President Trump’s Fiscal Year 2027 (FY27) budget request represents an unprecedented shift in national priorities: abandoning programs that help American families afford the basic necessities of life to fund a military expansion unseen in the United States during peacetime. The President himself admitted that funding for the military is the top priority for his Administration when he stated: “It’s not possible for us to take care of…. Medicare, Medicaid. They have to do it on a state basis. All these little scams… you have to let states take care of them. We have to take care of one thing: military protection.” – President Donald Trump, April 1, 2026.
The budget requests over $1.5 trillion for defense: absent a ground war, this is the biggest annual increase in the military budget as a share of Gross Domestic Product (GDP) in the history of the United States. Even when compared with funding when the country was engaged in a ground war, the Trump budget is the largest increase for military spending in over 50 years. At the same time, the budget calls for cutting nondefense discretionary funding, which is the portion of the budget that funds most domestic programs except for Social Security, Medicare, Medicaid and the Supplemental Nutrition Assistance Program (SNAP), to its lowest levels as a percentage of GDP since at least the Eisenhower administration.
Social Security Administration (SSA)
The President’s budget essentially flat-funds the Social Security Administration’s operations budget, which would lock in historically low levels of funding for the second year in a row, despite the increased demand for services driven by the fact that over 10,000 baby boomers are reaching age 65 every day. The request for $14.87 billion for FY27 funding includes salaries for 51,820 full time staff, a reduction of almost 20 percent from 2011, the year the first members of the baby boom generation reached age 65.
Despite the rosy picture painted by SSA Commissioner Frank Bisignano, SSA has clearly not recovered from the DOGE-driven purge of the Agency’s most experienced and knowledgeable staff in 2025. The 13 percent staff cut was the largest in SSA’s history, and has forced the Agency to triage operations, moving staff from one part of SSA to another as public demands reached critical levels: some days answering phones, other days staffing field offices, with only a bare minimum of training to adequately meet the new job requirements.
As a result of the overall shortage in staff, filling holes in one critical area inevitably leaves gaps in others, and the consequences of this staff inadequacy are already being felt by consumers who continue to report alarming delays and logjams as they attempt to access their earned benefits. More than half of seniors and survivors who scheduled an appointment with an SSA field office to file an application for benefits waited more than a month until their appointment. More than 800,000 people are in a queue awaiting an initial decision on their application for disability benefits, and it will take SSA more than 6 months, on average, to make a decision – twice as long as in the past. These long waits can be particularly harmful for people of color, low-income applicants, and others who on average are less likely to have savings or other resources to fall back on. Thousands are dying while waiting for a decision on whether they are eligible for disability benefits, and many more have endured years without income, in the process often exhausting their life savings and even losing their homes.
While no field offices have officially been shuttered in the chaos, reports abound of ‘ghost’ field offices where staffing levels are low or non-existent – leaving only a hollow shell where previously a robust office operated.
The budget request assumes significant improvements in operations with no indication of how the additional workload will be handled by the already exhausted and demoralized workforce. Relying on ‘digital services’ and ‘artificial intelligence’ efficiencies to pick up the slack has proven to be unreliable at best, as the most ambitious of the Commissioner’s initiatives – to create a national, centralized system for scheduling appointments and handling cases – has been put on hold for the second time since its announcement due to inadequate planning and poor preparation. SSA apparently embarked on this massive reorganization without first determining whether it was even feasible, let alone if it would actually increase efficiency.
The American public has earned and deserves a Social Security Administration that is fully functional and meets their needs, as the Agency’s operations are almost entirely funded by the FICA contributions workers make with each and every paycheck. Denying Americans the service they have paid for is tantamount to denying them the Social Security benefits they have earned. Only a decade ago, Congress routinely allowed a customer service funding level that represented 1.2 percent of benefit outlays, an amount which allowed the Agency to provide the service the American people paid for and deserve. We believe it is imperative that Congress provide the highest possible funding for SSA in FY27, with a goal to restoring full funding to 1.2 percent of outlays.
Department of Health and Human Services (HHS)
For HHS, the Administration’s FY 2027 budget proposal argues, as did the FY 2026 budget proposal, for a significant restructuring of department, including establishing a new Administration for a Healthy America (AHA). The effect of this would be to consolidate programs in the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration, the Office of the Assistant Secretary for Health and select functions of the Centers for Disease Control and Prevention (CDC) into a single entity focused on prevention and public health. Congress has the final say on whether this restructuring will occur. Overall discretionary funding for HHS is proposed to be $111.1 billion, down 12.5 percent from enacted FY 2026 levels.
The budget as submitted is limited to programs whose funding is discretionary. It is silent on the Administration’s intentions for mandatory programs such as Medicare and Medicaid. Considering the President’s statement that the states should take over these programs, one can assume the Administration would support such a change if it were proposed. Medicaid is currently partly paid for by state governments. Medicare Part A is financed by payroll taxes and Medicare Part B is paid for with general revenue and premiums paid by beneficiaries.
Funding for the Centers for Medicare and Medicaid Services (CMS) is slated for $437 million less in the Administration’s budget request than enacted 2026 levels. In the area of oversight, the proposal includes $487 million for CMS’ survey and certification program — an increase of approximately $50 million over FY 2026 enacted levels. HHS’ Budget-in-Brief document states that the proposed increase aims to boost the frequency of inspections of health care facilities, specifically of nursing homes, home care agencies and hospice agencies. Further in accordance with the budget’s emphasis on program integrity, the Administration is proposing to increase spending by $2.8 billion in the Health Care Fraud and Abuse Control and Medicaid Integrity programs.
