Federal Budget Proposals Devastate Poor Seniors

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Income inequality in this country is climbing. At the same time, our population of aging people 65 and older is growing by 10,000 a day. As the population of poor seniors surges, the last few election cycles have included debates regarding which candidates will do the most to protect seniors and the programs they rely on. But most of this discussion has little relation to the budget proposals on the table now. For instance, Congressman Paul Ryan referred to maintaining Medicare as a generational promise to “my mom’s generation, for my generation and for my kids and yours,” in his 2012 Republican National Convention speech, but is seeking to gut Medicare in his fiscal year 2015 budget blueprint. Or, the many candidates who have, since 2010, spun opposition to the Affordable Care Act (“Obamacare”) as an opposition to cuts to Medicare for seniors, yet both House and Senate budget plans will actually hurt the very same seniors relying on Medicare for their health care. With the 2016 elections quickly approaching and Congressional leadership proposing FY2016 budgets, let’s check in on how rhetoric in support of our seniors is living up to its promise in the recent Congressional budget resolutions.


Access to Health Care

Cutting programs that facilitate access for the aging population to quality health care is a failure to protect low-income seniors. Medicare and Medicaid are crucial to seniors maintaining any sort of health security in old age—without sufficient funding for these programs to operate, their lives are at risk.

Unfortunately, both the recent House and Senate budget resolutions would damage the health care safety net upon which seniors rely. Both resolutions seek complete repeal of the Affordable Care Act (ACA). Repeal of ACA would be a disaster for poor seniors. Repealing the ACA (and its Medicaid expansion) means at least 14 million people will lose their health insurance or any opportunity for future coverage. That means some of the provisions of ACA that directly benefit poor seniors the most will go away, including free preventative screenings, Medicaid-funded Home and Community-Based Services, and affordable prescription medications. Both resolutions propose billions of dollars in cuts to Medicaid – the Senate by $400 billion over 10 years and the House by $913 billion over ten years.

The House Budget Committee resolution states: “With the creation of Medicare in 1965, the United States made a commitment to help fund the medical care of elderly Americans without exhausting their life savings or the assets and incomes of their working children and younger relatives.” However, the Medicare reform outlined in the resolution is far from keeping this commitment. The House budget proposes converting Medicare into a voucher program, disguised as a “premium support program,” cutting its funding in the next 10 years by $148 billion. The resolution also raises the Medicare age eligibility threshold, hurting the low-income seniors who would no longer qualify. Raising the age increases senior poverty as people who can no longer work will have to spend down their assets on health for the interim period between employment and Medicare eligibility.

Poor seniors can’t find security in income security programs without sufficient funding to operate.

Income Security

With all the political posturing regarding the importance of addressing the needs and priorities of seniors, policymakers are missing opportunities to actually help poor seniors in the here and now. Improvements to income security programs like Supplemental Security Income (SSI) would translate to huge improvements in millions of lives. And directly translate into rent, groceries, and prescription co-pays.

Unfortunately, instead of focusing on how programs like SSI (programs that amount to fewer homeless, sick, and hungry seniors) can be updated and improved to meet the challenge of 6.3 million seniors living in poverty today, our Congressional leadership is proposing cuts that would make things harder for all poor Americans.

$1.2 trillion in unspecified cuts to programs that seniors rely on like SSI and food stamps/SNAP are set forth in the Senate budget resolution, including at least $660 billion in cuts to income security programs. The House budget resolution similarly proposes $125 billion in cuts to food stamps/SNAP. Some have estimated that these cuts would “push 16 million people into poverty or [result in] making them more deeply poor.”

The House budget resolution also includes a section that would likely lead to a cut in Social Security Disability Insurance benefits.  A significant majority of those receiving disability insurance benefits are older adults – seven in ten beneficiaries are age 50 and older, and three in ten are age 60 and older. This part of the budget reiterates a House rule passed at the start of the current session that disallows any bill that would reallocate payroll taxes from Social Security’s retirement trust fund to its disability insurance trust fund to equalize the solvency of the two funds, unless the bill would also include some provision that would improve the financial outlook for the retirement trust fund. This requirement undermines Congress’s ability to consider fully all potential legislative solutions to address the projected shortfall in the disability insurance trust fund, expected to be depleted at the end of 2016, at which point revenue coming into the system would cover only 80% of benefits.

