From LeadingAge: House 2012 Budget Proposal Includes Cuts to Programs Serving Seniors.
On April 5, 2011, Rep. Paul Ryan (R-WI), chairman of the U.S House of Representatives Budget Committee, released his proposed fiscal 2012 budget. The budget does not set spending levels for every federal program. Instead, it would establish funding allocations for broad categories of federal programs. Follow-up legislation would be necessary to make any changes necessary in programs like Medicare and Medicaid.
The budget proposal includes the following provisions affecting long-term services and supports providers and those they serve:
- Repealing health care reform. The budget documents do not specifically mention the CLASS Act plan for financing long-term services and supports, but CLASS was enacted as part of health care reform.
- Replacing Medicare with voucher system. Beginning in 2022, the present Medicare program would be replaced with a voucher system. This proposal would apply to people now aged 55 and under. They would be given a choice of approved private health insurance plans and would receive a subsidy to help with the cost. People with low incomes or health risks would receive somewhat larger subsidies. The Congressional Budget Office (CBO) estimates that beneficiaries would have to pay more out of pocket than they do now for coverage comparable to the current Medicare benefit.
- Transforming Medicaid into a block grant. The amount each state would receive would be indexed for inflation and for population growth. However, there would no longer be the countercyclical effect of increased federal funding when demands on the program increase during a recession. States would gain increased “flexibility,” which could include the loss of the mandate for coverage of nursing home care. The budget documents do not mention Medicaid’s role in financing long-term services and supports.
- Changing rental assistance. The budget documents do not discuss senior housing or the role that rental assistance plays in enabling people living on fixed incomes to afford decent housing. The budget document calls for changes in rental assistance that, “Encourage recipients of federal housing aid to lead lives of increased self-sufficiency by decreasing disparities between assisted and unassisted renters and by making aid contingent on work or job training.”
- Decreasing funding for programs that support seniors in the community. The budget document would reduce to 2008 levels total spending on all discretionary spending programs, such as Section 202 housing, Section 8 rental assistance, Older Americans Act (OAA) programs. If this proposal were to be implemented program-by-program, we would lose the substantial increases in Section 202 and OAA funding that we have gained over the last 3 years.
The House Budget Committee plans to take up the budget proposal during the week of April 5. Assuming the committee approves the proposal, it could be considered on the House floor the following week. The U.S. Senate also must pass a budget resolution and the 2 houses would have to reach consensus on a final version.