Assisted Suicide Bill Going Before Court of Appeals; Assembly Won’t Act This Year

The Court of Appeals, the state’s highest court, will be hearing arguments this week in a case about whether citizens have a legal right to take their own lives through assisted suicide.    Last year, the top federal court in Canada concluded that it was a right and assisted suicide is now legal in that country.  A state court in Montana established the right there though most states that enacted assisted suicide did so either through their legislatures or through a statewide referendum.  Colorado voters approved it last fall and the California legislature approved it in 2015.

Here in New York, chances for legislative passage appear to be over with only three weeks left in the regular session of the Legislature.   Even the bill’s advocates with the organization Compassion and Choices have indicated the bill will not pass this year.  A year ago the bill passed the Assembly Health Committee by a slim margin.  However, there are several new members on the committee this  yearand  the bill has not been put on a committee agenda.  The bill’s sponsors struggled to find enough votes in the committee.

Compassion and Choices did claim progress this year, saying it doubled the number of bill sponsors.  They also were successful in getting the Medical Society of the State of New York to study the issue and discuss it with their members.  A number of physician members of the Society have been urging this approach because they oppose the Society’s position against the bill.  They are hoping to get the Society to take a neutral position.   The California Medical Society’s decision to move to a neutral position was a major factor in passage there in 2015.

The New York Alliance Against Assisted Suicide,which has included religious, disability and hospice organizations among others kept the pressure on against the bill and had the active support of some members of the Legislature.  A number of physicians, disabled activists and citizens wrote letters to the editor and opinion columns in newspapers across the state.   Many also lobbied at the Capitol as well.


Trump’s War on the Poor, Elderly and Vulnerable: Major Cuts to Senior Programs and Services

When Ronald Reagan was President he proposed to return federal funds to states as block grants with the belief that the states could better determine needs and manage the programs.  Now President Trump proposes to eliminate the Social Services Block Grant which funds adult protective services programs, the Community Services Block Grant which funds local anti-poverty programs, and the Community Development Block Grant which provides some funds for home delivered meals, and numerous other programs which benefit older persons.   I reported in a previous post that Medicaid is proposed to be cut by $800 billion over ten years.  The food stamp program (SNAP) is set for major cuts as well as Social Security Disability and SSI.

Trump also wants to do away entirely with the Low Income Home Energy Assistance Program (LIHEAP) and also eliminate the Senior Corps which has 245,000 older persons serving as volunteers, quite often for children and the disabled.  He also wants to eliminate Americorps.    Though Congress is likely to reject many of these cuts, the budget proposal is nothing more than a war on the poor, the weak and the vulnerable including  needy older persons.

The National Council of Aging’s Legislative Director Howard Bedlin has released a summary of ten major cuts impacting seniors.  He notes that many of the programs proposed for cuts have been around for decades

Here are 10 ways the Administration’s budget—if enacted—would impact senior programs:

Medicaid: Cut by $627 billion

The budget cuts Medicaid by $627 billion over 10 years. This is on top of the $839 billion proposed cut in the House of Representatives’ American Health Care Act, which would repeal and replace parts of the Affordable Care Act. Taken together, this would mean almost $1.3 trillion in Medicaid cuts over 10 years, an estimated 45% reduction in 2026. Nearly 7 million low-income seniors rely on Medicaid for their health and long-term care.

Senior Community Service Employment Program (SCSEP): Eliminated

The budget eliminates the nation’s only job training and placement program specifically for older adults. Last year under SCSEP, 70,000 older adults received on-the-job training while providing nearly 36 million hours of staff support to 30,000 organizations.

Medicare State Health Insurance Assistance Program (SHIP): Eliminated

The budget eliminates this program that each year supports 15,000+ counselors who provide free, state-specific assistance to over 6 million beneficiaries.

Low-Income Home Energy Assistance Program (LIHEAP): Eliminated

The budget eliminates this program that helps low-income individuals pay for their heating and cooling costs. About a third of the 6.8 million households receiving LIHEAP benefits include an older adult aged 60+.

Block Grants (SSBG, CSBG, CDBG): Eliminated

The budget eliminates the Social Services Block Grant (SSBG), Community Services Block Grant (CSBG), and Community Development Block Grant (CDBG). These programs provide states and localities with funding to improve economic security and independence for low-income families and seniors through services like home care, congregate and home-delivered meals, and transportation. SSBG is the only source of federal funding for Adult Protective Services. An estimated 4.4 million older adults receive services under SSBG and CSBG.

