The Federal Budget

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Background

Back in December 2017, Congress passed a massive tax reform bill which will allow wealthy individuals and corporations to get substantial breaks on their taxes, while costing the country almost $1.5 trillion over the next ten years. Because of this enormous increase to the federal deficit, Congress needs to reduce spending in other areas to offset the cost of the money it is putting directly in the hands of the wealthiest.

While some laws require Congress to fund certain programs, there are others that give Congress more discretion, and every year it has to decide how much to spend in these areas. Because Congress took six months to finalize the budget for Fiscal Year 2018 (FY18), which began on October 1, 2017, there have been two government shutdowns in the span of one month.

To end the more recent shutdown, Congress passed a two-year budget agreement which increased the total amount of discretionary funding it could spend in both FY18 and FY19. The final budget for FY18 was released on March 23, 2018. At the same time, the federal government has started the process of putting together its budget for FY19, which will begin on September 1, 2018.

Fiscal Year 18

The Fiscal Year for 2018 (FY18) began on October 1, 2017, but Congress had failed to pass a budget to authorize spending on any government programs. As a result, there were two government shutdowns while the House of Representatives and the Senate tried to negotiate funding levels. Six months later, the Congress passed a massive bill to fund the federal government for FY18, which the President signed on March 23, 2018 to make it into a law. This omnibus bill combines and consolidates many separate appropriations, funding the federal government through September of 2018.

Many programs for people with disabilities received increased funding for the rest of this fiscal year, including:

  • Support for adult employment and youth activities under the Workforce Innovation and Opportunity Act programs
  • The Developmental Disabilities (DD) Assistance and Bill of Rights Act programs, which includes DD State Councils, protection and advocacy agencies for people with DD, as well as grants that fund research, education, and other projects to support people with DD
  • Grants to support family caregivers of people with disabilities in community-based settings
  • State grants to remove physical barriers that prevent people with disabilities from voting
  • Affordable housing for people with disabilities under Section 811

Some new policy provisions:

  • New requirements and grants for law enforcement and public safety agencies to develop programs, best practices, trainings, and technological assistance to prevent children with disabilities from wandering and going missing, through Kevin and Avonte’s Law
  • The Government Accountability Office is now required to research the use of restraint and seclusion on children with disabilities in schools to expand the use of alternative, safer practices

However, the omnibus bill did not address other critical issues for people with disabilities, including health care subsidies and the Money Follows the Person (MFP) Program. Additionally, Congress cut 18% of the budget for the Supported Employment State Grant programs.

Congress still has the authority to provide the funding for these programs in later bills, so call your Representatives and ask them to cosponsor and support these bills.  Act now!

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

Medicaid

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.

Community Living

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

Resources

The President’s FY19 Budget

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

FY18 Omnibus Bill – Specific Line Items Affecting People with Disabilities, The Arc

Statements

Consortium for Citizens with Disabilities (CCD)

Autistic Self Advocacy Network (ASAN)

Global Health Council

Association of American Universities

The Greater Boston Food Bank

Healthcare Information and Management Systems Society (HIMSS)

National Coalition Against Domestic Violence (NCADV)

AcademyHealth

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