Aging Services in the President's Budget Request

Legislation | February 11, 2020 | by Linda Couch

On February 10, the President delivered his fiscal year 2021 (FY21) budget request to Congress. The annual delivery of the Administration’s request for program funding is the start of the process for Congress to determine funding levels for federal programs.

On February 10, the President delivered his fiscal year 2021 (FY21) budget request to Congress. The annual delivery of the Administration’s request for program funding is the start of the process for Congress to determine funding levels for federal programs.

Very soon, the House and Senate appropriations and other committees will have hearings on the funding of programs within their jurisdictions, develop bills, mark those bills up in subcommittee and full committee, and then proceed to reach agreement for passage on the House and Senate floors before the differences between the two chambers’ bills are ironed out before final enactment.

Fiscal year 2021 begins October 1. However, Congress rarely meets their October 1 deadline for enactment of all 12 appropriations bills. Typically, one or more Continuing Resolutions will be enacted to keep federal programs funded at the previous year’s spending levels until final bills are completed. Because this is an election year, at least one CR is all but assured.

Another typical occurrence is the consideration and swift dismissal of most of any President’s budget wish lists. The FY21 request is the third budget request from this Administration; each request has sought deep cuts to safety net programs, which Congress has rejected. As we delve into the details of the request below, we highlight the good, the bad, and the in-between. Congress is the ultimate decision-maker for appropriations and LeadingAge will be working to educate Congress on our policy priorities as Congress develops what will become final appropriations bills.

Medicare

Once again, Medicare is seen as an area ripe for savings in the President’s budget with proposed reductions of $8.8 billion in 2021 and nearly half a trillion ($479 billion) over ten years. A key focus related to Medicare is to “eliminate excessive spending and distortionary payment incentives” of which several proposals relate to areas of interest for LeadingAge members. However, we are encouraged, even if it does not go far enough, to see recognition for the need to support certified nurse aide (CNA) training.

LeadingAge’s analysis of Medicare in the President’s request.

Medicaid

The proposed budget would cut more than $900 billion dollars from the Medicaid program over the next ten years, a 16% cut. These cuts include items that would hurt aging services, including through a final MFAR rule, changes to long-term services and supports eligibility and enactment of work requirements that could affect people living in affordable housing communities.

LeadingAge’s analysis of Medicaid in the President’s request.

Affordable Housing

The President’s request for affordable housing programs seeks a 15% cut to HUD’s overall budget while leaving the Section 202 Housing for the Elderly account not only unscathed but with an increase over FY20 funding. The request seeks $100 million for new Section 202 homes and an extension of the Integrated Wellness in Supportive Housing (IWISH) demonstration. The request also seeks to effectively eliminate the public housing program, and the full elimination of HOME, CDBG, and the National Housing Trust Fund.

LeadingAge’s analysis of affordable housing in the President’s request.

Administration for Community Living

The proposed budget includes a $115 million cut for the Administration for Community Living (ACL), which funds Older Americans Act programs that serve HCBS, nutrition services, elder justice programs, and family caregiving, among other community-based programs. LeadingAge and the Leadership Council of Aging Organizations advocated for increased funding to address the ever-increasing population of low income and other older Americans, but the budget at best maintains FY 2020 funding levels with decreases for important programs like the National Family Caregiver Support Program.

LeadingAge’s analysis of the Administration for Community Living in the President’s request.

Geriatrics Training

The President’s FY21 budget request does not recommend funding for education and training related to geriatrics through either the Geriatric Workforce Enhancement Program (GWEP) or the Geriatric Academic Career Awards (GACA) administered by the Health Resources & Services Administration. LeadingAge sees this as a missed opportunity to highlight the need for faculty with expertise in geriatrics who are needed to train the workforce and provide specialized care to improve health outcomes for older adults.  

LeadingAge’s analysis of geriatrics training in the President’s request.