Q. I recently moved to the DC area to be closer to my children and grandchildren. I figured since I was in DC, I would follow government and public policy a little closer, mostly focusing on issues that affect seniors. I began watching local and national news channels, but they aren’t focused on such things these days. Can you fill me in on some of the more timely issues that are important to older Americans, and what might happen with them this year? Thanks for your help!
A. Welcome to the DC area! Now is an ideal time to explore senior policy issues, as the current session of Congress is focused on a number of things important to older Americans and those who serve them. Here’s a look at the key policy priorities that may see movement this year.
1. Older Americans Act (OAA) Reauthorization
The Older Americans Act (OAA) is up for reauthorization this year, and committees in both the Senate and House have held hearings about potential legislation.
The OAA currently helps 11 million older adults live as independently as possible, with nutrition programs and family caregiver support programs for older participants and their family caregivers. Currently:
• About 42% of group meal participants and 61% of home-delivered meal participants would skip meals or eat less in the absence of these programs;
• Group meal participants are less likely to be admitted into nursing homes, and those who live alone are less likely to be admitted to the hospital than nonparticipants;
• Caregivers who received four hours or more of respite care per week reported a decline in burden over time;
• Caregivers who received at least one education/training, counseling, or support group session experienced an increase in self-reported confidence over time.
In early May, the House Appropriations Committee approved a bill that increased funding for most Older Americans Act programs, including an $84 million increase for group and home-delivered meals, $64 million more for the Senior Community Services Employment Program (SCSEP), a $37 million increase for Supportive Services and Senior Centers, and a $6 million increase for Medicare State Health Insurance Assistance Programs (SHIPs). Congress has negotiated several bipartisan deals to raise the caps for two years. The last set of caps, for FY20 and 21, need to be raised for any investments to be made. If left intact, cuts would reduce available FY20 funding for programs like OAA services by $54 billion.
The current authorization of the Older Americans Act expires in September 2019, and the 116th Congress will have an opportunity to pass an OAA reauthorization. Reauthorization would provide an opportunity to strengthen and modernize the Act to better meet the changing and growing needs of our nation’s older population.
2. Two Medicaid Home Community-Based Services Expire This Year
Two key Medicaid Home and Community-Based Services (HCBS) programs expire at the end of this year: the Money Follows the Person program (MFP) and Spousal Impoverishment Protections.
• The Money Follows the Person (MFP) program The MFP Program has helped states transition older adults and people with disabilities back into their communities while retaining access to care. While states can continue to use remaining grant funding through 2020, they are currently scaling back their programs and reducing dedicated staff and resources. The proposed bipartisan legislation would extend MFP through 2022, remove barriers for individuals and states, enhance accountability, and contribute to sharing of best practices across states. This will assist states with achieving cost-efficiencies in their Medicaid programs while enhancing opportunities for individuals to live independently and age with dignity in their homes and communities.
• Spousal Impoverishment Protections
Medicaid’s Spousal Impoverishment Protections make it possible under the basic laws for an individual who needs nursing home level of care to qualify for Medicaid while allowing their spouse to retain a modest amount of income and resources. This has helped ensure that the spouse who is not receiving LTSS can continue to pay for basic rent, food, and medication while the other spouse receives their needed care in a facility. Congress extended this protection to eligibility for HCBS in all states beginning in 2014, so that married couples have the same financial protections whether care is provided in a facility or in the community. The expansion of the spousal impoverishment protection was originally set to expire earlier this year, but it was extended.
3. Making Prescription Drugs More Affordable for Medicare Beneficiaries
The Part D Extra Help Low-Income Subsidy (LIS) program is designed to help pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. Issues being examined by Congress include placing a cap on out-of-pocket spending, getting rid of the stringent asset eligibility thresholds (for those who have savings), instilling zero copayments for generic drugs, and making it easier for low-income seniors to pay zero monthly premiums.
How you can help
If you are passionate about these or other issues affecting seniors, tell your members of Congress. Congress can show its support for older adults and caregivers by boosting the reauthorization request for OAA and other aging programs as a response to the increasing population of older adults and the rising cost of providing aging services.
Have you planned for your future and for your loved ones?
Regardless of possible changes in the law, the need to plan in advance remains. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning (or had your documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please don’t hesitate to call us as soon as possible for an initial consultation:
Elder Law Fairfax: 703-691-1888
Elder Law Fredericksburg: 540-479-1435
Elder Law Rockville: 301-519-8041
Elder Law DC: 202-587-2797
About Evan H Farr, CELA, CAP
