A Slice of the Trump Budget’s Shrunken Pie for the Needs of Low-Income People

Well, we finally have the full version of Trump’s proposed budget for upcoming fiscal year. And we’ve all seen and/or heard news reports, op-eds, social media takes and the like.

They generally have one of two focuses — new cuts, both total and by cabinet-level department or cuts to certain specific programs.

These tacks are basically the same as when the administration released its skinny budget preview, except that we now have a shift prompted by a range of cuts to safety net programs that don’t depend on annual appropriations.

I expect to deal with some of both, but for the time being, I’ll stick with a large perspective on a subset of programs intended to serve human needs — the non-defense discretionary programs, i.e., those annually funded as Congress chooses and the President approves, as Presidents generally do.

We have a broad range of these, of course. They include, bur aren’t limited to programs that support:

• Some healthcare services, mainly for veterans.
• Sufficient, healthful diets for mothers and their young children, plus food for nonprofits to give low-income people and/or serve as meals.
• Public education, mainly for low-income children and those with disabilities.
• Other opportunities to achieve financial self-sufficiency and security.
• Child care so that parents can participate in such programs and afford paying jobs.
• Safe, stable housing that leaves enough income to help pay for other needs.

The Coalition on Human Needs chose 185 such programs and tracked their funding from 2010, the year before Congress passed the Budget Control Act, through the budget the federal government’s operating under now.

All but 32 had been cut, either directly or for want of adjustments to keep pace with inflation, it found. Nearly a third had lost at least 25%, even though the Obama administration and wise heads in Congress agreed to temporarily modify the spending caps the BCA imposed.

Seems that Republicans over on the Senate side aim for another bipartisan agreement to suspend or at least modify the caps, lest they have to ax spending below the too-low levels already in force.

What’s sure as dammit, as the Washington Post reports, is that they’ll not try to push through the extraordinarily harsh cuts the Trump administration proposes as-is.

Most of the new news rightly focuses on the billions of cuts to so-called mandatory spending programs — also sometimes called entitlements.

They’re mandatory because the laws that authorize them require the federal government to spend as much as necessary to cover the costs or its share of costs for the benefits of everyone eligible to receive and enrolled to get them.

Truth to tell, I’m torn between delving into these unprecedentedly sweeping proposals to gut the safety net and giving them short shrift because they’re DOA. So I’ll end here with just a few examples of the proposed NDD cuts and consequences.

The Trump budget would deny affordable housing to more than 250,000 of the country’s lowest-income individuals and families who could otherwise have vouchers to cover all but 30% of their income for rent.

At the same time, it would reportedly increase tenants’ rent responsibility to 35% of adjusted income and impose a $50 minimum on those who had no or virtually no countable income at all. Income regardless, tenants would have to pay for their household utilities, which current law folds in with rent.

Public housing, which subsidizes rents at the same rate, would lose another $18 billion — nearly 29% more than it’s lost through this fiscal year. The stock available has been steadily shrinking due to lack of funds for repairs and renovations.

For these, as well as other reasons, we have and foreseeably will have some 550,000 people who’ve become officially homeless or very soon will unless they get some one-time or temporary help with rent.

Some have been homeless for a long time or repeatedly because they need not only an affordable place to live, but services to help them with physical and/or mental disabilities.

The Trump budget, however, would cut the grants local communities receive for shelters, permanent supportive housing for the chronically homeless I’ve just cited and homelessness prevention or when that’s not possible swift support so people can leave shelters for affordable housing.

The budget would terminate the Low Income Housing Energy Assistance Program, another homelessness prevention program — and a lifesaver too, since people, especially the frail and elderly can freeze to death in their homes or die because they depend on medical equipment that uses electricity, as 26% did when the last survey was conducted.

Roughly 6.7 million families would lose the subsidies they need to keep their homes warm if Congress moves from under-funding LIHEAP to excising it from the safety net altogether.

Turning then to those job opportunities. The Trump budget would cut a range of programs that help people prepare for gainful work — adult basic education, including preparation for GED exams, career and technical education programs in high schools and colleges and the diverse programs funded by the Workforce Innovation and Opportunity Act.

The Trump budget would cut WIOA funding by 43%, as compared to 2015 funding, the Center for American Progress reports. Nearly 571,000 workers nationwide — close to half of the total then served — could be left to muddle through with only what has failed to net them a decent paying job or any at all.

Pretty ironic — or one might say hypocritical — for a President who’s made such a big deal about job opportunities and, more recently, about how he’ll change safety net programs so they no longer discourage work.

More as the dust clears or perhaps as I find angles you’re unlikely to see highlighted in the plethora of conventional and social media stories, analyses and overt budget-bashing.

Meanwhile, we do have ways we can support the defensive campaigns that will give Congressional Republican pause.

