House Republicans Take on Poverty, Have Little New to Say

June 7, 2016

House Speaker Paul Ryan may not be the policy wonk some say he is, but he’s a smart politician. He’s decided the Republicans have to start being for something, rather than just against everything the Obama administration has done — and Democrats want.

And he’s decided that being for radically less federal spending won’t do — not, as least, unless it’s a seemingly secondary benefit of policies that have something else going for them. Understandably, since reducing the deficit by spending cuts alone hasn’t polled well.

So he appointed House Republicans to task forces, each charged with producing policies that their party can be for. He revealed the first in the “better way” series this morning — the anti-poverty package.

This shouldn’t surprise us, since he’s made a big deal about his concern — genuine, I think — for poor Americans. Nor, I suppose, should the recycled rhetoric surprise us.

What might — it surely did me — is the egregious lack of policy specifics, except for the portion on evaluation. That, as you might expect, takes off from the claim that we can’t say whether most programs for low-income people work, but can say that most evaluated don’t.

The report leads off with an overview of the “welfare system” — not what we think of as welfare, but all federal programs that link eligibility to income levels, including some targeted to communities, not individuals.

Nothing new here, since it borrows from Ryan’s earlier account of the War on Poverty. The framework for what follows is thus that we’ve too many programs, run by too many federal agencies spending too much — and to no effect, since the poverty rate (two years ago) was basically the same as in 1996.

We’ve got a better measure than the official measure House Republicans use. An analysis based on it found that safety net programs the official measure doesn’t count have significantly reduced poverty rates.

The task force, however, uses the official rates as a jumping off point. Like Ryan’s earlier takes, its report asserts that the federal government measures success by how many people receive benefits, rather than by how many “get out of poverty.”

So how then are to we get more people out of poverty? We’ll expand work requirements, of course. All “work-capable” adults must work or prepare for work as a condition of receiving benefits of any sort.

How they’re to find jobs or suitable training opportunities the report doesn’t say — presumably, however, not through more federal funding.

We do, however, find an additional incentive states may use to prod them into finding jobs that pay far more than the minimum wage — a time limit, as well as a work requirement for people who live in public housing or receive any other sort of federally-funded housing assistance, e.g., vouchers.

It’s not only potentially employable adults who’ve got to work. The task force rehashes the old complaint about the number of children who receive Supplemental Security Income benefits because they have severe disabilities.

They receive benefits for too long, it says — on average, 26.7 years, which doesn’t seem all that long to me. However, they won’t receive benefits any more, if the task force has its way.

It would “reform” the program so as to provide “access to needed services in lieu of cash assistance.” No recognition whatever of disabilities that make gainful work impossible — or the fact that parents of SSI recipients must often support them indefinitely.

The task force does acknowledge “challenges” work-able adults face — child care, for example, transportation, stable housing and “help buying groceries.”

What then should the federal government do? “Work with community partners,” i.e. nonprofits and for-profit businesses, “to address hurdles.” Period.

The federal government could, however, penalize states that didn’t get people out of safety net programs swiftly — hurdles notwithstanding. It would give them an incentive by ratcheting down reimbursement rates as people remain in the programs longer. Not a forthright proposal. The report again fluffs.

On a more positive note, the task force recommends providing work-readiness activities for noncustodial parents so as to increase their ability to pay child support.

It would also let states receive waivers from unemployment insurance rules so they could explore better ways to get UI recipients back into the workforce. Nothing to object to here, though one might after seeing those better ways.

More generally, the task force would, of course, give states more flexibility. It alludes to letting them link welfare programs — presumably as block grants, though it uses neither that term nor others House Republicans have come to prefer.

Those voluntary links nevertheless recall Ryan’s Opportunity Grants — those mega-block grants he floated nearly two years ago.

We also find what seems a block grant in the section on education. First we’re treated to the usual trashing on Head Start for failing to produce demonstrable, lasting academic outcomes — broadened, however, to apply to early childhood education programs generally.

Then a suggestion that the federal government could “combine investments,” streamlining and simplifying its involvement. Involvement here seems reduced to sponsoring research and sharing results.

