The Federal Budget
Fiscal Year 19
The House of Representatives Budget Committee Proposal
June 2018: The Budget Committee in the House of Representatives is working on a plan to “balance” the federal budget, since the government spends more than it collects through taxes and is in serious debt. Their solution? Keep attacking Medicaid. The committee released a draft resolution in June for Fiscal Year 2019 (FY19) which would begin in October 2018. The committee has not voted on it yet, and it is still subject to change, but it is likely that something along these lines will move forward. The rest of the House of Representatives will review whatever plan gets passed by the House Budget Committee.
The President’s Budget Proposal
On February 12, 2018, President Trump submitted his proposal to Congress for the federal budget for FY19. The President’s Budget includes steep cuts to a wide range of federal programs that allow millions of people to access basic needs, including food, housing, and health care. While only the first step in the budget process for FY19, the proposal signifies the President’s intent to slash programs that assist people with disabilities and to cut them off from critical community supports.
Despite the availability of more discretionary funding for FY19, the President’s Budget cuts trillions of dollars from the programs that provide health care, community support, and basic needs for people with disabilities.
Our Biggest Concerns
Adequate Coverage: The President’s Budget cuts $763 billion from Medicaid and subsidies for private insurance over the next ten years, threatening the loss of coverage for millions of people with disabilities
- The fundamental structure of Medicaid would shift to provide a cap on the amount of medical spending per beneficiary, which poses a significant threat to people with disabilities who have higher medical costs.
- With such drastic cuts, states will have to find ways to limit the services they cover under Medicaid, and they will have an incentive to target services that help patients with higher medical costs.
- These cuts also put optional programs such as home and community-based services at risk. Without these services, more people with disabilities will be forced into institutions to receive care, separating them from their families and communities.
Access: The President’s Budget also includes several proposals and funding cuts that would make it harder for people with disabilities to access health care.
- The proposal attempts to implement “work requirements,” so that people could only receive Medicaid and other benefits if they are employed. Rather than helping people receive vocational training and access to jobs, these requirements punish people with disabilities by depriving them of health care coverage when they are unable to work.
- The President’s Budget also incorporates stricter requirements on producing documentation for people to enroll in health plans and to access timely benefits, which is a greater burden for people with disabilities.
- The budget cuts funding from the Department of Health and Human Services’ Office of Civil Rights, which will limit the government’s ability to respond to complaints of discrimination against people with disabilities in health care programs.
Affordability: The President’s Budget will drive up the costs of health care services for people with disabilities and reduce the amount of funding for public health initiatives that could improve health outcomes for people with disabilities.
- The various proposals that limit access to insurance for people with disabilities also make health care less affordable by creating barriers for people with fewer medical needs to access health insurance, driving up the cost of insurance for people with disabilities. The administrative requirements for implementing these initiatives will further divert funding from services for people with disabilities.
- In the budget, the President continues to try to repeal the critical consumer protections in the Affordable Care Act, including those that prohibit insurers from discriminating against people with disabilities or pre-existing conditions either by outright exclusion or by forcing them to pay more for their coverage.
- The budget additionally proposes deep cuts to research and public health initiatives that could lower the cost of care for all Americans and improve health outcomes, including $7 billion in cuts to the National Institutes of Health.
Education: The President’s Budget threatens to cut the Department of Education’s funding by $7.1 billion over the next decade.
- These cuts are intended to support “school choice” initiatives, which theoretically give families more educational options such as private and charter schools. In reality, these types of initiatives disproportionately hurt people with disabilities, because non-public schools are not required to follow the same policies that prohibit discrimination against people with disabilities.
- The proposal cuts all discretionary funding for transition programs that help students with intellectual disabilities in higher education, which could entirely eliminate the program unless Congress passes new legislation.
Employment: Despite the imposition of work requirements, the President’s Budget drastically cuts and eliminates programs that help people with disabilities access jobs and sustainable income.
