September 19, 2018

Advocating for the Most Vulnerable Americans under a Trump Administration

Like many of my family members and friends, I am still in a state of shock and disbelief that Trump has been declared our new President-elect, but it didn’t take long for my personal email inbox to fill up with calls to action from leaders and activists in the disability rights and social services sector. There were many calls to take to the streets  and to support nonprofits that help population groups that now feel very threatened such as illegal immigrants, refugees and members of the LGBTQ community.

But there is an another large group of vulnerable American citizens very likely to be negatively impacted by the Trump Administration—the more than 8 million poor seniors and people with disabilities who are dependent on their monthly SSI check for their housing, utilities and food costs. These are persons who are aged 65 or older, blind or disabled adults, and blind or disabled children who meet very strict income and asset limits ($2,000 for singles, $3,000 for married couples). The current federal maximum subsidy per month for the aged and disabled is $773, with a California state additional supplement of $116. For most people, SSI provides automatic coverage of Medicaid (in California, called Medi-Cal). This very low-income cohort is also a group historically least likely to vote, as demonstrated in 2012, when 75% of people who made under $10,000 didn’t vote.

Although Trump pledged to sustain Medicare and Social Security while on the campaign trail, there no past track record to know if he will follow through on that promise, but we do have ample evidence about his vice-president elect, Mike Pence, who is likely to be given the government benefits portfolio. While Governor of Indiana, Pence created a different version of Medicaid, called Healthy Indiana, which requires that even the poorest Hoosier living below the federal poverty line pay monthly amounts into individual accounts similar to health savings accounts. Individuals who fail to keep up lose the enhanced coverage (of vision and dental services) and face copayments. There is no proof that the state is yet saving money or that its approach is making beneficiaries healthier.

In Congress, Pence has consistently voted in favor of legislative efforts to cut benefits in Social Security, Medicare and Medicaid and is one of Congress’ biggest proponents of privatization. The National Committee to Preserve Social Security and Medicare scored Mike Pence at 0% on issues important to seniors during the 2011-2012 Congress since he voted for multiple pieces of legislation that would cut benefits and programs that protect senior’s health and financial security.

It is also very likely that the Trump administration, together with the Republican-controlled House and Senate, will seek to turn as many federal programs as possible into “block grants” meaning that the states can receive a consolidated grant of federal funds, formerly allocated for specific programs, that a state can use with wide discretion. Invariably, these block-grants result in a “race to the bottom” as a March 2016 study from the Center on Budget and Policy Priorities (CBPP), of the 13 major housing, health and social services block-granted programs launched in recent decades, 11 suffered funding cuts since their inception and 10 since 2000. As reported in the LA Times, “Block grants' basic structure makes them especially vulnerable to funding reductions over time,” the CBPP found. Although the grants are typically tied to requirements that states maintain the programs at historical levels, it's easy for them to divert the money for other purposes, including filling in their general budgetary needs.

Unfortunately, the people most impacted by the cuts are the very people least likely to vote or actively participate in any type of advocacy. So, it means that us, the majority of Americans who voted for Hillary Clinton in the popular vote, will need to speak up often and loudly for the most vulnerable among us.