Ryan appointed a separate task force to deal with tax reform. We’re nevertheless treated to a rehash of the now-familiar claim that safety net benefits discourage work because recipients lose them as they earn more.

We’ve little evidence that they actually respond to the so-called cliffs by working less — or for less money — than they could. Perhaps they know that they’d almost always do better by working and earning what they can.

Be that as it may, the task force has only two general solutions. One would increase the Earned Income Tax Credit. For whom and how it doesn’t say.

The other solution — yet again — is more state flexibility. This supposedly would enable states to tailor benefits packages so that no one lost more than they gained by working.

Most, as the report acknowledges, don’t lose — at least until they’re earning quite a bit. That’s feature, not a bug, of course, in programs intended to help low-income people meet their basic needs. But it’s another dagger to thrust at the safety net.

Bottom line for me is that there isn’t much there there — to borrow from Gertrude Stein. Not, at least, much there there for us who’ve paid any attention to what House Republicans — Ryan in particular — have proposed and tried to justify ever since they gained a majority.

 

 

 


When Is a Hard-Up Family a Family?

December 14, 2015

Not long before Jesse died, we were chatting, as we often did, about issues I was working on — in this case, the District of Columbia’s homeless shelters.

I had to explain to him that if we became homeless and had no place to stay, we would have to live on the streets or spend our nights in separate sex-segregated shelters, then meet up some place or other when they turned us out at daybreak.

He was dumbfounded. It apparently had never occurred to him that we weren’t a family, according to the District’s homeless services policies.

I recalled the moment as I read reports of interviews with the homeless people the District is sweeping out of the campsites they’ve set up. The Department of Human Services, to its credit, has placed some of them in housing units. It wants most of them, however, to go into the shelters — at least, for awhile.

A fair number, it seems, don’t want to go — understandably, given conditions in what are called shelters for singles. Repeated references to bedbugs. Fears of having their belonging stolen. Fights. Bad food.

But it’s not only such shelter conditions. “They split you and your husband up,” said one woman interviewed. “We prefer to have privacy.”

None in the shelter for either — let alone privacy for the two together so they could comfort each other, talk about next steps and, well, do what couples do only when alone in a room with a door.

The problem, you see, is that they don’t have children in their care, just as Jesse and I wouldn’t have if we’d had to throw ourselves on the mercies of DHS.

This isn’t a singular safety net policy. We see it, for example, in states’ Medicaid policies. Twenty-two exclude all childless adults who don’t have disabilities, except pregnant women. All cover parents, though some only those far below the poverty line.

These are state choices, as the variations indicate. But the federal government itself doesn’t view childless couples as families — or for that matter, couples whose children are grown ups.

The only nationwide source of cash income for poor people who aren’t severely disabled is Temporary Assistance for Needy Families. But couples who have no children living with them don’t qualify.

So-called general assistance programs could fill this gap in the safety net. But the federal government provides no funds for them. So states that had GA programs have exercised their unlimited flexibility to get rid of them or scale them back in various ways, as the Center on Budget and Policy Priorities reports.

Only 11 provide cash benefits to childless adults who aren’t demonstrably unemployable — because they’re elderly, for example, or disabled, but haven’t yet (and perhaps can’t) surmount the hurdles to gaining Supplemental Security Income.

SNAP (the food stamp program) does provide cash-equivalent aid for childless couples. But as I’ve written before, able-bodied adults without dependents can generally get benefits for only three months in any three-year period unless they’re working or participating in a job training program at least half-time.

This restriction applies to childless couples if both spouses or partners have no disabilities unless they’re caring for someone in the household who’s disabled or have a child on the way. And the chances that both can get into — and remain in — certified job training programs are, in many states, virtually nil.

The time limit originated in the same law that brought us TANF — the Personal Responsibility and Work Opportunity Reconciliation Act.

I mention this because it perversely disadvantages couples who’ve chosen not to have children unless and until they can afford to provide for their basic needs, plus the time, attention and opportunities that support healthy, well-rounded development. Seems like personal responsibility to me.

