Every American is affected by who serves as president, but experts expect Donald Trump's presidency to have an especially big impact on older citizens. More than 46 million Americans are 65 or older. That's 14.5 percent of the U.S. population, or one in seven people, according to the Census Bureau. Based on campaign promises and other public statements, here's how seniors' lives could change with Trump in the White House.
Trump promised tax cuts throughout his campaign, and with Republicans controlling the House and Senate, massive, across-the-board cuts are almost certainly on the horizon. Like all taxpayers, seniors could benefit from this, at least in the short term -- especially those nearing the end of their earning years. The larger impact, however, will likely be felt in the ways Congress decides to pay for those tax cuts.
Already under pressure for at least a decade, the Older Americans Act is likely to be in the crosshairs when it comes time to pay for sweeping tax cuts in a country with a growing population dominated by aging baby boomers. Enacted in 1965, the act supports a range of services designed to improve the lives of senior citizens. Among the most important is Meals on Wheels, a nutrition program that targets the increasing population of elderly, frail Americans who are no longer self-reliant.
Repealing the federal estate tax, dubbed the "death tax" by many Republicans, has long been a priority for the GOP. Trump has vowed to eliminate the measure, which taxes inheritances over $5.45 million for individuals and $10.9 million for couples. Democrats say a repeal would benefit only the super-rich. Republicans argue it's a burden for farmers and small-business owners who want to pass businesses on to their children. Either way, it's likely to go, and its repeal would affect how much money and property a small minority of seniors can pass on to their heirs.
More than 4.6 million low-income senior citizens get at least part of their medical care through the Medicaid program. The federal government paid about 63 percent and the states paid 37 percent of Medicaid costs in fiscal 2015, according to the Kaiser Family Foundation. Republicans want to shift that responsibility -- and control over who can get it and how -- in favor of the states, a move for which Trump has stated support. To compensate for the reductions in federal funding, states would be able to force non-disabled adult recipients to work, seek work, or train for work. States also may choose to charge premiums or copays, now the rare exception for Medicaid recipients.
AFFORDABLE CARE ACT
Repealing the Affordable Care Act, President Barack Obama's signature health care legislation, has been a priority for Republicans since its inception. Trump has unambiguously stated his support for immediate repeal. Millions of seniors are covered under Obamacare, as the act is known, through its expansion of Medicare and the Part D prescription drug program. Medicare Part D closed the so-called "doughnut hole" that exposed many seniors to higher prescription drug costs. The ACA also entitles seniors enrolled in Medicare to free preventive services and screenings.
As part of his so-called "penny plan," Trump aspires to reduce discretionary spending by 1 percent each year with the exceptions of Medicare, Medicaid, defense, and Social Security. This would trim spending on all domestic and social programs, including those that affect seniors, even as the population expands and ages.
Advocates for seniors worry that penny plan cuts will hit low-income housing particularly hard, especially in project-based rental assistance, Section 8 housing, and public housing. More than 900,000 seniors live in housing sponsored by the Department of Housing and Urban Development. Trump has tapped former political rival Ben Carson to run HUD, which has a budget of $47 billion. It's unclear what changes Carson would make or how he would deal with a reduced budget, but he has repeatedly said he does not believe in programs that encourage dependency.
SOCIAL SECURITY HOUSING
Michael Korbey, the man leading Trump's Social Security transition team, is a lobbyist who has advocated cutting and privatizing Social Security for decades. House Speaker Paul Ryan and other Republicans have pushed to privatize the longtime safety net program as well. Trump has vowed that he will not cut Social Security, which one in three seniors says is their primary source of income. The government could, however, raise the age of retirement that makes seniors eligible to collect, or alter the cost-of-living index.
The National Institutes of Health is a $32 billion federal agency tasked with biomedical research. Much of its funding goes to diseases that disproportionately affect seniors, such as Alzheimer's and cancer. The NIH has long enjoyed bipartisan support and, as of now, Trump doesn't seem to have immediate plans to change the organization's structure or funding. His pick to run the Department of Health and Humans Services, which governs the NIH, has also indicated support for federal funding for medical research -- but that doesn't make it exempt from budget cuts.
The Department of Labor adopted a rule last year that requires financial advisers and their firms to act as fiduciaries when dealing with the 401(k)s and IRAs their clients will live off in retirement. That means they are required to act in their clients' best interest and avoid or report conflicts of interest. Many in the financial industry, including financial professionals now advising the Trump administration, resisted this as government overreach. Trump has not yet made guarantees either way on the rule, which is set to take effect in April.
