Last week, Congress passed an outline of the 2019 budget. This week, President Trump rolled out his own budget plan, which would fill in some of the spending details. While most proposals in President Trump’s newly released 2019 budget are unlikely to become law, the fiscal framework does show the White House’s priorities for government over the coming year. And those apparently don’t include support for older adults, younger people with disabilities, or their families.
For example, the Trump budget would:
- Restructure the Medicare drug benefit to reduce costs for some beneficiaries but raise them for others.
- Reduce overall Medicare spending by $236 billion over 10 years.
- Freeze most funding under the Older Americans Act.
- Eliminate key federal block grants that states use to fund programs for seniors.
- Create a new six-week family leave program, but exclude those caring for frail parents or other relatives with disabilities
- Abolish the Senior Community Service Employment Program (SCSEP)
- Cut funding for Food Stamps (SNAP) and shift the benefit from a voucher to a box of home-delivered food.
Let’s take a closer look at a few of these proposals:
Medicare drug benefit. Trump has proposed eliminating cost-sharing for seniors with very high prescription drug costs, but at the same time he’d increase out-of-pocket expenses for many others, especially those who have significant costs but have not quite reached the threshold where medicine would be free ($8,418 this year).
Other Medicare changes. The budget would reduce overall spending for the program by $236 billion over 10 years. Much of the reduction would come from cutting payments to doctors, skilled nursing facilities, and other providers.
Older Americans Act and related programs. The White House would roughly freeze funding for the nation’s senior services programs, continuing a decade-long trend. It proposed very small increases in some areas, including nutrition programs such as Meals on Wheels, and would cut funding for others, such as falls prevention, elder rights support, and chronic disease self-management. The budget would cut funding for disability programs by about 30 percent.