The federal Earned Income Tax Credit also disadvantages childless couples, even when lawfully wed. And it altogether denies the credit — and thus the potential refund — to young childless workers.

Far be it from me to say our safety net programs shouldn’t put a high priority on the well-being of the next generation. But we don’t have to choose between children and working-age adults who don’t have any.

And we surely don’t have to treat homeless couples who don’t have children with them as if they weren’t families.

 


Brooding on My Blog’s Seventh Birthday

December 7, 2015

Yesterday was my blog’s seventh birthday. The occasion always prompts reflections, some of which I’ve shared.

I’ve spoken in the past about how things were when I launched the blog, compared to how they were when the birthday rolled round. I’ve spoken about the value of the blog as a source of discipline for learning and of relationships with advocates who inspire me — and readers who keep me going.

What’s top of mind today — and has been for awhile — grows out of the scope I carved out for the blog, but only gradually got a purchase on.

The scope is very — or one might say self-indulgently — broad, as the blog’s name indicates. It essentially licenses posts on any nexus between public policies and poverty, though as a practical matter, I’ve confined myself to the American scene.

I’ve stretched the scope as I’ve come to understand how our official poverty measure fails to do justice to the extent of economic hardship in our country.

Some of our major federal policies recognize this and so set income eligibility maximums above the federal poverty line — a simplified version of the thresholds the Census Bureau uses for the official measure.

At the same time, those income eligibility maximums vary a lot from state to state insofar as federal programs grant states flexibility.

We also see marked variations when we look at how states invest their own tax revenues in programs that provide a safety net and others that can help low-income people achieve a modicum of financial security.

States have always faced the challenges these choices reflect. They surely face them now, as they have ever since the Budget Control Act capped federal spending on non-defense programs that depend on annual appropriations.

The fact that the recent budget deal temporarily lifts the caps doesn’t relieve them from the challenges because the non-defense part of the budget includes a very wide range of programs.

Congressional appropriations committees have divvied up the new, higher spending level now. And at least on the House side, Labor, Health and Human Services, and Education — a major source of funds for programs that benefit low-income people — reportedly won’t get its fair share.

Highly doubtful that the Transportation-Housing and Urban Development budget will fully undo the damages to the federal housing voucher program or the capital fund that local agencies use to keep public housing units habitable.

Meanwhile, Congress will clearly do nothing now about a long-neglected piece of the federal budget that’s not subject to annual appropriations — the Temporary Assistance for Needy Families block grant.

It’s not only the federal government’s major share of funding for states’ TANF programs. It also determines how much of their own funds they must spend to get that share.

And as I’ve written (perhaps too often), it’s never gotten a penny more than it did the year that TANF ended welfare as we knew it. This means it’s now worth about a third less in real dollars.

Which brings me to the other nexus I’ve tried to deal with, but mostly one nibble at a time. That’s the nexus between federal policies — budgets included — and related state and local policies. These too include budgets, but not budgets only.

I’ve referred to states’ TANF policies — mainly the very low cash benefits they provide. And I’ve taken a poke from time to time at some states’ Medicaid eligibility policies.

I’ve also cited states’ varying responses to federal policy choices that can enable them to enroll more low-income people in SNAP (the food stamp program) — and qualify some of them for higher benefits.

I’ve noted disparities in minimum wages, as some states raise their minimums above the federal, while others either preserve the link or have no minimum of their own at all. I haven’t noted, but probably should have how much those higher minimums vary.

These and other such differences have made me increasingly conscious of what I think of as geographic inequality. We read a lot about income inequality — and about how children’s future financial prospects hinge so much on whom they’re born to.

But how low-income people, including children fare depends a whole lot on where they live. Part of that, of course, is that some local economies offer better opportunities than others. But a major part stems from policy choices.

I know I’m not saying anything new or original here. Only taking this occasion to say how the more I learn, the more I’m disturbed by how unfair our federal-state-local system is to so many poor and near-poor people who’ve got little, if any choice of where they live.