These benefits are a modest but vital source of income. When workers with disabilities receive disability insurance benefits, these benefits help to ensure that they don’t fall into poverty as they age into their retirement years.

All of these programs targeted in Congress’ budget resolutions were created to ensure that nobody should have to live without a home, food, or basic health care. They are our promise to those who cannot provide for themselves due to age or disability. Strengthening the social safety net—not cutting it—ensures the future we all envision for our loved ones, ourselves, and the generations to come.


Social Security Sued for Discriminating Against SSI Recipients Married to a Same Sex Spouse and Demanding Refunds of Benefits Paid

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Gay & Lesbian Advocates & Defenders (GLAD), Justice in Aging, and Foley Hoag, LLP today filed a class action lawsuit against the Social Security Administration (SSA) on behalf of Supplemental Security Income (SSI) recipients married to someone of the same sex in or before June 2013. The suit charges that SSA discriminated against these individuals for months, and in some cases more than a year, after that discrimination was held unlawful by the Supreme Court when it struck down the Defense of Marriage Act (DOMA) in June 2013.

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Justice in Aging Testifies on Importance of Social Security Disability Program at Senate Hearing

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Washington, DC – February 11, 2015. Justice in Aging Senior Staff Attorney Kate Lang testified today before the U.S. Senate Budget Committee regarding the importance of preserving Social Security disability benefits. Lang is also co-chair of the Income Security Committee of the Leadership Council of Aging Organizations (LCAO). The LCAO is a coalition of 72 national organizations representing millions of older adults. Read More

ISSUE BRIEF: SSA’s Failure to Process SSI Appeals Requests

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January 2014 — An  issue brief from the National Senior Citizens Law Center says that the Social Security Administration needs a uniform system in place to input and track appeals by Supplemental Security Income (SSI) recipients and to ensure that all requests for reconsideration are logged in upon receipt in a district office. It provides an overview of how those who have a legitimate basis for challenging benefit suspensions and reductions.

ISSUE BRIEF: Why SSI Needs An Appeal Process That Works

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September 2013 — An NSCLC issue brief, Why SSI Needs an Appeal Process That Works, provides an overview of how Supplemental Security Income (SSI) recipients are harmed when the Social Security Administration decides to stop or decrease their benefits, and they have a legitimate challenge to that decision but have no effective means of presenting their side of the case.

If SSI recipients are going to have their benefits reduced or suspended for financial or other non-medical eligibility reasons, the Social Security Administration (SSA) must notify them, and by law, they have a right to appeal the agency’s decision.

Unfortunately, SSA too often does not follow required due process safeguards in cases involving appeals to non-disability determinations. For example, they may lose the paper work, fail to continue benefits for someone even when they filed a timely appeal, and delay case reviews and conferences.

The issue brief is part of a series of reports that will reveal specific problems with the SSI non-disability appeals process.

The Fiscal Cliff Deal: What Does It Mean for Low-income Older Adults?

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The Fiscal Cliff Deal: What Does It Mean for Low-income Older Adults?

On Tuesday, January 1, 2013, by a vote of 257-167, the House of Representatives agreed to approve the Senate amendments to H.R. 8, the American Taxpayer Relief Act of 2012, also known as the “fiscal cliff deal.”  The President has agreed to sign it. The focus of the deal is the extension of the Bush-era tax cuts for most Americans; however, tucked inside the legislation are a few provisions that may impact health care for low-income older adults. These include extending the funding for low-income outreach programs, the establishment of a Commission on Long-Term Care and the extension of the Qualified Individual program and Special Needs plans.

Extension of funding for low-income outreach programs:

Congress agreed to extend funding outreach and assistance for low-income programs.[1]  The Medicare Improvements for Patients and Providers Act of 2008 and the Affordable Care Act (ACA) initiatives to provide outreach and enrollment assistance to low-income beneficiaries were set to expire on January 1.  Many aging and disability groups advocated for their extension, and the fiscal deal extended funding for the following programs in 2013:

  • State Health Insurance Programs: $7.5 million
  • Area Agencies on Aging: $7.5 million
  • Aging and Disability Resource Centers: $5 million
  • National Center for Benefits and Outreach Enrollment: $5 million

Long-term Services and Supports:

The fiscal deal repeals Community Living Assistance Services and Supports (CLASS) Act.[2]  While the Obama Administration halted implementation of the ACA provision to create a voluntary, national long-term care insurance program a year ago, the legislation officially removes CLASS from the ACA.

