Gayle Meyers doesn't fit the stereotype of a poor person, but the developmentally disabled woman from Buffalo has lived for years on Social Security disability payments, with Medicaid to take care of her health needs.
In other words, she's lived her adult life with the aid of programs that President Trump's fiscal 2018 budget, released Tuesday, would cut.
"I would not be happy at all" in the unlikely event that Trump's budget cuts make their way through Congress, said Meyers, 65.
She is not alone.
Trump's budget, released in full detail, proposes unprecedented cuts in the social safety net that would likely prove especially costly in cities such as Buffalo, which for years has ranked among the nation's 10 poorest large cities.
For example, Trump's budget calls for:
- Cutting more than $600 billion from Medicaid, the health care program for the poor that New York expanded, with the federal government's help, to serve people just above the poverty line.
- Cutting the food stamp program – which serves more than 150,000 people in Erie County alone – by 29 percent.
- Trimming Temporary Assistance to Needy Families, otherwise known as welfare, by 13 percent.
- Tightening eligibility requirements for Social Security disability payments and Supplemental Security Income, programs that have grown as traditional welfare has shrunk.
- Eliminating the Low Income Home Energy Assistance Program, which serve 105,000 families in Erie and Niagara counties.
- Trimming money for public housing by 17 percent.
It's enough to leave agencies that serve the poor feeling shell-shocked.
"I think it's catastrophic," said Amy Jakiel, senior day supervisor for a People Inc. facility on Delaware Avenue, where Meyers goes for arts programming several days a week. "Every single person we serve relies on these programs to maintain their quality of life."
Accounting for taxpayers
But the Trump administration has a different take on those programs.
"We are not kicking anybody off of any program who really needs it," Budget Director Mick Mulvaney said Tuesday. "We have plenty of money in this country to take care of the people who need help, OK? And we will do that. We don't have enough money to take care of people, everybody who doesn’t need help."
The $4.1 trillion spending plan, called "The New Foundation for American Greatness," differs from earlier federal budgets in one big way, Mulvaney said. The budget takes taxpayers into account as much as it considers the effect of federal benefits on those who receive them.
Asked if that approach was compassionate, Mulvaney said: "Compassion needs to be on both sides of that equation. Yes, you have to have compassion for folks who are receiving the federal funds, but also you have to have compassion for the folks who are paying it. And that is one of the things that is new about this President’s budget."
Trump's fellow Republicans – who control the levers on Capitol Hill – don't wholeheartedly agree with every part of Trump's budget, however.
Rep. Chris Collins, a Clarence Republican and close Trump ally, praised the president for releasing a spending plan that aims to result in a balanced budget in 10 years while also cutting taxes. But he also took issue with Trump's proposed funding cuts to the National Institutes of Health and a number of other programs.
"Congress will have a vital say in this budget process and my top priority is always about fighting for my constituents," Collins said. "I am committed to protecting programs like NIH funding, Community Development Block Grants, Meals on Wheels, Great Lakes funding, among others, that play an important role in strengthening our community."
While Trump proposed cutting those programs months ago, the full budget plan offers more specific details about his cuts in anti-poverty programs.
Rep. Tom Reed, R-Corning, said he is concerned about some of those, too.
"As you deal with a lot of the lines in the federal budget, obviously, a lot of them are geared toward the lower-income, more poverty side of the equation, and rightly so," Reed said. "Those are people that are dealing with life's curveballs. They're in a position to need assistance, and I will stand with those types of programs."
At the same time, he said Congress should take a close look at anti-poverty programs because "the American taxpayer is tapped out." The best way to do that, Reed said, would be to review each program's efficiency and effectiveness before cutting them.
'Brazen broken promise'
Meantime, the most powerful Democrat in Washington – Senate Minority Leader Charles E. Schumer of New York – vowed to stand in the way of Trump's most draconian budget cuts.
"The Trump budget is one giant, brazen broken promise to the working men and women of America. It completely abandons them," Schumer said Tuesday. "Fundamentally, this is a deeply unserious proposal that should be roundly rejected by both parties here in Congress. I’m optimistic that that’s what will happen."
Most notably, Trump's budget includes a 17 percent cut over 10 years in Medicaid, which provides health care for around 200,000 people in Erie County alone.
The Trump budget cut largely duplicates the Medicaid reform in the health reform bill recently passed in the House.
Bill Hammond, health policy director for the Empire Center, a conservative-leaning Albany think tank, said it appears that those cuts would largely affect more middle-income people who were added to the state's Medicaid program under Obamacare, rather than the poorest of the poor. What's more, those cuts are not supposed to take full effect until 2020.
Others worry, though, about the cumulative effect the president's proposed the Medicaid cuts would have, along with more immediate cuts in other social programs. For example, the budget calls for cutting funding for the Children's Health Insurance Program – which covers more than 9,000 children in Erie County, by 19 percent over a decade, and the trimming would begin with the start of the fiscal year on Oct. 1.
Similarly, the deep cuts to welfare and food stamps would begin in October as well.
Together, the cuts could make some poorer even poorer in one of the nation's poorest cities, said Erie County Executive Mark C. Poloncarz.
"Many of these cuts would be devastating to the people who can least afford to deal with them," Poloncarz said.
Like Gayle Meyers, many poor people receive help from several different programs at once – and if all are cut simultaneously, it's not just the poor who will suffer, but also the institutions that serve them.
For example, People Inc. – which serves 12,000 developmentally disabled persons in Western New York – gets 90 percent of its funding from Medicaid, and many other social service nonprofits similarly rely on federal funds.
For that reason, such agencies statewide plan to band together to oppose the Trump budget, said Kevin Horrigan, associate vice president for public affairs at People Inc.
"What we have to do is prevent this from happening," Horrigan said.
In that fight, People Inc. will have an ally in the state's hospitals. Emergency rooms can expect a wave of newly uninsured, lower-income clients who have no other way to get health care, said Bea Grause, president of the Healthcare Association of New York State. And for hospitals, that cost burden would come on top of expected cuts in Medicaid reimbursements.
"We get double-dinged here," Grause said.
Buffalo gets double-dinged in another way, too. Rep. Brian Higgins, D-Buffalo, noted that the cuts in anti-poverty programs in Trump's budget are matched by similar cuts in National Institutes of Health funding – which would hurt the Buffalo Niagara Medical Campus – as well as cuts in infrastructure spending and the elimination of the Community Development Grant and the Great Lakes Restoration Initiative.
"Buffalo is hit hard, and it's a comprehensive hit, over a lot of programs that are important to Buffalo and its continued growth," Higgins said.
Mayor Byron W. Brown agreed, noting the Trump budget would hurt both the city and its residents.
"We would continue to grow, but this would dramatically slow the progress," Brown said.