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President Trump’s 2021 proposed budget would most hurt vulnerable older adults

Written by Diane Archer

Monique Morrissey writes for the EPI blog about President Trump’s proposed 2021 budget. Morrissey explains that this White House budget would hurt vulnerable older adults, even though it claims to benefit them. 

President Trump’s proposed budget would cut Medicare and Medicaid spending significantly. It would also cut discretionary spending unrelated to defense. In other words, funding for programs that help older Americans would be cut. Programs at risk include HEAP, which provides home emergency assistance to low-income older adults.

The President proposes more than $750 billion dollars in cuts to Medicare over ten years, which is likely to jeopardize access to care for older adults and people with disabilities. However, we don’t yet know what the President means when his proposed budget says that it will find Medicare savings by ending “excessive spending and distortionary payment incentives.” It also says that it would “preserve benefits and access to care.”

One Medicare provision in the proposed budget makes sense–to equalize payments for particular health care services across different venues. Right now, Medicare pays wildly different amounts for the same procedures depending upon whether they are performed in an outpatient or inpatient setting. 

The proposed Medicare budget cuts would likely increase people’s out-of-pocket health care costs and undermine access to care. The President would like to cut government payments to providers that cover unpaid medical bills. Consequently, providers may be less inclined to treat people with Medicare with limited incomes. In addition, hospitals and clinics in low-income areas may be forced to shut down. These potential issues would likely end up affecting middle-class older adults as well.

The President also wants to cut back on Medicaid expansion, which could leave more older adults without adequate health care coverage and put more health care providers serving people with low incomes at risk. In addition, he wants to increase copays for emergency room visits for people with Medicaid, which would deter them from getting needed care. And, the President wants to repeal the Affordable Care Act, which would not only increase the number of uninsured Americans dramatically but also drive up costs in Medicare. For example, it would mean the Part D prescription drug coverage gap would be reinstated.

The President proposes to cut Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) by $76 billion over ten years. He intends to reduce the number of people who benefit from SSDI by five percent. He also wants to cut Social Security administrative costs, which are already too low. Further reductions in spending on administration could mean the closing of more Social Security offices or reductions in their hours of operation.

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