In a subsequent section, the deal establishes a Commission on Long-Term Care.[3]  The purpose of the Commission is to thoughtfully evaluate the current long-term services and supports (LTSS) landscape and craft a plan to establish, implement and finance a coordinated LTSS delivery system.  The deal’s creation of this Commission marks the first time Congress has committed to a comprehensive evaluation of LTSS since the Pepper Commission over twenty years ago.[4]

The 15 member Commission will provide recommendations after: 1) analyzing how LTSS currently operates in Medicare, Medicaid, and long-term care insurance, 2) exploring other health programs that interact with LTSS, and 3) examining issues related to the LTSS workforce.

The Commission will consult with MedPAC, MACPAC, the National Council on Disability and relevant consumer groups.

The following individuals will each appoint three members to serve on the commission: the President, the Senate majority leader, the Senate minority leader, the Speaker of the House and the House minority leader. The members must be appointed within one month of the day the law is enacted.  The members must represent: consumers of LTSS, older adults, individuals with cognitive and functional limitations, caregivers, the health care workforce, private long-term care insurance, employers, state insurance departments, and state Medicaid agencies.

The commission has the power to hold hearings, commission studies by the Government Accountability Office and the Congressional Budget Office and receive information and technical assistance from federal agencies.

Six months after the Commission is appointed, the Commission must vote on a comprehensive long-term care plan.  Any legislative recommendations or proposals included in the plan will become the “Commission bill.”  If a quorum of members approve the Commission bill, then ten days after its approval, the Commission will submit the bill to the President, Senate and House.  After submission, the Senate majority leader, or one of his or her designees must introduce the bill the next day the Senate is in session.   The Commission bill follows the same process in the House, as the majority leader of the House or one of his or her designees must introduce the bill on the next legislative day.

Extension of QI and SNPs

The deal extends the Qualifying Individual (QI) program through December 31, 2013.  The QI program pays Medicare Part B premiums for individuals with incomes between 120 and 135 percent of the federal poverty level and resources below $6,940 for an individual and $10, 410 for a couple.[5]  With this extension, low-income older adults who may have lost their Part B coverage due to significant out-of-pocket costs should be able to maintain coverage.

In addition, the deal extends Medicare Advantage Plans for special needs individuals (Special Needs Plans) through 2015.  This is particularly significant for the dual eligible demonstration, as there have been questions among advocates about the interaction between existing SNPs and plans selected to participate in a demonstration.

The deal still leaves many questions about the health-care future for low-income older adults unanswered.  While the deal delays the sequester for two-months, future negotiations over the sequester, spending and the debt-ceiling may signal additional changes to Medicare and Medicaid.


[1] H.R. 8, The American Taxpayer Relief Act of 2012, Section 610, Extension of Funding Outreach and Assistance for Low-Income Programs (January 1, 2013).

[2] H.R. 8, Section 642.

[3] H.R. 8, Section 643.

[4] Howard Gleckman, “Fiscal Cliff Deal Repeals CLASS Act, Creates Long-Term Care Commission,” (January 1, 2013) available at

Supplemental Security Income Program Celebrates 40th Anniversary!

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Income Support Program for 8,000,000 Poor Needs to be Strengthened

WASHINGTON DC – The National Senior Citizens Law Center celebrates the fortieth birthday of the Supplemental Security Income (SSI) program which was signed into law by Pres. Richard M. Nixon on October 30, 1972 to replace a variety of state programs providing income support for the elderly poor and people with disabilities.

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SSI Transfer Penalty: Harsh Consequences Need Attention

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In a Policy Issue Brief entitled SSI Transfer Penalty: Harsh Consequences Need Attention, NSCLC calls for repeal of the penalty due to the hardship it causes for Supplemental Security Income beneficiaries. The Foster Care Independence Act of 1999 (Pub. L. No. 106-169) increased federal expenditures for foster care. In order to make the legislation revenue neutral, Congress had to seek offsetting cuts elsewhere. One of those cuts was a provision authorizing a transfer penalty in the SSI program. It establishes a period of ineligibility when an individual transfers a resource for less than fair market value while the individual is receiving SSI or during a 36 month look-back period prior to applying for SSI. This policy is based on the unrealistic assumption that people will give away valuable property just for the opportunity to live on a subsistence income amounting, in most cases, to $674 a month. The brief was widely circulated through an Income Alert, Washington Report and with the Social Security Works coalition.