Much of the news coverage of President Trump’s proposed 2020 budget, which was released Monday, focuses on two aspects.
One: It’s just a PR exercise, since presidential budgets never get enacted. Two: Trump’s demand for $8.6 billion to build his border wall sets up a new conflict with Congress and maybe another government shutdown.
What shouldn’t fly under the radar, however, are the huge cuts to social safety net programs embedded in the document’s 150 appalling pages. These include drastic reductions in Social Security, Medicare and Medicaid — which Trump always promised to protect from any cuts — and to food stamps, housing assistance and family assistance.
Some of the support for social programs trumpeted by the budget document turn out to be largely mythical. Trump boasts of his determination to “defeat the HIV/AIDS epidemic.”
But as Lindsey Dawson of the Kaiser Family Foundation points out, the cuts and limitations he’s proposing to Medicaid would undermine care for HIV patients, 41% of whom get their health coverage via that program. And the $3.5-billion appropriation for the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which Trump claims would “continue the United States’ position as the world’s top HIV/AIDS donor,” actually represents a cut of nearly 20% from 2019 funding, which is $4.34 billion.
A family leave program touted by Ivanka Trump is another myth. It would require families claiming benefits to give up some of their Social Security benefits in return, which we identified last year as a terrible idea.
On the other hand, Trump’s budget is great news for the 1%. He would continue the tax cuts enacted in December 2017, which went largely to corporations and the wealthy.
It’s probably true that Trump’s budget will be dead on arrival on Capitol Hill, since the Democratic House won’t accept many of its provisions and even plenty of Republicans see lots in it to hate. But the document is useful for divining what goes through Trump’s head and those of his minions in the White House.
Many calculations of the damage Trump would do to social programs are necessarily estimates, because the budget document is vague about some of the cuts. But let’s take a quick look at what we do know, thanks to the work of budget experts in various fields. Except where noted, all dollar figures cover 10 years.
Social Security and healthcare: Cuts all around. Trump proposes to pare as much as $1.5 trillion from Medicaid, partially by repealing the Medicaid expansion enacted as part of the Affordable Care Act, and partially by converting the program to a block grant to states — a system that destroys the program’s ability to match funding with costs and results in a massive shortfall over time.
Trump would gut the nation’s disability programs by $84 billion. At least $10 billion of that would come from Social Security disability through changes in eligibility rules. An additional $400 million would come out of the Social Security Administration’s administrative budget, which is already strapped for cash, in the next year alone. Beneficiaries could expect more busy signals on the phone lines and longer waits at Social Security offices.
Trump proposes to model Obamacare repeal on the Graham-Cassidy bill, a 2017 repeal proposal that we labeled the worst one of all. Graham-Cassidy would have destroyed protections for people with preexisting medical conditions and cost as many as 21 million Americans their health coverage.
As for Medicare, Trump proposes to pare more than $500 billion from the program through a series of ill-defined initiatives on “wasteful spending, fraud, and abuse,” a catch-all category that includes reducing reimbursements to hospitals and other providers caring for patients. The historical record of such promises is not auspicious. Typically the fraud busters find a lot less to wring out of the system than they project, but they use the claims of widespread fraud to rationalize program cuts. Medicare advocates would have to watch this very carefully.
Food stamps and other public assistance: The food stamp program, formally known as the Supplemental Nutrition Assistance Program, or SNAP, would be cut by $220 billion. This would mean a cut of nearly one-third in a program that provides average benefits of about $1.40 per person per meal.
Trump proposes to resurrect his food-box idea to replace food stamps, a stupid proposal from 2018 that would have increased administrative costs for states and saddled recipients with food supplies they couldn’t use. Trump calls the idea “innovative.”
Trump is proposing to tighten work requirements on SNAP as well as Medicaid, despite a lack of evidence that such requirements do anything to help people find jobs and growing evidence that they result in needy families being thrown off the programs by the thousands. As a report this year by the National Academy of Sciences concluded, “It appears that work requirements are at least as likely to increase as to decrease poverty.”
According to Bobby Kogan, chief mathematician for the Senate Budget Committee, Trump’s budget would eliminate $1.3 billion in discretionary government programs. That would mean cuts, some of them drastic, to programs such as housing subsidies and heating assistance, the Centers for Disease Control and Prevention and Head Start — “Most of the programs that we think of when we think of what the government does,” Kogan tweeted.
Science and education: Draconian cuts. In 2020 alone Trump would slash the budget of the Environmental Protection Agency by 31.2% and the National Science Foundation by 9%, some $3.2 billion combined in one year. These agencies long have been in the cross hairs of conservatives, who detest their focus on antipollution regulations and on climate change solutions.
The budget would eliminate subsidized federal student loans for higher education and repeal a program giving university graduates who take public service jobs a break on repaying their student loans. But it would pump $45 billion over 10 years into private and parochial K-12 schools, undermining public education, through the Education Freedom Scholarships, a voucher program promoted by Education Secretary Betsy DeVos.