See photos of President Trump as he settles into his new life as president:
President Trump settles into his new life as president
President Trump settles into his new life as president
Canadian Prime Minister Justin Trudeau (R) is greeted by U.S. President Donald Trump prior to holdiing talks at the White House in Washington, U.S., February 13, 2017. REUTERS/Carlos Barria (
Japanese Prime Minister Shinzo Abe (L) and U.S. President Donald Trump (2nd L) are seen at Trump International Golf club in West Palm Beach, Florida, U.S., February 11, 2017. Picture taken February 11, 2017. Cabinet Public Relations Office/Handout via Reuters ATTENTION EDITORS - THIS PICTURE WAS PROVIDED BY A THIRD PARTY. FOR EDITORIAL USE ONLY. NOT FOR SALE FOR MARKETING OR ADVERTISING CAMPAIGNS.
U.S. President Donald Trump, First Lady Melania Trump (R), Japanese Prime Minister Shinzo Abe and his wife Akie Abe (L) pose for a photograph before attending dinner at Mar-a-Lago Club in Palm Beach, Florida, U.S., February 11, 2017. REUTERS/Carlos Barria
Japanese Prime Minister Shinzo Abe and Akie Abe (R) attend dinner with U.S. President Donald Trump his wife Melania (L) at Mar-a-Lago Club in Palm Beach, Florida U.S., February 10, 2017. REUTERS/Carlos Barria
U.S. President Donald Trump holds his earpiece as he holds a joint press conference with Japanese Prime Minister Shinzo Abe (not pictured) at the White House in Washington, U.S., February 10, 2017. REUTERS/Jim Bourg
U.S. President Donald Trump watches as Vice President Mike Pence (R) swears in Jeff Sessions (L) as U.S. Attorney General while his wife Mary Sessions holds the Bible in the Oval Office of the White House in Washington February 9, 2017. REUTERS/Kevin Lamarque TPX IMAGES OF THE DAY
U.S. President Donald Trump and First Lady Melania Trump greet a marching band as they arrive at Trump International Golf club to watch the Super Bowl LI between New England Patriots and Atlanta Falcons in West Palm Beach, Florida, U.S., February 5, 2017. REUTERS/Carlos Barria
US President Donald Trump watches the Super Bowl with First Lady Melania Trump (R) and White House Chief of Staff Reince Priebus (L) at Trump International Golf Club Palm Beach in West Palm Beach, Florida on February 5, 2017. / AFP / MANDEL NGAN (Photo credit should read MANDEL NGAN/AFP/Getty Images)
US President Donald Trump salutes before boarding Air Force One from MacDill Air Force Base on February 6, 2017 in Tampa, Florida.
President Donald Trump on Monday paid his first visit to US Central Command, meeting officers who will form the tip of the spear in implementing his new strategy to defeat the Islamic State group. / AFP / MANDEL NGAN (Photo credit should read MANDEL NGAN/AFP/Getty Images)
U.S. President Donald Trump and First Lady Melania Trump attend the 60th Annual Red Cross Gala at Mar-a-Lago club in Palm Beach, Florida, U.S., February 4, 2017. REUTERS/Carlos Barria
White House Chief of Staff Reince Priebus (L) listens as U.S. President Donald Trump talks to journalists members of the travel pool on board the Air Force One during his trip to Palm Beach, Florida while flying over South Carolina, U.S., February 3, 2017. REUTERS/Carlos Barria
U.S. President Donald Trump hosts a strategy and policy forum with chief executives of major U.S. companies at the White House in Washington, U.S. February 3, 2017. REUTERS/Kevin Lamarque
U.S. President Donald Trump and Vice President Mike Pence leaves after meeting with Harley Davidson executives at the South Lawn of the White House in Washington U.S., February 2, 2017. REUTERS/Carlos Barria
U.S. President Donald Trump pulls a chair out for Paula White from the New Christian Destiny Center to as they attend a meeting regarding the supreme court nomination at the Roosevelt room of the White House in Washington, U.S., February 1, 2017. REUTERS/Carlos Barria
U.S. President Donald Trump arrives to announce his nomination of Neil Gorsuch for the empty associate justice seat of the U.S. Supreme Court at the White House in Washington, D.C., U.S., January 31, 2017. REUTERS/Carlos Barria
On Friday, February 3, a Marine salutes U.S. President Donald Trump as he boards Marine One on the South Lawn of the White House, en route to Andrews Airforce Base where he will depart for Palm Beach, Florida.. (Photo by Cheriss May/NurPhoto via Getty Images)
US President Donald Trump sits after signing a memorandum about Labor Department's rules on investing in the Oval Office of the White House on February 3, 2017 in Washington, DC. / AFP / Brendan Smialowski (Photo credit should read BRENDAN SMIALOWSKI/AFP/Getty Images)