Not saying I’d like to see all policies determined by our federal government — surely not the one we have now. Low-income people have it bad enough already. I shudder to think how much worse off the geographically fortunate would be if left to the tender mercies of the majorities in Congress.

Won’t think because I can’t bear to what would happen to all struggling people if the next election not only sustains those majorities, but puts a like-minded candidate — or a loose cannon — in the White House.

What would a ninth birthday post look like then?

 


Subsidized Housing Cuts Poverty Rate More Than Census Measure Shows

October 13, 2015

My post on the dismal status of the Housing Choice voucher program led off with a call for larger investments in anti-poverty measures that have proved effective. But I didn’t wrap back around to how the vouchers fit in. Just too much, I felt, to cram into a single post.

So here’s the missing piece.

The Coalition on Human Needs, the source of my jumping-off point, draws on the Census Bureau’s Supplemental Poverty Measure for proofs of effectiveness. Many other progressive analysts and advocates do so as well.

As I’ve said before, the Bureau shows the impacts of major social insurance and safety net programs by recalculating poverty rates without their cash value.

The impacts of federally-funded housing subsidies — vouchers and public housing rolled together — seem relatively small, though not negligible when analyzed this way.

Without them, the SPM poverty rate would have been 0.9% higher in 2014. So it would seem they lifted roughly 2.8 million people over the poverty threshold — about 7 million fewer than the refundable tax credits, the top-ranked program one might classify as safety net.

The impact of the housing subsidy programs on the poverty rate has remained about the same ever since the Bureau began issuing its SPM reports in 2010. Small variations, but within the statistical margin of error.

The under-funding I’ve been going on about is one reason the impacts aren’t greater. But it’s not the only reason. Eligibility for housing assistance is another.

An individual or family doesn’t have to be hovering near the poverty threshold to qualify. The cut-off instead is 30% of the median income for the area they live in. That’s often, if not always considerably higher than the applicable poverty threshold.

In the District of Columbia, for example, the cut-off for a couple with with two children last year was about $9,000 higher than the maximum the family could have and still be counted as poor, if renters.

True, the DC Housing Authority exercises preferences when awarding new housing vouchers and public housing units, including one for homeless people, who are likely to be poor. But how many people in poverty actually benefited from such assistance last year is an open question.

More to the point, we can’t assume that what DCHA does reflects housing authority policies generally — except probably its current focus on veterans.

The impact figure is relatively small for a third, important reason. The dollar value of a housing subsidy doesn’t capture its full anti-poverty impact.

The value the SPM attributes to it is the different between the market-rate rent for an apartment, including basic utilities and what the household actually paid. But safe, stable housing is a platform of sorts for rising out of poverty. Or looked at another way, not having it makes rising more difficult.

Shifting around from place to place — or even worse, living in a shelter — makes finding and keeping a job unusually challenging. No permanent address. In some cases, no ready, regular access to a shower or a washing machine and dryer. Limited, if any access to a computer. Negative effects on both physical and mental health.

And if nothing else, time and energy that must be diverted to negotiating yet another temporary housing arrangement, packing and unpacking, figuring out new transit routes to work or training, other services, school and daycare for the kids, if any, etc.

For children, housing instability often has long-term consequences that make poverty in adulthood more likely — these better documented by research than consequences for adults.

Children whose families move around a lot, even if not in and out of a shelter, face higher risks of mental health problems — some manifesting themselves as what experts refer to as behavioral problems.

These help account for academic difficulties, as measured by standardized test scores and grades. So do frequent shifts from one school to another.

The end result is a relatively high dropout rate. And we know what employment and earnings prospects are for folks without at least a high school diploma.

Such effects are hard to convert to dollars that adults, both current and future, would have if stably housed, thanks to vouchers or apartments in public housing.

But I’m sure as can be that enabling low-income people to live in decent housing they can afford reduces poverty more than the SPM shows.


Hopes for a Better TANF Program Undercut by Lack of Funding

August 24, 2015

Temporary Assistance for Needy Families just had its 19th birthday. It’s long overdue for an overhaul. And we just may see one before the end of the year.

