This column contains corrections.
President Donald Trump’s hateful rhetoric about people with disabilities during the presidential campaign is no longer just words. Now his budget threatens to set disability rights and inclusion back 50 years or more by stripping away critical protections and slashing vital programs that ensure basic living standards for the 1 in 5 Americans with disabilities. Meanwhile, despite media reports to the contrary, his budget breaks one of his core campaign promises: not to cut Social Security.
President Trump’s budget proposal would be especially damaging to veterans and people living in rural areas, who are especially likely to be disabled. What’s more, his budget proposals would disproportionately harm the very areas that shifted toward Trump during the 2016 election. New analysis from the Center for American Progress reveals that in counties that shifted most heavily toward Trump in 2016—where he performed at least 15 percentage points better than Mitt Romney in 2012—the share of people who report having a disability is 28 percent higher than the national average.
Here is how President Trump’s budget would harm people with disabilities.
State and congressional district data
The nation’s Social Security system supports people in a variety of circumstances, including workers who are retired, surviving widows and children, and workers who become disabled. Despite what President Trump and White House Budget Director Mick Mulvaney may claim, there is no such thing as “core Social Security.” Cutting any part of the program is a cut to Social Security and represents a betrayal of one of Trump’s central campaign promises.
President Trump’s budget breaks that promise by proposing cuts of $72 billion over the next decade, largely by targeting Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Notably, under the guise of encouraging work, Trump’s budget would make it harder for workers with disabilities to access the benefits they need by adding more red tape to an already difficult eligibility determination process.
Trump also proposes reducing SSI benefits for families that include multiple people with disabilities, thereby threatening to push people with disabilities and their families deeper into poverty and economic uncertainty. This new family penalty could affect more than 1 million households receiving SSI, including roughly 331,000 multirecipient households with at least one child receiving SSI.* Indeed, households with multiple children with disabilities are significantly more likely to live in poverty and experience material hardship—such food insecurity, housing precarity, and lack of access to health care. Rural areas would be particularly hard hit by Trump’s proposed cuts because they have higher rates of disability.
President Trump’s drastic budget cuts to housing programs would be particularly harmful for people with disabilities, who are especially likely to struggle with finding affordable housing. In addition to other proposed cuts to affordable housing programs, Trump’s budget also targets the U.S. Department of Housing and Urban Development’s Section 811 program—which boosts the supply of affordable, accessible housing for people with disabilities—with a staggering 20 percent cut from the funding provided in fiscal year 2016. This could eliminate 6,855 units of affordable housing and mean institutionalization for people with disabilities who are currently able to live independently.
In Ohio, this could translate to roughly 340 fewer available units. In Pennsylvania, nearly 260 units could be eliminated due to these proposed cuts. These estimates are available for all states here.
President Trump’s budget would cut more than $1.4 trillion from federal Medicaid funding over 10 years. These cuts include the $839 billion in Medicaid cuts over 10 years contained in the American Health Care Act (AHCA), which the House of Representatives recently passed, along with an additional $610 billion in cuts. In 2027, Medicaid funding would be cut roughly in half at a time when it is projected to cover 87 million people. Slashing Medicaid would force states to eliminate people’s health insurance coverage or reduce vital services, either of which would be disastrous for people with disabilities.
As a result of these harsh cuts, tens of millions of people would lose coverage. The AHCA alone would eliminate Medicaid coverage for 14 million Americans by 2025. The AHCA’s Medicaid cuts could take coverage from 720,000 nonelderly people with disabilities, according to estimates from the Center for American Progress based on the last available Congressional Budget Office score of the AHCA. These estimates are available by state and congressional district. If access to home- and community-based services are slashed, people with disabilities could be driven from their homes and forced into institutions, tearing families and communities apart.