CAP and fifteen partners, including CHN have launched an initiative called Hands Off—and #HandsOff as a hashtag for those who want to tweet about programs they want protected.

They’ve got a website where we can contribute stories about how the programs have helped us and what would happen to us, our families or others we know if they’re cut. With our permission, they’ll share our stories.

Reporters, as you know, are always looking for the personal lead-in or thread.

The coalition, CAP says, will also ensure that members of Congress learn from the stories how their own constituents would be affected. How then they may vote, as it doesn’t say, but needn’t.

Some members lean toward — or out-and-out support — less federal spending, especially on so-called welfare programs. But getting reelected and preserving their majority will trump the Trump proposals handily.

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What Federal Policymakers Have Done and Can Do About Lead Poisoning … And What We Can Do to Prod Them

Picking up where I left off. As I said, the Flint water crisis in some ways unusual, in others not. Higher percents of young children have dangerously high blood lead levels in other poor communities for example.

And these are only children who’ve been tested — some unknown fraction. Not because the irreversible damages lead in the blood can cause have only recently been known. Not because the federal government has done nothing but compile data.

It hasn’t done all it can to protect children (and adults) from lead poisoning, however. In fact, some recent decisions have probably made matters worse.

Congress could partly undo the damage, without first resolving the conflicts holding up action on next year’s budget. And with or without Congress, the administration could increase protection for millions of low-income families.

What the Federal Government Has Done (and Not)

Lead was recognized as a health hazard a long time ago. The federal government seems to have become energized in the 1970s — hence the leaded-paint ban I mentioned, plus related provisions in the Toxic Substances Control Act and the Safe Water Drinking Act.

Federal rules have required blood lead level tests and followup care for young children in Medicaid since 1989 — rules never effectively enforced, however. Congress mandated the phase-out of lead in gasoline a year later, setting 1996 as the deadline.

Congress acted again in 1992, requiring the U.S. Department of Housing and Urban Development to issue rules protecting some tenants and homeowners against leaded paint hazards.

Both the first version and the latest, issued in 1999, apply to federally-assisted housing of various sorts built before 1978, including public housing and housing subsidized by Housing Choice (formerly Section 8) vouchers.

The rules, among many things, require “environmental intervention” when a single test finds 20 micrograms of lead per deciliter of blood in children under six. The intervention trigger is just a tad lower if multiple tests are conducted.

We’ve learned more about levels of lead in blood since then. Heeding the research, the Centers for Disease Control twice ratcheted down its high-risk threshold. It’s been 5 micrograms per deciliter since 2012.

But HUD’s standard remains the same. And the trigger for action, as you can see, is damage already done. Young children are like the canaries coal miners once used to alert them to hazardous gases — by keeling over.

Squeeze on Targeted Lead Poisoning Prevention Funds

You’ll recall perhaps that Congress capped spending on programs that depend on its annual choices about a year before CDC last cut its lead blood level threshold in half.

Two programs that help fund lead poisoning prevention have gotten whacked far more than the caps themselves required, as the Coalition on Human Needs reports. One is now worth 28.6% less in real dollars than the year before Congress set the caps. The other, focused specifically on children has lost 55.6%.

What will happen for the upcoming fiscal year is anybody’s guess, since neither the House nor Senate has even set spending targets for the subcommittees that develop program-specific budget proposals.

What Congress Could Do Now

Congress doesn’t have to wait until Republican leaders resolve conflicts and the subcommittees do their work. It could act swiftly to channel some money to Flint and other communities with lead in their water. Because others there are, though we don’t know how many.

A bill awaiting action in the Senate (how often do I have to write this?) would provide $170 million to support urgently needed water infrastructure improvements, plus $17.5 million to monitor lead exposure and alert the public if excessive levels are found.

An additional $30 million would supplement funding for three programs to help prevent toxic lead exposure, with a special focus on pregnant women, mothers and their children.

The money wouldn’t restore what the two I mentioned have lost since 2010. Nor the third, which funds health-related screenings as one of many services for low-income pregnant women, babies and their mothers.

But “Congress has a lot of catching up to do,” as CHN’s monthly report says. So one can hope — if one’s still capable of that these days — that more Senators will sign on to the bill and press Majority Leader Mitch McConnell for a vote.

Meanwhile, Democrats in both the House and Senate have introduced bills that would require HUD to use CDC’s blood lead level maximum as its trigger for intervention.

They would also require HUD to strengthen its risk assessment standards, which now permit just a look around the place and altogether exempt efficiency units, even if small children live there — or will.

And they’d require HUD to make it possible for a family with a young child in a subsidized housing unit to move immediately if a lead hazard is found — and the hazard has already put the child at high risk. Why HUD wouldn’t have to swift children with less lead in their blood to safety I don’t know.