Congress last reauthorized TANF 10 years ago. By and large, it made a flawed program worse — assuming, as I think we should, that it’s supposed to provide a safety net for poor families, while helping parents prepare for and find jobs that enable them to support themselves and their children.

Now the House subcommittee responsible for TANF seems poised to finish a reauthorization bill. And surprisingly, the discussion draft responds to concerns that progressive advocates, as well as some state administrators have raised for a long time.

I say “surprisingly” not only because Republicans control the subcommittee, but because Congressman Paul Ryan, who now chairs the full Ways and Means Committee, has often cited TANF as the model safety net program.

The bill, which is still a work in progress, is far from problem-free. Most importantly, it fails to do one big thing. And that will mean either no new law or some harmful consequences.

The one big thing is to boost the block grant — the federal government’s share of money for the benefits and services states’ programs provide. It’s been stuck at the same level as when TANF began. So it’s lost about a third of its real dollar value.

The draft would provide not a penny more. At the same time, it would require states to do two things they don’t have to do now — develop genuinely individualized plans for TANF families and track employment-related outcomes for those that leave the program.

The new mandates are surely promising, though the latter warrants revisions, as CLASP’s detailed comments show. They would also, however, require investments of administrative resources.

Other changes would tend to offset the administrative burden, but states would still come up short on funds to make those outcomes as good as they might otherwise be.

At the same time, the draft would eliminate the TANF Contingency Fund — a pot of money that states can tap (until it runs dry) when a recession or other hit to their economy indicates they’ll have more families to serve.

States would have as much flexibility as ever to cope with funding crunches by dropping their already-low income eligibility ceilings, reducing the lifetime time limits for participation, as some states have eagerly done, and/or by other measures to shrink their caseloads, e.g., pre-enrollment job search requirements, costly, ineffective, but still humiliating drug tests.

The draft would eliminate a major incentive states have to do reduce their caseloads by any or all of these, as well as by doling out so-called full family sanctions, i.e., total benefits cut-offs, which also reduce the caseload count.

But the fixed block grant funding level, plus the loss of extra funds in extra-bad times would leave states with another incentive to serve as few families as they can — and to forgo their new opportunities to improve employment prospects for those they do.

I’ll return to the promising features I’ve referred to — and a couple I haven’t — in a separate post. I’ve begun with the big problem because they’ll all be for naught if the federal government fails to do its share for our country’s poorest families, as it has — and increasingly so — for most of the last 19 years.

 


Census Bureau Busts Myths (Again)

July 20, 2015

You know the myths well, I suppose. Safety net benefits trap recipients in poverty — an assertion cagily repeated by the House Agriculture Committee Chairman just a few weeks ago. They’re a spider web, Presidential candidate Jeb Bush opines.

A new Census Bureau report tells us otherwise. About a third of the people who participated in one or more of our major safety net programs did so for a year or less during a recent four-year period that includes part of the Great Recession.

About the Report

The Census report updates a very similar program participation report issued about three years ago. Both use an ongoing survey of a sample of American households. So it’s possible to track entries into and exits from major safety net programs over time.

The report focuses on people who benefited from any of six programs that limited eligibility based, at least in part, on income — Medicaid, including the Children’s Health Insurance Program, SNAP (the food stamp program), SSI (Supplemental Security Income), housing assistance and Temporary Assistance for Needy Families, lumped together with dwindling general assistance programs.

Many, many numbers in the report — some in the text, even more in graphs. It’s hard — for me, at least — to tease out what they tell us from a policy perspective. I’ve nevertheless taken a crack at it, as follows.

Not Much Program Growth

Participation rates in the six programs rose somewhat from 2009 to 2011, but then leveled off. In 2012, slightly more than one in five people (21.3%) participated in at least one.

Medicaid had the highest average monthly participation rate, increasing from 13.9% in 2009 to 15.3% in 2012. States that chose to expand their Medicaid programs presumably accounts for this.

