As details about the President’s proposed Fiscal Year (FY 2018) budget have emerged, concerns about how the needs of families – particularly those facing the greatest barriers to opportunity – will be met in an equitable and effective manner have intensified. When the President’s proposed “skinny” budget was released in March with limited details, it was clear that the health and well-being of children and families were at-risk. Now, the full version of the proposed budget, “A New Foundation for American Greatness,” makes it even more apparent that the cuts proposed by the President would increase the challenges facing families who experience poverty, food insecurity, homelessness and other forms of compounding disadvantage – disproportionately children and families of color.
The President’s proposed budget ignores key opportunities to advance equity and instead dramatically cuts – or eliminates entirely – funding for a number of essential safety net programs. All Americans lose in this budget proposal – only a small handful of wealthy households would stand to gain – but the budget is merciless in its treatment of low-income families. Overall, $1.7 trillion would be cut from mandatory domestic spending over 10 years. These devastating cuts are directed at programs that are vital pieces of the social safety net for families with low incomes, including $616 billion from Medicaid and the Children’s Health Insurance Program (CHIP), $21 billion from Temporary Assistance to Needy Families (TANF), $40 billion from the Earned Income Tax Credit (EITC) and Child Tax Credit, $72 billion from programs that support people with disabilities, and $193 billion from the Supplemental Nutrition Assistance Program (SNAP). These programs provide crucial supports to families seeking pathways out of poverty and can mitigate the effects of poverty on children and youth as they grow and develop. The proposed cuts are targeted directly at families experiencing poverty, families of color and immigrant families, moving the budget in a direction that worsens inequities.
The threats posed to families by the President’s dangerous proposals are significant and far-reaching. Specifically, cuts to Medicaid, CHIP and SNAP will negatively impact the health and well-being of children and families and signal l a clear attack by the Administration on children and families, reducing access to and affordability of critical health services, increasing food insecurity and ultimately contributing to poorer outcomes for families. These cuts are particularly significant for children and families of color who, due to compounding effects of disadvantage, face greater threats to their health than white children and families.
Cuts to Medicaid: The President’s devastating proposal to eliminate $610 billion from Medicaid over the next 10 years – in addition to the estimated $800 billion that would be eliminated from the program under the American Health Care Act (AHCA) – would shred an integral piece of America’s health care safety net. Medicaid serves as the primary source of health insurance for Americans with low-incomes, covering nearly 70 million people, over half of whom are children. The Affordable Care Act (ACA) expanded access to Medicaid to nonelderly adults with low-incomes, further improving health care access and affordability for families experiencing poverty in the 31 states and District of Columbia that implemented this option.
Medicaid access has been particularly important for children of color given that it has, in coordination with CHIP, covered 54 percent of black children and 52 percent of Hispanic children in 2014, as well as 25 percent of Asian children and 26 percent of white children. Medicaid has reduced racial and ethnic disparities in access to primary and preventive care, which is crucial to closing gaps in health and developmental outcomes for children of color.
Medicaid has reduced racial and ethnic disparities in access to primary and preventive care, which is crucial to closing gaps in health and developmental outcomes for children of color.
The proposed Medicaid cuts would also be disastrous for children and families involved with child welfare systems, who depend on health care coverage and access to supports and services funded through Medicaid. A strong Medicaid program is critical for these young people as children and youth placed in foster care typically have more complex health care needs than their non-foster care peers.
Cuts to CHIP: The President proposes reducing funding for the Children’s Health Insurance Program (CHIP) – which insures 5.6 million children – by at least 20 percent over the next two fiscal years, directly impacting the health of children across the country. Cuts would be achieved by eliminating an element of the ACA that increased by 23 percent the portion of the program’s costs that is paid for with federal money. This would greatly increase the burden upon states to fund CHIP at the same time that they are also being asked to pick up a greater portion of the costs for SNAP and Medicaid. Currently CHIP and Medicaid work together to ensure that children receive the health care they need, promoting healthy development. CHIP also effectively reduces disparities in coverage and health outcomes for young children of color.
The budget proposal would add additional eligibility restrictions to CHIP, creating a coverage gap for families with slightly higher incomes who nevertheless may not be able to afford health coverage for their children, particularly in high-cost regions. Federal funding would no longer be available to help cover children from families with incomes of more than 250 percent of the federal poverty level. Currently, 18 states and the District of Columbia allow families with incomes higher than 300 percent of the poverty line to access CHIP, according to data from the Kaiser Family Foundation. These families would all be at risk of losing health care coverage for their children, including access to preventive care.
Cuts to SNAP: The President’s proposed $193 billion reduction in spending for SNAP – equal to more than 25 percent of the program’s budget – will lead to higher rates of hunger and food insecurity, and poorer health for children and families. Food insecurity, or a lack of consistent access to enough, nutritious food, is a serious threat to the health and well-being of over 42 million people across the country and disproportionately affects families of color, households headed by a single woman, households with young children and those who identify as LGBT. SNAP is currently serves one of the nation’s most effective public health and anti-poverty tools, offering nutrition assistance to 42 million families of every description.
The President’s budget would restrict eligibility for the program, impose work requirements beyond those already in place, and requiring states to begin matching 25 percent of the benefits their residents receive by 2023. SNAP has been an effective program for decades because of its flexible structure as a federally-funded entitlement that allows SNAP to respond to sudden changes in need, including spikes in unemployment and natural disasters. Shifting cost burdens to the states will dissuade states from ensuring all families who need SNAP benefits receive them. Furthermore, the U.S. Department of Agriculture reports that only about 14 percent of SNAP participants who are assumed to be able to work are unemployed, making the imposition of additional, redundant work requirements unnecessary, ineffective and burdensome for states to implement. The ultimate impact of these additional restrictions will be to discourage eligible households from participating in SNAP when they experience food insecurity, to the detriment of the health and well-being of children, youth and families across the nation.
SNAP has been an effective program for decades because of its flexible structure as a federally-funded entitlement that allows SNAP to respond to sudden changes in need, including spikes in unemployment and natural disasters.
Nutrition supports are also critical for youth who are seeking to gain stability as they move into adulthood, including youth aging out of foster care, who are significantly more likely to experience poverty, homelessness and food insecurity as they transition into adulthood without the same degree of support from family members that many of their peers have. Food insecurity at these pivotal points can contribute to poorer outcomes in health and education for young children and youth. Because food insecurity disproportionately impacts families of color, reducing federal supports for families experiencing food insecurity will also ultimately deepen inequity across the nation.
The President’s proposed FY 2018 budget is alarming in its disregard for the struggles of our country’s low-income families, and will likely lead to greater disparities for children and families of color. The proposed budget offers important insight into the Administration’s policy priorities signaling a lack of concern with the health and well-being of children and families and a disregard for equity. CSSP is redoubling its commitment to meeting the needs of families facing the most significant barriers, including families of color and others who on a daily basis experience inequitable access to opportunities for health and economic stability. We will continue to monitor appropriations activities, uplift any negative impacts on children and families, and bring to light the ripple effects federal budget proposals will have in state and local budgets.