Senior Corps & AmeriCorps: Eliminated

The budget eliminates both of these national service programs that enlist older adults in volunteerism and serve seniors in communities nationwide. Last year, 245,000 Senior Corps volunteers provided 74.6 million hours of service.

Supplemental Nutrition Assistance Program (SNAP): Cut by $194 billion

Federal SNAP funding would be cut by $194 billion over 10 years. The budget also shifts more funding responsibilities to the states and erodes policies that streamline access for seniors and people with disabilities. Almost 5 million seniors rely on SNAP benefits to afford food.

CDC Falls Prevention: Eliminated

The budget eliminates $2 million in falls prevention funding in the Centers for Disease Control (CDC) budget. However, it retains $5 million in falls prevention funding in the Administration for Community Living budget. Every 19 minutes, an older adult dies from a fall; every 11 seconds an older adult is treated in an emergency room for a fall-related injury.

Chronic Disease Self-Management Education (CDSME): Cut by $3 million

The budget cuts federal funding for community-based workshops for people with chronic conditions from $8 million to $5 million, or 37.5%. Over 90% of older adults have at least one chronic disease and two-thirds have two or more.

Older Americans Act (OAA) and Elder Justice Act (EJA): Increases reversed

The budget reverses the modest FY17 increases for Supportive Services, Senior Nutrition, Caregiver Support, Native American programs, and the Elder Justice Act.

Download the NCOA  funding table for a complete list of aging services programs.

Trump Budget to Slash Medicaid, Food Stamps, Social Security Disability While Cutting Taxes for People like Him

Anybody who thinks Donald Trump is a populist fighting for the little person will find out otherwise if they read his budget which is being reported today by major media outlets.   Trump slashes programs for those in need, cutting  $1.7 trillion in human needs programs over 10 years.  Medicaid would be cut by $800 billion over ten years. That was included in the Republican health care bill.  SNAP (food stamps) will be cut by $190 over 10 years, about a 25% cut.   School lunches and housing programs would be cut.  Also, there will be cuts in Social Security disability benefits, despite Trump’s pledge not to cut Social Security.

The massive cuts which are planned would have a big impact on the poor including older persons on Medicaid in nursing homes and using long term care services.   States would be forced to make those cuts in Medicaid.   Robert Greenstein of the Center on Budget and Policy Priorities calls it a “reverse Robin Hood” budget proposal.

There will also likely be large cuts in aging services programs since the Department of Health and Human Services was targeted for budget cuts of $17 billion in his budget outline released earlier this year.  At the same time as the budget cuts are proposed, President Trump and Republicans in Congress are pushing for massive tax cuts that will benefit him and the wealthy along with big increases in military spending.  The budget does include a federal paid family leave program which Ivanka Trump has been pushing.

The same strong advocacy directed at the bill to repeal and replace the Affordable Care Act now must be directed at the federal budget.   Some Republicans in Congress are opposing the Medicaid cuts and will likely oppose other cuts but it will be necessary to show the personal impact that cuts would have on different people.


US Senate Passage of House Bill Unlikely

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Despite the euphoria of House Republicans who supported the narrow victory of their health bill yesterday, 217-213, there is little chance a bill like it will pass the United States Senate.  The Senate may pass its own bill but it is likely to be dramatically different from the House version.  Then, it would have to go to  a conference committee for compromises which would probably be unacceptable to conservative Freedom Caucus in the House.

The House bill would be a disaster, causing at least 24 million to lose health insurance because the bill reduce subsidies to those most in need.  That was the estimate of the Congressional Budget Office of the previous version of the bill before it was made worse by provisions allowing states to opt out of requirements that insurance had to not discriminate against those with pre-existing conditions.  In addition, the bill will end Medicaid as a federal entitlement program in 2020 and turn it into a block grant to the states, cutting $880 billion.  Taxes in the Affordable Care Act for higher income Medicare beneficiaries would also be cut in the House bill, causing the long term health of Medicare to be decreased, moving the date forward by over three years to 2024 when the Trust Fund for Medicare couldn’t pay full benefits.

All New York Democrats voted against the bill with only Republicans John Katko and Dan Donovan voting against it.  The other seven Republicans in the state voted for it.   The issue is likely to be the centerpiece of the battle for control of the House of Representatives in 2018 and Republicans chances of holding it may be more endangered now.  Historic averages of losses for the first midterm of a party that controls the White House and the House and Senate is 35 seats.  Republicans would lose control of the House if they lost 23 seats.