The more than 15 million people with disabilities, including children and seniors, who rely on Medicaid are at risk under Trump’s plan—and some communities are particularly threatened. More than 43 percent of people with disabilities who have health coverage through Medicaid are people of color, thus cutting Medicaid would disproportionately harm this community. Medicaid is especially important for people with disabilities in 11 states—California, Connecticut, Kentucky, Maine, Massachusetts, Michigan, New Mexico, New York, Rhode Island, Vermont, and West Virginia—and the District of Columbia. In these places, Medicaid covers more than 40 percent of people with disabilities.
President Trump’s budget contains a 29 percent cut over 10 years to the Supplemental Nutrition Assistance Program (SNAP), the nation’s largest nutrition assistance program. More than 620,000 households that include someone with a disability would lose their benefit in 2018—and nearly 2.6 million in 2027—if this cut is implemented by taking families off SNAP.**
Furthermore, Trump’s budget would dramatically reduce federal funding for several programs that serve seniors—people who are about three times as likely as working-age individuals to have a disability. This includes the Meals on Wheels program, which delivers meals to the homes of elderly Americans, a large share of whom are homebound.
Households that include someone with a disability would be especially hard hit by these cuts as they experience food insecurity at about twice the rate of nondisabled households—in part because they tend to face higher unemployment rates, lower wages and incomes, and higher costs, including medical expenses. For this reason, households that include someone with a disability must turn to nutrition assistance programs at greater rates to help put food on the table. In 2013, 1 in 5 households that participated SNAP—4.6 million households—included at least one nonelderly member with a disability. Cuts to nutrition assistance would throw thousands of households that include someone with a disability into—or deeper into—poverty and financial hardship, while increasing hunger and undermining health.
Trump’s proposed cuts would also disproportionately affect rural areas, hurting both families and rural economies, as rural Americans are more likely to receive nutrition assistance than their nonrural counterparts. Additionally, reducing funds for programs that assist elderly Americans would not only exacerbate existing health problems, it would also be penny-wise but pound-foolish since these programs have been shown to help seniors age in their homes, saving significant taxpayer costs on assisted-living facilities.
For state and congressional district estimates of SNAP cuts for households that include someone with a disability, see here.**
President Trump’s budget includes particularly cruel cuts to some key supports for people with disabilities. He would eliminate the Limb Loss Resource Center, which supports the roughly 2 million adults living with limb loss, and the Paralysis Resource Center, which supports the 6 million Americans living with paralysis. Trump’s budget would slash a program that supports people with traumatic brain injuries by 67 percent compared with FY 2016 funding levels. He would eliminate a maternal and child health program focused improving research on and screening for autism and other developmental disorders. The budget would also cut 26 percent of funding for the Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities, despite the fact that a baby is born with a birth defect every four and a half minutes in the United States. The Trump budget would even eliminate the Special Olympics education program.
The president’s budget paints a target on the backs of people with disabilities and their families and breaks Trump’s promises not to cut Social Security—and to fight for those who have been left behind. Rather than slashing programs and services that enable people with disabilities to maintain basic living standards, President Trump and his colleagues in Congress should work to strengthen them by increasing access to health care and caregiving services, improving job training and educational options, and adequately funding housing and nutrition services to guarantee that people with disabilities have a fair shot.
Katherine Gallagher Robbins is the director of family policy for the Poverty to Prosperity Program at the Center for American Progress. Harry Stein is the Center’s director of fiscal policy. Jackie Odum is a research associate for the Poverty to Prosperity Program and Michela Zonta is a senior policy analyst for the Housing and Consumer Finance Policy team. Rachel West is an associate director for the Poverty to Prosperity Program.
* Correction, May 25, 2017: This article incorrectly stated the number of multirecipient SSI households with children who receive SSI that could be affected by the new SSI family penalty. The correct number is 331,000 multirecipient households with at least one child receiving SSI.
**Correction, August 11, 2017: Nutrition assistance estimates in this article as well as the spreadsheet “Nutrition assistance cut by state and congressional district” have been corrected to be based on Congressional Budget Office projections of SNAP enrollment between 2016 and 2027.