HUD may have to update its rules anyway. The Shriver Center, the Health Justice Project at Loyola University Chicago and nearly 30 allies have filed a petition calling on the agency to do so. Their proposals generally resemble what the House and Senate bills mandate, but they spell it all out and add some pieces.

What We Can Do

Advocates have created opportunities for concerned individuals to support both the pending Senate bill and the rulemaking petition.

Those of you with Senators can fire off emails urging them to get on board with the bill and press for a vote. And everybody, even disenfranchised District of Columbia residents, can sign the petition to HUD.

You know that all the brouhaha about Flint and lead poisoned children will die down, as such things always do. Even friendly Congress members will turn their attention elsewhere. HUD will surely be distracted by agency leadership changes — no matter how the Presidential race nets out.

So we need to do what we can now to get as much done as feasibly can be done now.

 

More Ways Public Programs Could Improve Life for Low-Income Seniors

Here, as promised, are the remaining three steps that Kevin Prindiville, the Executive Director of Justice in Aging advocates to fight senior poverty — and though he doesn’t say so, the hardships of those who’ll remain poor or nearly so.

Increase Assistance With Healthcare Costs

Rising healthcare costs are “one of the drivers of seniors’ economic vulnerability,” Prindiville says. We can go a step further.

Medical out-of-pocket costs are the main reason the senior poverty rate rises when the Census Bureau uses its Supplemental Poverty Measure, instead of the official measure. Factoring them out would produce a 6.3% drop in the SPM senior poverty rate — about 2.8 million fewer poor seniors.

Prindiville advocates reducing or altogether eliminating medical out-of-pockets for low-income seniors. He also urges unspecified expansions of programs designed to help poor and near-poor seniors afford health care — Medicaid, Medicare Savings Programs and the low-income subsidy for Medicare Part D.

Basically, the savings programs help low-income individuals and married couples pay for Medicare premiums — both Part A (hospital costs) and Part B (out-patient costs) for the lowest-income group. The program for these Qualified Medicare Beneficiaries also helps them pay those out-of-pockets.

The subsidy program pays for either the full or partial costs of the optional Part D insurance program, which generally covers some share of prescription drug costs. Here too, how much help beneficiaries get depends on their income level.

Prindiville again stresses the need to protect these programs from cost-shifting proposals. I earlier suggested that he was referring to Republicans’ premium support, a.k.a voucher, programs for Medicare.

But a recent Part D reform needs protection as well, since Republicans seem set on repealing the Affordable Care Act. That would reopen the so-called donut hole, which the ACA has shrunk and will ultimately close.

More seniors would again have to pay the full costs of prescription drugs that exceed a fairly low maximum — just $2,830 in 2010, when the ACA was passed.

And they’d have to continue paying those costs till they reach another maximum — more than $6,000 by 2020, according to Families USA, which optimistically forecast, in 2012, that the ACA will stay in place.

Provide Federal Support for the Long-Term Care Safety Net

Seniors, as well as younger people with severe disabilities can face formidable costs for in-home help with daily activities, e.g., bathing, dressing, housework, and for community-based services like transportation.

Medicaid covers some long-term care costs for some beneficiaries — for whom and how sufficient depends on their state’s policies. A patchwork then — and no safety net at all for seniors with more than minimal incomes and assets.

We’re often advised to take out long-term care insurance, which will partially defray the costs of services in our homes and communities or, when they won’t suffice, residence in a nursing home or assisted living facility.

I have long-term care insurance. Let me tell you, it’s not cheap, especially if you don’t buy in while you’re young and spry. My annual premium is well over twice the average monthly Social Security benefit for retirees.

The ACA attempted to address this problem and the related low-coverage problem by creating a voluntary long-term care insurance program structured somewhat like Social Security. But the U.S. Department of Health and Human Services concluded that the program couldn’t, as intended, pay for itself.

So HHS suspended it. And Congress subsequently repealed it. We’re thus back to square one — a long-term care safety net for some seniors, inordinate costs and/or burdens on younger family members for the rest.

Prindiville launches a preemptive strike against what might surface next. Proposals that would instead rely on seniors, including the poor and potentially poor, to save more for their long-term care needs are “simply unrealistic,” he says.

So he advocates strengthening and expanding public programs to meet long-term care needs, especially through services that enable seniors to age in place — or at the very least, in their communities. Specifics yet to come, I suppose. But we see glimmers in the last of his five steps.

Reauthorize the Older Americans Act

OAA is one of those programs that provides state and local agencies with grants they can use for a wide range of services — all for seniors, of course, but not necessarily only those in poverty.

We’re perhaps most familiar with Meals on Wheels, but it’s also a source of funding for transportation, legal services, benefits counseling, divers health-related services and more.

Poor seniors rely on OAA-funded services heavily, Prindiville says. For seniors more generally, they’re often the difference between aging in place, as most of us want to do, and living out the rest of our days in a nursing home.

