When you can’t budge it

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The Trump administration issued a preliminary “skinny” budget proposal a few months ago, followed more recently by its official 2018 budget request to Congress.

Of the many draconian cuts the budget would impose, I want to talk about two that would particularly affect older Americans were they to go into effect. 

These aren’t by any means the largest cuts, or even the cuts that would harm the greatest number of people. But they are significant all the same, and worth some discussion.

In the budget of the Administration for Community Living (a division of the Department of Health and Human Services formerly known as the Administration on Aging, before it was merged with the Office on Disability), only one program is zeroed out:  the State Health Insurance Assistance Program, commonly called SHIP.

This program operates throughout the country. Using trained volunteers — who are, themselves, older adults — it provides Medicare beneficiaries with individualized assistance concerning the intricacies of Medicare, prescription drug coverage, medigap policies and long-term care insurance.

The free, confidential service also assists older adults with appeals of insurance denials and with cases of healthcare fraud or abuse.

SHIP costs the federal government about $50 million annually to train and manage the volunteer counselors. In a $3,650,000,000,000 ($3.65 trillion) budget, $50 million represents less than .0014% of the total. It is, as some say, not even a rounding error.

But with this relatively negligible amount of money, the program leverages the intellectual abilities and devotion of more than 15,000 older adult volunteers, enabling them to assist more than 6 million Medicare beneficiaries each year.

Does it not seem to be shortsighted in the extreme to zero out a program that does so much good for so little cost?

I have a similar beef about another worthwhile program, this one slated to be zeroed out in the Department of Labor budget. Called the Senior Community Service Employment Program (SCSEP), it’s the federal government’s only job training and placement program aimed at older Americans.

The program places unemployed, low-income older adults in part-time, on-the-job training positions in nonprofit, government and faith-based organizations, where they earn a minimum wage salary paid for by SCSEP. The workers gain a variety of valuable skills, and are expected to find unsubsidized employment after a limited time in the program.

Last year, about 70,000 older adults participated, training at more than 21,000 organizations, where they provided nearly 36 million hours of support. Nearly half of each year’s participants find gainful employment soon after their SCSEP stint.

This program is more costly than SHIP: Its annual budget has been around $400 million a year (averaging about $5,700 per person).

But that amount enables tens of thousands of low-income adults, who presumably qualify for other aid, to “get off the  dole,” earn a livelihood for the foreseeable future, and probably spend every dime of what they earn, boosting their local economy.

There are many other worthwhile programs similarly targeted for complete or partial elimination in the president’s budget request. Many dwarf these two programs.

But I focus on these two because they seem to be such good examples of targeted, effective programs that leverage relatively small expenditures into significant benefits.

The administration’s budget request is really just that: It tells Congress what the president wants to see happen. But Congress holds the power of the purse, and it will decide on the final budget. I don’t think any observers expect all of the Trump cuts to be approved.

Still, if you would like to see programs like these retained, now is the time to speak to your congressional representatives. Truly, every constituent’s comment is important. Few people ever take the time to call, write or email their representatives, so the few that do tend to have an outsize impact. I urge you to take action.

Before I close, however, I ask you to join me in a thought experiment. Imagine that our efforts fall on deaf ears, and these two programs are zeroed out of the final budget.

What happens next year? Do the 15,000 experienced SHIP counselors just find something else to do with their time? Do the 21,000 nonprofits that received 36 million hours of help from competent older adults just downsize their programs or dump more work on their already overworked employees?

Can we not imagine that the ingenuity and drive of all these people could be harnessed to continue providing such worthwhile services without the relatively modest contributions of our federal government?

I’d like to think a few of those highly-trained SHIP volunteers could find a way to manage the program, keeping their fellow volunteer counselors on the job.

Or perhaps the excellent local SHIP managers who have hitherto been paid through the federal grant could do some of their own fundraising, and task other SHIP workers with helping to raise the rest of the money necessary to keep their local programs running. 

And maybe the nonprofits who need the help could find a way to continue offering on-the-job training to low-income adults.

And maybe the adults who need that training — and have a 50/50 chance of finding paid employment after completing it — could find a way to get to those offices for a few months even without the minimum wage they would have been paid under SCSEP.

Don’t get me wrong. I think these programs should continue to be federally funded. They accomplish a great deal with a small investment.

And most of the larger programs that face huge cuts — like the $700 million cut from the National Institute on Aging’s research budget, or the $3.3 billion cut from the Low-Income Home Energy Assistance Program — could not continue to do what they do without federal assistance.

But I would like to think that the programs that leverage small dollar investments into huge benefits through the efforts of older workers and volunteers could continue to operate, thanks to the ingenuity and abilities of those very people.

In the meantime, write your representatives! These and many other worthwhile programs targeted for extinction are depending on it.