This year marks the 50th anniversary of three of the nation’s most important programs for seniors-Medicare, Medicaid, and the Older Americans Act (OAA). It is also the year when advocates and policymakers from across the country will be discussing the future of services for seniors at the 2015 White House Conference on Aging.
“These events offer the perfect opportunity for Congress to expand and reinforce its commitment to supporting older Americans’ health and economic security,” said Howard Bedlin, vice president of public policy & advocacy for the National Council on Aging (NCOA). “The aging population is growing rapidly, and seniors want to stay independent as long as possible. Now is the time to strengthen and expand aging services to meet the needs of all seniors, especially those who are struggling.”
Specifically, NCOA urges Congress to:
1. Protect and assist low-income Medicare beneficiaries
The Medicare Qualified Individual (QI) program pays Medicare Part B premiums for beneficiaries whose incomes are 120-135 percent of poverty-about $14,000-$15,750 per year. Without this assistance, these seniors would not be able to afford doctor visits.
Congress temporarily extended QI to March 31, 2015, along with increases in Medicare physician payments. Momentum is building to permanently fix Medicare physician payments. Congress should make the QI program permanent at the same time and fund outreach to help seniors access this and other Medicare low-income benefits, since most who are eligible for assistance do not receive it.
2. Renew the Older Americans Act (OAA) and the Elder Justice Act (EJA)
The OAA and EJA are both overdue for reauthorization. Renewing these statutes would mean strengthening and modernizing aging services and protections to meet the diverse needs of our growing older population-especially those who are vulnerable and struggling.
The OAA funds critical, cost-effective programs that allow seniors to stay healthy and independent in their communities, including job training and placement under the Senior Community Service Employment Program (SCSEP), health promotion and disease prevention, senior nutrition, senior centers, caregiver support, and more.
The EJA provides for a nationally coordinated, multidisciplinary approach to the silent crisis of elder abuse, neglect, and exploitation.
Congress should build upon the progress made last year on these issues and pass bipartisan bills this year.
3. Restore investments in aging services
A variety of community services help older adults maintain or improve their health and economic security, allowing them to stay independent and avoid more costly care. These include OAA programs, nutrition and energy assistance, and affordable housing.
Investments in aging services have not kept up with inflation or the rapid growth in the senior population. Due to budget caps and sequestration, FY14 funding for these and other non-defense discretionary (NDD) programs was about 15 percent below FY10 levels, resulting in service reductions and growing waiting lists. The looming FY16 sequester will reduce NDD investments to a 50-year low as a share of the economy.
Sequestration must be replaced with a balanced approach that does not increase poverty, hunger, or income inequality.
4. Protect and strengthen long-term home care under Medicaid
The number of Americans needing long-term care (LTC) will more than double as the baby boomers age. Medicare does not cover long-term care, and private LTC insurance is unaffordable for most. This means often seniors have to spend down their life savings into poverty before getting help from Medicaid, which has an institutional bias with mandatory nursing home but optional home care coverage.
Several Medicaid reforms to promote access to home care are expiring-such as the Money Follows the Person and Balancing Incentive Programs. Congressional leadership is needed to extend these programs and pass other legislation recommended by the bipartisan Long-Term Care Commission to improve access to home and community services and support family caregivers. Proposals to place arbitrary caps on Medicaid services also should be opposed.
5. Improve access to elder falls prevention and chronic disease self-management programs
Falls among seniors are widespread, expensive, and often preventable. Each year, one in three Americans age 65 or older falls. The annual cost for treating these injuries is over $36 billion, which could increase to nearly $62 billion in 2020, with Medicare paying about $48 billion.
In addition, the vast majority of older adults are affected by multiple chronic conditions, collectively accounting for more than three-quarters of all health expenditures. Chronic disease self-management education (CDSME) is a low-cost, evidence-based model that helps individuals manage their conditions, improve their health status, and reduce their need for more costly medical care.
Last year, Congress provided $5 million for falls prevention and $8 million for CDSME from the Prevention and Public Health Fund. Collectively, this funding reaches just over half of the states. This year, investments should be increased so at-risk seniors in additional states can access these important services.
For more information, visit www.ncoa.org/get-involved/i-am-an-advocate.html.