In this respect, one could view them as part of the long-term care safety net — and a cost-effective one too. A semi-private room in a nursing home costs, on average, more than $80,00 a year.

Medicaid picks up all or most of the costs for about 70% of elderly nursing home residents. So there’s a compelling fiscal case, if needed, for the OAA-funded services that complement the in-home and community services that Medicaid funds.

OAA is also one of those programs that Congress should have reauthorized some years ago. A pending bipartisan bill in the Senate would do that. Here’s one step that might actually get taken.

Getting the program adequately funded to meet the needs of our graying population is a whole other matter.

Prindiville’s steps — both protecting what we have and gaining what we don’t — all hinge on persuading our federal policymakers that we view the well-being of seniors as a high priority. Justice in Aging has a petition we can sign. And it does it need more signatures!

 

Better Subsidized Child Care, But Could Be for Even Fewer Children

Shortly before the Senate began its extended Thanksgiving vacation, it did a remarkable thing. It again passed, by an overwhelmingly bipartisan vote, a bill to reauthorize the Child Care and Development Block Grant.

The House had already passed an amended version of the original bill on a voice vote, indicating that no member wanted dissents (if any) recorded. So we’ll soon have a generally better CCDBG, for the first time in nearly 20 years.

Not altogether the best bill we could have had, as such things rarely are. Nevertheless, a bill that will do various things to help ensure safe and potentially higher-quality child care.

And it will ensure that low-income parents can afford it for at least a year, even if they lose their jobs, end an education or training program or start earning somewhat more money than their state’s maximum for eligibility.

The hitch, however, is that it won’t add a cent to the block grant, though it does raise the cap on the amount Congress may appropriate by about $400 million over the next six years. Flat funding for the upcoming fiscal year, however.

So parents who manage to get CCDBG-funded vouchers should have fewer near-term worries about how they’ll afford child care — in many cases, the single largest expense in a family’s budget.

They should have fewer worries about their children’s safety because the bill requires, among other things, regular facility inspections, health and safety training for providers and employee background checks focused mainly on convictions for crimes of violence, child pornography and recent drug-related felonies.

And over time, parents should have fewer worries about whether their kids are getting the kind of care that develops the thinking, verbal and social skills they’ll need to be fully ready for kindergarten and beyond.

Under the former law, states had to set aside 4% of their block grant for quality improvements. The new law increases the mandatory set-aside up to 9% by the fifth year it covers. And it adds another 3% to improve care for infants and toddlers, beginning in the second year.

But there will be fewer of these less worried parents if Congress doesn’t also pass a hefty funding increase. Indeed, there already are fewer of them than in the recent past, even though the required set-aside has remained the same.

Preliminary data from the U.S. Department of Health and Human Services indicate that an average of roughly 1.5 million children a month received CCDBG-funded child care in Fiscal Year 2012.

This represents a one-year decrease of 116,400, CLASP reports — and a decrease of about 263,000 since Fiscal Year 2006.

Here in the District of Columbia, CCDBG supported child care for an average of 1,300 children — 54% fewer than in Fiscal Year 2006. And it’s hardly the case that we’ve got fewer low-income families now — or that child care has become more affordable.

The average cost of having an infant cared for in a local center was nearly $21,950 two years ago — about $3,750 more than in 2010.

A single mother earning the median for a family of her type would have had to pay 90.6% of her income for the care, unless it was subsidized. Perish the thought she had two children whose care she needed to pay for in order to work.

In Fiscal Year 2012, states and the District spent a total of $1.5 billion less on child care than they did the year before, in part because they ran out of Recovery Act money and in part because they used more of their Temporary Assistance for Needy Families funds for other things.

Combined federal and state childcare spending fell to the lowest level since 2002, when dollars went a whole lot further. And CCBDG spending, including transfers from TANF was virtually the same last fiscal year.

For this fiscal year, Congress restored the $154 million CCBDG had lost because of sequestration. What it will do for the upcoming fiscal year is a question mark. As I said, the reauthorizing bill provides for level funding. But that doesn’t mean the block grant will get it.

Even if it does, states will have to spend significantly more to comply with the new requirements. They’ll not only soon have to invest more in improving childcare quality.

They’ll have to develop complex new plans, including a process for ensuring that certain low-income families get priority. And they’ll have to collect and make readily accessible several types of information “to promote parental choice.”

So we should have better, more accountable publicly-funded childcare systems. But the requirements could further squeeze the amount states have to spend on subsidies.

Thus,  CLASP says, “Far greater investment — at the state and federal levels — will be needed to reverse this troubling trend” toward fewer and fewer low-income children in child care that wouldn’t bust the family budget.

Those of you who aren’t disenfranchised District residents can urge your Representative and Senators to provide the funding CCDBG needs. The National Women’s Law Center makes this quick and easy with an e-mail you can personalize.