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Aging Policy Priorities on the Horizon

The current session of Congress is focused on a number of issues important to older Americans and those who serve them. Our Public Policy and Advocacy team is also hard at work preparing for our upcoming Age+Action Conference, Hill Day visits, accompanying virtual advocacy efforts, and advocacy opportunities throughout the Summer. Here’s a look at the key policy priorities that may see movement this year.

Older Americans Act (OAA) Reauthorization

The OAA is up for reauthorization this year, and committees in both the Senate and House have held hearings about potential legislation. Reauthorization provides an opportunity to strengthen and modernize the Act to better meet the changing and growing needs of our nation’s older population.

Our top priority is to include the creation of an Innovation Center in any OAA reauthorization legislation. The Innovation Center would lead a robust aging services research and development authority to evaluate, improve and support scaling of evidence-based programs and innovations that can improve outcomes and promote independence and healthy aging. OAA programs and innovative aging services effectively address social determinants of health, save Medicare and Medicaid dollars by reducing emergency room and hospital admissions, and delaying nursing home placement. We are working to strengthen the program’s capacity to provide evidence demonstrating which aging services programs can best reduce spending and improve quality of life for older Americans, and therefore merit greater investment and scaling.
We are also encouraging legislators to create healthy aging provisions that:

  • Support investments in falls prevention and Chronic Disease Self-Management Education (CDSME);
  • Enhance the definition of “disease prevention and health promotion” to highlight the role the Aging Services Network plays in responding to public health emergencies and emerging health threats; and
  • Strengthen federal leadership in promoting falls prevention, including home modifications

The economic security of older adults can also be improved via OAA reauthorization, and we are advocating for amendments that would:

  • Provide that the baseline for the Senior Community Service Employment Program (SCSEP) authorization levels remain consistent with current statute and grow accordingly in the future; and
  • Emphasize that SCSEP services include providing access to a range of direct and referred services to promote economic self-sufficiency

Extending or making permanent expiring Medicare and Medicaid programs

Authority for funding low-income Medicare beneficiary outreach and enrollment efforts expires October 1. Almost 3 million individuals eligible for the Medicare prescription drug Low-Income Subsidy are not enrolled, and less than half of eligible low-income beneficiaries receive needed assistance paying Medicare Part B monthly premiums. Thirty-five members of the Leadership Council of Aging Organizations (LCAO) wrote a letter endorsing efforts to make funding permanent and increase it from $37.5 to $50 million annually. Without sufficient funding, outreach efforts will not reach the millions of beneficiaries who cannot afford their health care costs.

In addition, 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. MFP has proven very successful in helping states transition older adults and people with disabilities back into their communities while retaining access to care. We support bipartisan House and Senate legislation to extend MFP for 5 years and make spousal protections permanent, thereby addressing Medicaid’s institutional bias and reducing unnecessary nursing home placement.

Aging Services Funding and the Federal Budget

Federally funded aging services are failing to keep pace with inflation and the increasing number and diversity of older adults. Appropriations committees decide funding levels for OAA and other discretionary (not mandatory “entitlement”) programs each year. Education and advocacy are important parts of winning funding increases.
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 congregate 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). NCOA supports these increases and is urging Congress to also increase funding for Title IIID Health Promotion and Disease Prevention programs, as well as direct funding for falls prevention and CDSME.

Action on Senate appropriation bills and final resolution of FY20 funding currently depends on larger budget debates. Since the Budget Control Act of 2011 created caps on spending and raised the threat of across-the-board cuts known as sequestration, 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, forced cuts would reduce available FY20 funding for non-defense discretionary (NDD) programs like OAA services by $54 billion.

Making Prescription Drugs More Affordable for Medicare Beneficiaries

In the ongoing debates around prescription drug prices, we want to make drugs more affordable for seniors who struggle with costs the most—beneficiaries with low incomes and those with high out-of-pocket costs, often because they have multiple chronic conditions. We are advocating to strengthen the Part D Extra Help Low-Income Subsidy (LIS) program and placing a cap on out-of-pocket spending for those with the highest drug costs.

We are particularly eager for Congress to ease the current stringent asset eligibility thresholds, which penalize low-income beneficiaries who did the responsible thing during their working years to put away a modest nest egg of savings. For LIS enrollees, we also support zero copayments for generic drugs, creation of LIS applications in languages other than English and Spanish, and making it easier to pay zero monthly premiums.

How you can help

During the Age+Action Hill Day on June 19, we are asking colleagues and partners across the country to tell their members of Congress about their work and the needs of older adults in their communities.

Those who can lobby are asked to join us in urging Congress to:

  • Reauthorize the OAA and strengthen the capacity to promote innovation, foster healthy aging, and support economic security;
  • Permanently extend Medicare low-income outreach and enrollment and Medicaid HCBS services; and
  • Invest in aging services.

You can still support this effort if you’re not attending our conference. Look for details on Virtual Advocacy Day the week of June 17, and check our Advocacy Toolkit for more information.

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Howard Bedlin

About Howard Bedlin

Howard Bedlin is NCOA's Vice President of Public Policy and Advocacy. He is responsible for all of NCOA’s federal and state legislative advocacy efforts on issues and programs of concern to older adults, which include the Older Americans Act, Medicare, Medicaid, long-term care, income security, and community services programs.