What the Administration’s FY19 Budget Request Means for Seniors
On Feb. 12, the Administration released its FY19 budget request, which outlines its funding priorities. The request does not reflect the budget deal that Congress passed earlier, but more detailed documents are expected from agencies in the coming weeks.
Congress is focused on finalizing FY18 appropriations. Like last year, lawmakers will likely move forward with their own plans for FY19, and few major policy changes are expected to pass in this election year. Largely due to last year’s tax cuts, the Administration’s budget would never balance, with accumulated deficits of an estimated $7.2 trillion over the next 10 years. Here are some other major proposals which, if enacted, would affect seniors.
Medicare: Cut by $237 billion
The budget includes a variety of Medicare cuts, most of which would reduce provider payments, such as spending reductions for Graduate Medical Education and Medicare bad debt payments. Several Medicare drug pricing proposals are also included, some of which could increase beneficiary out-of-pocket costs, and some which would reduce them. NCOA is supportive of the proposals to cap Part D out-of-pocket costs by eliminating the current 5 percent cost-sharing in catastrophic coverage and eliminating generic drug co-payments for beneficiaries eligible for low-income subsidies.
Medicaid:Cut by about $1 trillion
The budget eliminates the Medicaid expansion and imposes per capita caps or block grants on the entire program. The caps would limit Medicaid funding at a set amount per beneficiary, irrespective of states’ actual costs. The cap would grow more slowly each year than the projected growth in state per beneficiary costs. Nearly 7 million low income seniors rely on Medicaid for their health and long-term care. The proposal is based on a Graham-Cassidy Senate bill that Congress rejected last year, which the Congressional Budget Office estimated would reduce federal spending on Medicaid by about $1 trillion from 2017-2026.
SSDI and SSI: Cut by $72 billion
The Social Security Disability Insurance (SSDI) program and Supplemental Security Income (SSI) programs would be cut by an estimated $72 billion over 10 years.
Medicare State Health Insurance Assistance Program (SHIP): Eliminated
The budget eliminates this program that each year supports 15,000+ counselors who provide free, state specific assistance to over 7 million beneficiaries.
Senior Community Service Employment Program (SCSEP): Eliminated
The budget eliminates the nation’s only job training and placement program specifically for older adults. In 2016 under SCSEP, 60,000 older adults received on-the-job training while providing over 33 million hours of staff support to more than 20,000 organizations, at a value of $806 million, twice the amount of the program’s current appropriation.
Falls Prevention: Eliminated
The budget eliminates $5 million in falls prevention funding in the Administration for the Community Living (ACL) budget. No details are yet available regarding the $2 million in funding in the Centers for Disease Control (CDC) budget, but the Administration proposed no funding for FY18. Every 19 minutes, an older adult dies from a fall; every 11 seconds an older adult is treated in an emergency room for a fall-related injury.
Chronic Disease Self-Management Education (CDSME): Eliminated
The budget eliminates $8 million in funding for community-based workshops for people with chronic conditions. The budget also repeals the Prevention and Public Health Fund, which currently provides funding for CDSME and falls prevention. Over 90 percent of older adults have at least one chronic disease and two thirds have two or more.