WASHINGTON, DC - FEBRUARY 03: U.S. President Donald Trump delivers opening remarks at the beginning of a policy forum with (L-R) daughter Ivanka Trump, Global Infrastructure Partners Chairman Adebayo Ogunlesi, IBM CEO Ginni Rometty, PepsiCo CEO Indra Nooyi, Blackstone Group Chairman and CEO Stephen Schwarzman and other business leaders in the State Dining Room at the White House February 3, 2017 in Washington, DC. Leaders from the automotive and manufacturing industries, the financial and retail services and other powerful global businesses were invited to the meeting with Trump, his advisors and family. (Photo by Chip Somodevilla/Getty Images)
U.S. President Donald Trump arrives to announce his nomination of Neil Gorsuch for the empty associate justice seat of the U.S. Supreme Court at the White House in Washington, D.C., U.S., January 31, 2017. REUTERS/Carlos Barria TPX IMAGES OF THE DAY
U.S. President Donald Trump signs an executive order cutting regulations, accompanied by small business leaders at the Oval Office of the White House in Washington U.S., January 30, 2017. REUTERS/Carlos Barria
Activists gather outside the White House to protest President Donald Trump's executive actions on immigration in Washington January 29, 2017. REUTERS/Aaron P. Bernstein
WASHINGTON, DC - JANUARY 31: National Security Agency Director Michael Rogers waits for the arrival of U.S. President Donald Trump for a meeting on cyber security in the Roosevelt Room at the White House January 31, 2017 in Washington, DC. Citing the hack of computers at the Democratic National Committee by Russia, Trump said that the private and public sectors must do more to prevent and protect against cyber attacks. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - FEBRUARY 1: (AFP OUT) President Donald Trump holds an African American History Month listening session attended by nominee to lead the Department of Housing and Urban Development (HUD) Ben Carson (R), Director of Communications for the Office of Public Liaison Omarosa Manigault (L) and other officials in the Roosevelt Room of the White House on February 1, 2017 in Washington, DC. (Photo by Michael Reynolds - Pool/Getty Images)
U.S. President Donald Trump gives a thumbs-up to reporters as he waits to speak by phone with the Saudi Arabia's King Salman in the Oval Office at the White House in Washington, U.S. January 29, 2017. REUTERS/Jonathan Ernst
U.S. President Donald Trump walks from the Oval Office to Marine One upon his departure from the White House in Washington January 26, 2017. REUTERS/Kevin Lamarque
The Marine One helicopter transporting U.S. President Donald Trump is seen as it departs from the South Lawn of the White House in Washington, U.S., for a trip to Philadelphia, January 26, 2017. REUTERS/Carlos Barria
U.S. President Donald Trump holds an executive order dealing with members of the administration lobbying foreign governments, after signing it in the Oval Office at the White House in Washington, U.S. January 28, 2017. REUTERS/Jonathan Ernst
British Prime Minister Theresa May looks on as U.S. President Donald Trump speaks during their joint news conference at the White House in Washington, U.S., January 27, 2017. REUTERS/Carlos Barria
Members of a ceremonial guard carry flags prior to the arrival of British Prime Theresa May at the White House in Washington, U.S., January 27, 2017. REUTERS/Carlos Barria
U.S. President Donald Trump (R) and Vice President Mike Pence return to the White House after a visit to Homeland Security headquarters in Washington, U.S., January 25, 2017. REUTERS/Jonathan Ernst
U.S. President Donald Trump holds up a signed executive order to advance construction of the Keystone XL pipeline at the White House in Washington January 24, 2017. REUTERS/Kevin Lamarque TPX IMAGES OF THE DAY
Turkey's President Recep Tayyip Erdogan (R) and British Prime Minister Theresa May arrive to speak after their meeting at the presidential complex in Ankara on January 28, 2017.
British Prime Minister Theresa May on January 28 promised steps to ramp up trade between Turkey and Britain ahead of Brexit but also urged Ankara to uphold human rights following a failed coup. On her first visit to Turkey as premier and fresh from meeting new US President Donald Trump at the White House, May held three hours of talks with President Recep Tayyip Erdogan.
/ AFP / Adem ALTAN (Photo credit should read ADEM ALTAN/AFP/Getty Images)
WASHINGTON, DC - JANUARY 27: British Prime Minister Theresa May looks on as U.S. President Donald Trump speaks in The Oval Office at The White House on January 27, 2017 in Washington, DC. British Prime Minister Theresa May is on a two-day visit to the United States and will be the first world leader to meet with President Donald Trump. (Photo by Christopher Furlong/Getty Images)
Members of the Trump administration walk through the colonnade of the White House on January 27, 2017 in Washington, DC. / AFP / Brendan Smialowski (Photo credit should read BRENDAN SMIALOWSKI/AFP/Getty Images)