President Donald Trump is calling for modifications to Medicaid and Social Security alongside cuts to federal spending on many programs that benefit people with disabilities.

The president’s annual budget proposal released earlier this week includes cuts to the U.S. Centers for Disease Control and Preventions’ Center on Birth Defects and Developmental Disabilities, reductions in housing assistance, wiping out spending on Special Olympics and supported employment and slashing funds for state councils on developmental disabilities.

“There are no winners in the president’s budget,” said Eric Buehlmann, deputy executive director for public policy at the National Disability Rights Network. “The president’s budget came with huge cuts in health care, housing, education and other important disability related programs.”

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Funds for special education would go up slightly under the $4.4 trillion budget request for 2019 even as overall spending on education would drop.

Given that the federal government has traditionally failed to meet its obligation to fully fund special education, Buehlmann said the small increase for the program is unsatisfactory.

“This just perpetuates a system that does not provide all the needed services and supports for students with disabilities,” he said.

Meanwhile, Trump continues to press for a fundamental restructuring of Medicaid. Instead of providing matching grants to help states pay for whatever services are provided through the entitlement program, the president wants states to get a set amount of money from the federal government each year.

Under the plan, states could choose between receiving a certain amount for each beneficiary — an approach known as per capita cap — or receiving a block grant, essentially a lump sum from the federal government.

Disability advocacy groups have spent much of the last year opposing such changes to Medicaid, which they say would pinch states and compromise funding for everything from health care to home and community-based services for those with developmental disabilities.

The president would also like to see changes to the Supplemental Security Income program so that there would be a “sliding scale” for those living in households with multiple beneficiaries.

“The budget includes sensible reforms to problems in our current welfare system, and aims to end debilitating dependency while ensuring that our safety net is reserved for those Americans who truly need help,” Trump said in the budget request.

Disability advocates, however, contend that Trump’s plans would effectively work to dismantle the government supports that allow those with disabilities the opportunity to become independent.

“The president’s budget would have a devastating impact on people with disabilities and their families with unprecedented cuts to Medicaid, Social Security and many other programs that make community living possible for many people with disabilities,” said Marty Ford, senior executive officer for public policy at The Arc. “We remain vehemently opposed to proposals, like these from President Trump, that attack the systems of support that enable individuals with disabilities to live, work and thrive in the community.”

The budget reflects Trump’s wish list, but ultimately Congress will determine how federal dollars are allocated.