BOISE, Idaho - The Trump administration released its proposal to balance the country's budget over the next decade on Tuesday, and says it will require large cuts to domestic programs to do it.
More than $800 billion would be slashed from Medicaid by 2027.
Lauren Necochea, director of Idaho Voices for Children, said the math doesn't add up for children from lower-income families, who would see large cuts to their health-care coverage.
"When we talk about cuts to Medicaid, we're talking about cuts to children's health coverage, because in Idaho, about 75 percent of the Medicaid enrollees are children," Necochea said. "The Trump budget cuts even more deeply than the American Health Care Act, and also makes cuts to the Children's Health Insurance Program."
The Children's Health Insurance Program (CHIP) would see a 20 percent reduction in funds next year. CHIP serves more than 5.5 million children nationwide.
Presidential budgets are mostly recommendations, laying out an administration's priorities. They don't set spending in stone; it's up to Congress to pass a final budget.
The White House proposal also includes a paid family-leave program, giving new parents up to six weeks of paid time off. Necochea agreed that family leave would help parents - but pointed to other ways the administration looks to save money, such as cutting $193 billion from the Supplemental Nutritional Assistance Program, or food stamps, over the decade.
"It's great to start a conversation about family leave," she said, "but this comes in the context of a proposal that dramatically reduces family economic stability."
If enacted, Necochea said, the proposal would shift many costs to the states. She said she isn't sure Idaho could pick up the bill for all the cuts at once.
The budget proposal is online at whitehouse.gov.
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A new report showed more than 100,000 eligible Virginians 65 and older are not enrolled in the Supplemental Nutrition Assistance Program.
With senior participation rates at just 37.4%, advocates are calling for urgent action, particularly during Hunger Action Month.
Cassie Edner, public benefits attorney and director of Virginia Hunger Solutions at the Virginia Poverty Law Center, explained several factors contribute to the low enrollment, according to the report by the National Council on Aging and the Urban Institute. She noted a general lack of awareness and the complexity of applying for benefits in the Commonwealth may be key barriers for many, regardless of eligibility.
"It just could be too low," Edner acknowledged. "We often hear of people that say, hey, this isn't worth going through the hoops that we have to go through in order to receive just $23 per month."
Despite progress made with programs such as the Elderly Simplified Application Project, which streamlines the process for seniors without earned income, Edner emphasized more must be done to reach the most vulnerable populations. The Virginia Food Access Coalition and the Federation of Virginia Food Banks are partnering with the coalition to urge legislators to reduce administrative barriers to SNAP participation.
Edner and other advocates are urging policymakers to raise the minimum SNAP benefit for seniors to $50 per month and simplify the application process. In the meantime, the center operates a hotline to assist seniors in navigating the benefits process. She said many seniors are unaware of deductions to help increase their minimum benefit.
"You just need more than $35 in medical expenses for seniors and individuals with disability to get a $200 deduction for medical expenses, and we often see this not used often," Edner observed. "In some of the state, it may be difficult to receive information about SNAP."
Edner suggested mailing issues could be a factor, as the report shows the lowest SNAP enrollment rates are in Southeast and Northern Virginia, with fewer than one in four eligible seniors receiving benefits in York County and Poquoson City.
The U.S. Department of Agriculture's 2023 Household Food Security Report revealed 13.5% of U.S. households, 18 million in total, experienced food insecurity last year. In Virginia, 10% of the population faced food insecurity between 2021 and 2023.
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Last year's Medicaid expansion in South Dakota increased eligibility to another 51,000 adults but a new report showed among people across the state who qualify, only 39% are enrolled.
Groups likely to be uninsured include young adults and American Indian young adults. About half of those who are uninsured now qualify for Medicaid benefits.
Xanna Burg, director of South Dakota Kids Count, said low enrollment rates are, in part, due to timing. She explained the expansion was rolling out just as states were ending the federal requirement which kept everyone on Medicaid covered during the pandemic.
"I think having those happen in tandem hurt the ability to really do this significant outreach to eligible populations," Burg observed. "Because you're trying to deliver one message saying, 'We've expanded eligibility,' and then there's this other message that's saying, 'You need to, like, re-enroll.'"
Matt Althoff, secretary of social services, has said some people who were disenrolled are making more income and no longer qualify and this should be celebrated. The expansion actually increased the income level for households to qualify, from just over $14,000 a year for a family of four, to about $43,000.
Burg noted one challenge for enrollment is, the information helping to determine eligibility is housed under different programs in the state. She argued more communication could boost the numbers.
"Thinking about where programs can talk to each other, whether it's through SNAP or WIC or the Free and Reduced Price Lunch Program," Burg suggested. "Working across agencies to really identify these populations that might be eligible."
State officials said it could take up to two years to reach full enrollment.
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Members of the U.S. House Work and Welfare Subcommittee came to Illinois this month to drum up support for work requirements for anyone seeking public assistance.
U.S. Rep. Darin LaHood, R-Peoria, and U.S. Rep. Danny Davis, D-Chicago, held a field hearing on what they called the "Dignity of Work," stressing the importance of employment as a solution to lift people out of poverty.
Nearly 12% of Illinois residents live below the federal poverty line - LaHood said at the hearing that teamwork is needed to help more of them find jobs.
"Whether it's through churches, nonprofits, private foundations or government programs," said LaHood, "when providing relief and assistance to those in need, we should be exploring every possibility to promote work as the surest pathway out of poverty."
But the Center on Budget and Policy Priorities points out that most working-age adults who receive assistance like Medicaid or SNAP are already working - their jobs don't pay enough to meet basic household expenses.
Others are dealing with child care or elder care, have health issues, or are between jobs and need assistance only temporarily.
Testimony at the hearing included multiple examples of people who were able to become self-sustaining with help from the federal programs.
Kristy Schofield, now the director of Homeless and Housing at Dream Center Peoria, said she was a single mother of two and living in her car before reaching out for help.
She said these programs are a godsend for someone who has lost hope.
"These programs give our guests an opportunity to work - and with that, accomplish and achieve," said Schofield, "thereby gaining that self-esteem and belief in themselves, and lowering the chance that they will live in poverty."
Congressman LaHood said, "Tying federal benefits to the expectation of work is not a punishment."
He cited an Axios-Ipsos poll out last year that found growing support for making people look for work if they want public assistance - including 80% of Republicans, 66% of Independents, and 49% of Democrats.
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