On the other hand, the participation rate for housing assistance remained basically flat, at 4.2%. And the rate for TANF/General assistance ticked down to a paltry 1% in 2012. Not much of a safety net there for the poorest among us.

Deterrents to Work

The new Census figures don’t deliver a clear rebuttal to the claims that safety net programs discourage beneficiaries from working. They do, however, tell us a few relevant things.

First and foremost, by far and away the high percent of beneficiaries are under 18 — most presumably too young to work. In an average month during 2012, slightly over 39% of safety net beneficiaries were in this age group. That’s well over double the participation rate for working-age adults.

Among them, 33.5% of those who were unemployed participated in at least one safety net program during the four-year period. This is more than 10% higher than the rate for their peers who weren’t counted as part of the labor force because they were neither working nor actively seeking work.

Hard to Live on Those Benefits

Anyone who thinks the safety net is a comfortable hammock ought to take a look at the Census Bureau’s findings on benefits. During the four-year period, the median benefit for all six programs was $404 a month, adjusted for inflation.

The median is skewed upward by SSI benefits, with a median of $698 a month — about 75% of the federal poverty line for a single person.

Other major cash and near-cash benefits drag the overall median down. TANF/GA participants received a median of $321 a month.

Cycling In and Out

Long about the time the Census Bureau issued its report, Vox published a post by a working woman who’s angry as all get out because people look down on her for participating in SNAP.

She says, among other things, that she doesn’t “do it all the time” — only when she can’t pay her bills and also buy food for her family. She’s never participated for more than 18 months at a stretch.

We can’t see this sort of cycling in and out in the figures the Bureau reports. But we do see something that suggests it — and more clearly, the cycling out part.

Fewer than half the people who participated in any of the safety net programs did so for more than three of the four years the report covers. Variation there, depending on program — from 49.4% for housing assistance to 9.8% for TANF/GA.

At the same time, TANF/GA racked up by far and a way the highest percent participating for no more than a year. This doesn’t, of course, mean that states’ TANF program do a great job at moving poor parents from welfare to work that pays enough to support them and their children.

It could indicate how very low some states set their income cut-offs for continuing eligibility and/or their success at cutting their caseloads by other means, e.g., with sanctions that effectively bump families out of their programs or extremely short time limits, a strategy some Red states have adopted.

It surely does, however, suggest that families don’t linger in TANF because those benefits afford them such a comfortable hammock. Or snare them in “perpetual dependence” because they’d lose the cash and have to pay higher taxes if they moved up the income ladder. (Quoting Bush again here.)

So far as SNAP is concerned, less than a third (30.4%) of those who received them did so for more than a year — whether for 12 months running or some months at one point, some months later we can’t tell.

Another 38.6% participated for three to four years. This could indicate, among other things, under-employment — not failures to work by those who could be expected to, as the Center on Budget and Policy Priorities says.

We know, from other sources, that it indicates rock-bottom earnings by fast-food workers and many in the retail sales sector.

Will any of this make a difference to policymakers who evince such concern about how our safety net programs discourage work — and are growing by unsustainable leaps and bounds? A rhetorical question. Yet the rest of us — some policymakers included — can come to a better understanding of how dynamic “the dynamics of economic well-being” in this country are, thanks to the Census analysis.


More Ways Public Programs Could Improve Life for Low-Income Seniors

June 4, 2015

Here, as promised, are the remaining three steps that Kevin Prindiville, the Executive Director of Justice in Aging advocates to fight senior poverty — and though he doesn’t say so, the hardships of those who’ll remain poor or nearly so.

Increase Assistance With Healthcare Costs

Rising healthcare costs are “one of the drivers of seniors’ economic vulnerability,” Prindiville says. We can go a step further.

Medical out-of-pocket costs are the main reason the senior poverty rate rises when the Census Bureau uses its Supplemental Poverty Measure, instead of the official measure. Factoring them out would produce a 6.3% drop in the SPM senior poverty rate — about 2.8 million fewer poor seniors.

Prindiville advocates reducing or altogether eliminating medical out-of-pockets for low-income seniors. He also urges unspecified expansions of programs designed to help poor and near-poor seniors afford health care — Medicaid, Medicare Savings Programs and the low-income subsidy for Medicare Part D.