- The President’s Budget cuts $11 million, almost a third, of the budget for the Office of Disability Employment Policy under the Department of Labor.
- The proposal further cuts the Workforce Innovation and Opportunity Act programs, limiting access to job training and career development for all workers.
- The budget practically obliterates the Administration on Intellectual and Developmental Disabilities (AIDD) Projects of National Significance by cutting its funding by 90%. The proposal further eliminates state supported employment grants for people with intellectual and developmental disabilities.
Community Support Programs: The President’s Budget drastically cuts funding for a variety of services and programs that help support and meet the needs of people with disabilities in the community
- The proposal significantly reduces funding for State Councils on Developmental Disabilities, taking agency away from people with these disabilities as well as their ability to identify and meet the needs of members of their communities.
- The budget makes substantial cuts to the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and the University Centers for Excellence in Developmental Disabilities, both of which support research on employment supports and services for people with disabilities, among other basic needs.
- Furthermore, the President’s Budget eliminates the Community Services Block Grant, the Social Services Block Grant, and the Community Development Block Grant, all of which provide social services for low-income people and make a huge difference in the lives of people with disabilities.
Access to Basic Needs
Disability Benefits: The President’s Budget cuts tens of billions of dollars from Social Security disability benefits, including Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI).
- The budget cuts almost $7 billion from SSI over the next ten years by limiting the amount of benefits a family can receive if more than one member of the family has a disability. Effectively, families are being punished for having more than one child with a disability, and are at a serious risk for losing access to their basic needs.
- Not only will there be less funding available to support the families of people with disabilities who are unable to work, but the proposal also cuts the time limit for retroactive benefits in half. So when workers become disabled, they will only be able to recover benefits from six months after the injury, rather than the 12 months under the current law.
Housing: The budget would also cut substantial amounts of funding to programs that help low-income families and people with disabilities afford rent by reducing the Department of Housing and Urban Development’s budget by over 18%.
- Over 200,000 families would no longer be able to receive housing vouchers, which would likely include 89,000 adults with disabilities. These families will experience greater hardship as a result, and potentially even homelessness.
- The budget also cuts the Public Housing Capital Fund by over $1 billion, preventing the government from repairing unsafe or inaccessible homes for people with disabilities.
- The President’s Budget would also eliminate the Low Income Home Energy Assistance Program (LIHEAP), such that even families who could afford housing may lose access to other basic needs like heat and electricity without assistance to pay their utility bills. It also eliminates the Weatherization Assistance Program which makes structural improvements to houses to help them save costs on utilities.
Food: The budget proposes slashing 30% of Supplemental Nutrition Assistance Program (SNAP) benefits (previously food stamps), cutting $213 billion from the program over the next decade.
- These cuts will strip many of these families of their SNAP benefits altogether, forcing many people with disabilities into substantial hardship and hunger without access to food. Estimates suggest that close to 2.6 million households with someone with a disability could lose nutrition assistance over the next decade.
- The President’s Budget also proposes restructuring the delivery system of SNAP benefits, threatening to control which foods families will receive, most of which would be significantly less healthy and lead to greater health problems in the long term.
What You Can Do
Call your representatives and urge them to reject the FY19 proposals to gut Medicaid, community support programs, and basic needs for people with disabilities. The next step of the budget process goes through Congress, so act now!
Preliminary Summary and Analysis of the President’s Budget for FY19, Autism Society 2/13/18
Trump 2019 Budget Roundup, Center on Budget and Policy Priorities 2/14/18
President’s Budget Would Hurt People with Disabilities, Center on Budget and Policy Priorities 2/21/18
The Trump Administration’s BluePrint for Healthcare, FamiliesUSA 2/18
The Top 10 Lies in the Trump Budget, Forbes 2/18/18
The President’s FY19 Budget: Pay Attention to What He Does, Not What He Says, Prosperity Now 2/13/18
Trump’s Budget Balloons Deficits, Cuts Social Safety Net, Chicago Tribune 2/12/18