with higher Medicare premiums,” he warns.

“We are particularly pleased that this legislation permanently repeals Medicare’s therapy caps, something that AARP has long supported. Millions of vulnerable patients who need occupational, physical, and speech-language therapy will now be protected from an arbitrary limit on how much Medicare will pay for needed therapy,” said Nancy LeaMond, AARP’s Executive Vice President and Chief Advocacy & Engagement Officer, in a released statement..

“AARP is also pleased that Congress expedited the closing of the Medicare prescription drug coverage gap known as the ‘donut hole,’ which will now close in 2019, one year earlier than currently scheduled. Medicare beneficiaries will soon get permanent relief from higher out-of-pocket costs for prescription drugs. We also applaud the provision that adds biosimilar drugs to the Medicare Part D Coverage Gap Discount Program. This change will lower out-of-pocket costs and encourage the development and use of these drugs,” adds LeaMond.

Social Security, Medicare Are Solvent…at least for Now

Published in Woonsocket Call on July 16, 2017

Just days ago, a released annual federal report, the 2017 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds, says the nation’s Social Security and Medicare programs continue to work, are fiscally solvent, but future fixes will be needed to maintain their long-term actuarial balance.

The Social Security Administration’s (SSA) annual snap shot of the fiscal health of Social Security and Medicare, two of the nation’s largest entitlement programs, released on July 13, is important to millions of beneficiaries. According to the federal agency, in 2017 over 62 million Americans (retired, disabled and survivors) received income from programs administered by SSA, receiving approximately $955 billion in Social Security benefits.

The Good News

The trustee’s report projects that Social Security will be financially solvent until 2034 (unchanged from last year), after which SSA can pay 77 percent of benefits if there are no changes in the program. The 269-page report also noted that the Medicare Trust Fund for hospital care has sufficient funds to cover its obligations until 2029, one year longer than projected last year, then 88 percent afterward if nothing is done to strengthen the system’s finances

The trustees report says that there is now $2.847 trillion in the Social Security Trust Fund, which is $35.2 billion more than last year — and that it will continue to grow by payroll contributions and interest on the Trust Fund’s assets.

Social Security Administration efficiently manages its entitlement program, says the trustee report. The cost of $6.2 billion to administer to program in 2016 was a very low 0.7 percent of the total agency’s expenditures.

The trustee’s project a 2.2 percent cost-of-living adjustment (COLA) for Social Security beneficiaries in 2018, the largest increase in years. In addition, Medicare Part B premiums will also remain unchanged next year. Most beneficiaries pay a monthly premium of $134 (this amount increases for those with higher incomes.)

Social Security is “Stable and Healthy for Now”

According to the National Committee to Preserve Social Security (NCPSSM), the recently released trustee’s report confirms that the federal entitlement program is “stable and healthy for now,” while acknowledging there will be future challenges if “corrective action is not taken.”

“Forty percent of seniors (and 90 percent unmarried seniors) rely on Social Security for all or most of their income. The average monthly retirement benefit of $1,355 is barely enough to meet basic needs, and the Trustees’ latest projected cost-of-living increase of 2.2 percent will not keep pace with seniors’ true expenses. Under these circumstances, any benefit cuts (including raising the retirement age to 70 as some propose) would be truly painful for our nation’s retirees,” says Max Richtman, NCPSSM’s president and CEO, in a statement responding to the release of the federal report.

“Opponents of Social Security may once again try to use this report as an excuse to cut benefits, including raising the retirement age,” warns Max Richtman. “We must, instead, look to modest and manageable solutions that will keep Social Security solvent well into the future without punishing seniors and disabled Americans,” he says.

Depending on what the final Senate health bill looks like, the legislation could reduce the solvency of Medicare by two years, say Richtman. “The National Committee opposes the GOP health plan and rejects efforts to privatize Medicare. We advocate innovation and continuing efficiencies in the delivery of care, allowing Medicare to negotiate prescription drug prices, and restoring rebates the pharmaceutical companies used to pay the federal government for drugs prescribed to “dual-eligibles” (those who qualify for both Medicare and Medicaid) – in order to keep Medicare in sound financial health,” he says.

Safeguarding and Expanding Social Security Benefits

In a statement, Richard Fiesta, Executive Director of the Washington, DC-based Alliance of Retired Americans, notes that the Trustees project that the Social Security Disability Insurance (SSDI) trust will be fully solvent until 2028, five years longer than last year’s report. “In light of this data, it makes no sense that the President’s FY 2018 budget seeks to cut Social Security Disability Insurance funding by $63 billion,” he says.

Despite the trustees’ strong report, Fiesta believes that improvements can be made that would benefit all workers and retirees. His organization supports safeguarding and expanding Social Security benefits, providing a more accurate formula for cost-of-living adjustments, and lifting the cap on earnings for the wealthiest Americans.

Fiesta adds, “reining in the prices of prescription drugs would strengthen Medicare for the future and reduce costs to retirees.”

AARP CEO Jo Ann Jenkins, in a statement, calls for bipartisan action in Congress and the Trump administration to ensure the strong fiscal health of Social Security and Medicare programs. “Social Security should remain separate from the budget. Medicare can improve if we reduce the overall cost of health care, rather than impose an age tax, and if we lower prescription costs, instead of giving tax breaks to drug and insurance companies,” she says.

Finally, in a statement, Nancy Altman, President of Social Security Works, also chairing the Strengthen Social Security Coalition, says that this year’s trustee’s report clearly indicates that the nation can fully afford an expanded Social Security. Altman says that polling continues to show that Americans support expanding the program’s benefits.

Altman believes the Social Security program can solve the nation’s “looming retirement income crisis, the increasing economic squeeze on middle-class families, and the perilous and growing income and wealth inequality.” So, when confronting these challenges, she says, “the question is not how can we afford to expand Social Security, but, rather, how can we afford not to expand it.”

Ensuring the Long-Term Solvency of Social Security

Those nearing retirement or retired will be assured existing Social Security benefits, promises the 2016 Republican Party Platform. “Of the many reforms being proposed, all options should be considered to preserve Social Security. As Republicans, we oppose tax increases and believe in the power of markets to create wealth and to help secure the future of our Social Security system,” says the Platform. Simply put, the GOP opposes the raising of payroll taxes on higher income taxpayers to stabilize or expand Social security and supports privatization, allowing Wall Street to control your Social Security benefits.

On the other hand, last year’s Democratic Party Platform opposed Social Security cuts, privatization or the weakening of the retirement program, along with GOP attempts to raise the retirement age, slash benefits by cutting cost-of-living adjustments, or reducing earned benefits. The Democratic Platform called for taxing people making above $250,000 will bring additional funding into the entitlement program.

Congressional gridlock has not blocked legislation from being introduced to fix the nation’s Social Security program. According to Social Security Works, over 20 Social Security expansion bills have been introduced in the House and Senate since 2015. Recently, the Social Security 2100 Act, introduced by Rep. John Larson (D-CT), has 162 House cosponsors —around 85 percent of all Democratic representatives. Similarly, around 90 percent of Senate Democrats are on record in favor of expanding, not cutting Social Security.

Many consider Social Security to be the “third rail of a nations politics.” Wikipedia notes that this metaphor comes from the high-voltage third rail in some electric railway systems. Stepping on it usually results in electrocution and the use of the term in the political arena refers to “political death.” With the Social Security and Medicare programs now on firm financial footing, it is now time for Congress to seriously consider legislative actions to ensure the longevity and expansion of these programs. When the dust settles after the upcoming November 2018 elections, we’ll see if Social Security is truly “a third rail.”