Basically, the savings programs help low-income individuals and married couples pay for Medicare premiums — both Part A (hospital costs) and Part B (out-patient costs) for the lowest-income group. The program for these Qualified Medicare Beneficiaries also helps them pay those out-of-pockets.

The subsidy program pays for either the full or partial costs of the optional Part D insurance program, which generally covers some share of prescription drug costs. Here too, how much help beneficiaries get depends on their income level.

Prindiville again stresses the need to protect these programs from cost-shifting proposals. I earlier suggested that he was referring to Republicans’ premium support, a.k.a voucher, programs for Medicare.

But a recent Part D reform needs protection as well, since Republicans seem set on repealing the Affordable Care Act. That would reopen the so-called donut hole, which the ACA has shrunk and will ultimately close.

More seniors would again have to pay the full costs of prescription drugs that exceed a fairly low maximum — just $2,830 in 2010, when the ACA was passed.

And they’d have to continue paying those costs till they reach another maximum — more than $6,000 by 2020, according to Families USA, which optimistically forecast, in 2012, that the ACA will stay in place.

Provide Federal Support for the Long-Term Care Safety Net

Seniors, as well as younger people with severe disabilities can face formidable costs for in-home help with daily activities, e.g., bathing, dressing, housework, and for community-based services like transportation.

Medicaid covers some long-term care costs for some beneficiaries — for whom and how sufficient depends on their state’s policies. A patchwork then — and no safety net at all for seniors with more than minimal incomes and assets.

We’re often advised to take out long-term care insurance, which will partially defray the costs of services in our homes and communities or, when they won’t suffice, residence in a nursing home or assisted living facility.

I have long-term care insurance. Let me tell you, it’s not cheap, especially if you don’t buy in while you’re young and spry. My annual premium is well over twice the average monthly Social Security benefit for retirees.

The ACA attempted to address this problem and the related low-coverage problem by creating a voluntary long-term care insurance program structured somewhat like Social Security. But the U.S. Department of Health and Human Services concluded that the program couldn’t, as intended, pay for itself.

So HHS suspended it. And Congress subsequently repealed it. We’re thus back to square one — a long-term care safety net for some seniors, inordinate costs and/or burdens on younger family members for the rest.

Prindiville launches a preemptive strike against what might surface next. Proposals that would instead rely on seniors, including the poor and potentially poor, to save more for their long-term care needs are “simply unrealistic,” he says.

So he advocates strengthening and expanding public programs to meet long-term care needs, especially through services that enable seniors to age in place — or at the very least, in their communities. Specifics yet to come, I suppose. But we see glimmers in the last of his five steps.

Reauthorize the Older Americans Act

OAA is one of those programs that provides state and local agencies with grants they can use for a wide range of services — all for seniors, of course, but not necessarily only those in poverty.

We’re perhaps most familiar with Meals on Wheels, but it’s also a source of funding for transportation, legal services, benefits counseling, divers health-related services and more.

Poor seniors rely on OAA-funded services heavily, Prindiville says. For seniors more generally, they’re often the difference between aging in place, as most of us want to do, and living out the rest of our days in a nursing home.

In this respect, one could view them as part of the long-term care safety net — and a cost-effective one too. A semi-private room in a nursing home costs, on average, more than $80,00 a year.

Medicaid picks up all or most of the costs for about 70% of elderly nursing home residents. So there’s a compelling fiscal case, if needed, for the OAA-funded services that complement the in-home and community services that Medicaid funds.

OAA is also one of those programs that Congress should have reauthorized some years ago. A pending bipartisan bill in the Senate would do that. Here’s one step that might actually get taken.

Getting the program adequately funded to meet the needs of our graying population is a whole other matter.

Prindiville’s steps — both protecting what we have and gaining what we don’t — all hinge on persuading our federal policymakers that we view the well-being of seniors as a high priority. Justice in Aging has a petition we can sign. And it does it need more signatures!

 


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