The President’s Budget Request Impact on Programs for the Disabled and Older Americans Act Programs
This is part three of a series on health care budget cuts.
Because of the Trump administration’s reorganization of the U.S. Department of Health and Human Services (HHS), in which many important programs for the disability community and older Americans and the disability community are moved or eliminated, it is difficult to track all changes. With the backdrop of Congress’s intention to reduce Medicaid, SNAP and other funding of programs these communities rely upon, the president’s proposed budget is particularly significant in the potential to limit access to vital supportive services. In addition, there is a consolidation programs with funding decreases.
Under the reorganization of HHS, the Administration for Community Living is eliminated. Many of its functions are being moved to the newly formed Administration for Children, Families, and Communities (ACFC) and to the Centers for Medicare and Medicaid Services (CMS). While details are not completely available, it appears the ACFC will administer $29.3 billion in discretionary funding for programs addressing the social service needs across the lifespan. It is suggested but not confirmed that Centers for Independent Living (CILs) will be included in this agency, but funding is unclear. However, the Aging and Disability Resource Centers (ADRCS) are moved to CMS, but funding is eliminated.
In brief:
- National Institutes of Health: This budget proposes cutting nearly 40% of the National Institutes of Health (NIH) funding, putting at risk funding for the Intellectual and Developmental Disabilities Research Centers (IDDRCs) in AUCD’s network. In the absence of IDDRCs, there will be a gap in discoveries and technologies that have been essential for advancing health care for people with disabilities.
- Congregate Nutrition, Home-Delivered Nutrition, and Nutrition Services Incentive Program: Moved to the Administration for Children and Families (ACF) and level-funded.
- Supportive Services and Senior Centers, National Family Caregiver Support Program, Native American Nutrition and Supportive Services, and Native American Caregivers Support: Moved to the Centers for Medicare and Medicaid Services (CMS) and level funded.
- Health Promotion and Disease Prevention (Preventive Health): Moved to CMS and funding eliminated.
- Falls Prevention, Chronic Disease Self-Management Education (CDSME), and Alzheimer’s Disease Initiative: Moved to CMS, but the Prevention and Public Health Fund (PPHF) would be eliminated, along with additional appropriations for falls prevention. The $16.7 million appropriation for Alzheimer’s Disease Initiative would be retained. Elimination of the PPHF would erase a significant source of investment in other public health initiatives as well. The fund not only supports ACL healthy aging grants, but also key programs at the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration.
- Elder Rights: Moved to CMS and slashed to $5 million, eliminating the Long-Term Care Ombudsman Program, Adult Protective Services support and other elder abuse, neglect and exploitation efforts.
- Aging Network Support: Moved to CMS and reduced by over 40%, potentially eliminating the Direct Care Workforce Strategies Center.
- Aging and Disability Resource Centers (ADRCs): Moved to CMS and eliminated.
- Other Non-OAA ACL Aging Services: Medicare State Health Insurance Assistance Program (SHIP) and Lifespan Respite Care moved to CMS and eliminated.
- Low-Income Medicare Beneficiary Assistance: Moved to CMS and retained because the Medicare Improvements for Patients and Providers Act is a mandatory program.
- Low-Income Home Energy Assistance Program: Program is eliminated. The administration cites “energy dominance, lower prices and an America First platform” as justification for the program’s elimination.
- Community Services Block Grant: Funding is eliminated. This block grants supports programs to reduce poverty and is part of the broader cuts of HHS.
- Special Education Simplified Funding Program: Level funded at FY 2025 levels. Consolidation of seven Individuals with Disabilities Education Act (IDEA) programs to provide states and school districts. Preschool grants as well as some activities currently overseen by the Department of Education’s Office of Special Education under IDEA Part D would be folded into grants distributed to states under Part B. Programs that would be impacted are the Parent Training and Information Centers, technical assistance centers, training for new special educators and general educators, assistive technology and accessibility supports and more.
- Low Income Home Energy Assistance (LIHEAP): Program is eliminated. The administration cites “energy dominance, lower prices and an America First platform” as justification for the program’s elimination.
- HUD Self Sufficiency Programs: Programs are eliminated because the administration believes they duplicative and better handled at the state and local government level.
- HCV Program, Public Housing, Project-Based Rental Assistance, Section 202 Housing for the Elderly and Section 811 Housing for Persons with Disabilities: These programs would be combined into one State Rental Assistance Block grant (SRABG) and funded at 31.79 billion. Together these programs assist more than 4 million households with the lowest incomes including families, people with disabilities, older adults, workers, caregivers and others who had previously experienced homelessness. In addition, the president’s request includes that the Secretary of HUD would develop a formula for FY2026 that would prioritize the maintenance of assistance for people with disabilities and older adults who already receive HUD assistance.