The Administration is again proposing to reduce CDC’s budget by $484 million, according to some analyses. But the National Association of City and County Health Officials (NACCHO) warns that “when factoring in the funds previously at the CDC that would be transferred to…AHA, the total funding reduction to existing CDC programs would be a more than 30 percent for FY27. The budget also does not allocate any funding from the Prevention and Public Health Fund, which the administration has tried to eliminate.” Research funding at the National Institutes of Health (NIH) would suffer a cut of $3.7 billion – yet the budget document asserts that this is sufficient to “support gold standard science, maintain global competitiveness and national security, and maximize the impact of NIH research on the American people.”
Discretionary Programs Affecting Older Americans
The Department of Health and Human Services’ Administration for Community Living (ACL) administers most Older Americans Act (OAA) programs, including a wide range of home and community-based services — such as home-delivered and congregate meals, in-home support, transportation, legal assistance, elder abuse prevention, and caregiver support. The Trump Administration attempted to close ACL last year and move its programs to the HHS Administration for Children and Families. However, since Congress did not approve the restructuring, ACL was not shuttered.
Despite the Act’s broad and critical mission, funding over the past two decades has not kept pace with inflation or the rapid growth of the older population, undermining program effectiveness. Unfortunately, the President’s FY 2027 budget recommendations would further erode OAA’s funding by eliminating, cutting or flat-funding its programs.
The budget proposes to end the OAA Title V Senior Community Services Employment Program (SCSEP) which promotes part-time, paid community service work for low-income, unemployed individuals aged 55 or older. SCSEP received $395 million in FY 2026. The only part of the OAA not administered by HHS is SCSEP, which is overseen by the Department of Labor.
The FY 2027 budget recommends flat-funding the following OAA programs at FY 2026 levels:
- Supportive Services and Centers: $414 million
- Congregate Meals: $ 565.342 million
- Home Delivered Meals: $381.342 million
- Nutrition Services Incentive Program (NSIP): $112 million
- Preventive Health: $26.339 million
- Family Caregiver Support: $209 million
- Grants to Native Americans: $40.264 million
- Native American Caregivers: $14 million
The President’s budget recommends that two OAA programs receive small increases:
- Ombudsman, Elder Abuse: $26.885 million, a $227,000 or 0.8 percent increase over FY 2026.
- Elder Rights Support: $34.005 million, a $130,000 or 0.3 percent increase over FY 2026.
While not part of the Older Americans Act, but administer by the ACL, the President would flat-fund, cut or eliminate the following:
- Chronic Disease Self-Management Program (CDSMP) is a direct education intervention that helps individuals and caregivers of those with chronic health conditions build a “toolbox” of strategies they can utilize to help achieve their health goals. The President’s budget would eliminate CDSMP, which received $8 million in FY 2026.
- Alzheimer’s Disease Program provides grants from ACL that support dementia-capable home and community-based services. The President’s budget would cut this program by $14.7 million or 46.6 percent from the FY 2026 enacted level for a total of $16.8 million in FY 2027.
- Elder Falls Prevention Program provides older adults (60+) and adults with disabilities access to local evidence-based programs that have been proven to reduce falls and the risk of falls. The President’s budget would cut this program by $5 million or 66.6 percent from the FY 2026 enacted level for a total of $2.5 million in FY 2027.
- State Health Insurance Assistance Program (SHIP) provides one-on-one unbiased counseling to individuals who are eligible for Medicare, including those who also are eligible for Medicaid, to help make informed decisions about health insurance and to enroll in the plans that best meet their needs. The President’s budget would flat-fund SHIP at $55.242 million in FY 2027.
- Lifespan Respite Care Program empowers coordinated state systems to provide accessible, community-based respite care services. The President’s budget would flat-fund this program at $11 million in FY 2027.
- Senior Medicare Patrols (SMPs) assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse. The President’s budget would flat-fund this program at $35 million in FY 2027.
- Community Care Corps program awards grants to local organizations to implement innovative models in which local volunteers assist older adults, people with disabilities or family caregivers with non-medical care in their own homes in order to help maintain their independence. The President’s budget did not mention this program.
Other federal government programs which serve seniors would be either eliminated or flat-funded by the President’s budget:
- Community Services Block Grant (CSBG) program, administered by the Department of Health and Human Services (HHS), provides funds to states, territories, and tribes to support services that alleviate the causes and conditions of poverty in under-resourced communities. CSBG helps to fund OAA programs. The FY 2027 budget recommends this program be eliminated. CSBG received $810.383 million in FY 2026.
- Community Development Block Grant (CDBG) program, administered by the Department of Housing and Urban Development, provides annual formula grants to states and local governments to support housing, infrastructure, and economic development, primarily for low- and moderate-income individuals. CDBG helps to fund OAA programs. The FY 2027 budget recommends this program be eliminated. CDBG received $3.3 billion in FY 2026.
- Social Services Block Grant (SSBG) program, administered by HHS, provides flexible funding to states for social services targeting low-income families, children, and the elderly, including OAA programs. The President’s budget would flat-fund this program at $1.7 billion.
- Low Income Home Energy Assistance Program (LIHEAP) provides federally funded assistance to reduce the costs associated with home energy bills, energy crises, weatherization, and minor energy-related home repairs. The FY 2027 budget recommends this program be eliminated. LIHEAP received $4.045 billion in FY 2026.
- AmeriCorps Seniors (previously known as “Seniors Corps”, administered by the Corporation for National Service, provides volunteer opportunities for people aged 55 and older in community service through three main programs: Retired and Senior Volunteer Program, Foster Grandparents Program, and Senior Companions Programs. The FY 2027 budget recommends this program be eliminated. AmeriCorps Seniors received $2.917 million in FY 2026.