What’s really happening with aging policy in Washington? At last week’s annual Gerontological Society of America Conference in New Orleans, a standing-room-only audience was privy to updates from key Congressional committee staffers.
Erika Salway, policy adviser for the Senate Health, Education, Labor and Pensions Subcommittee on Primary Health and Aging, discussed the committee’s work on issues affecting older adults, including federally qualified health centers, primary care, oral health, mental health and the Older Americans Act. Funding for the OAA is $1.8 billion, which may sound high, but she reminded the audience that its programs serve 10 million seniors every year and funding constitutes less than .06 percent of the federal budget. The OAA funds essential services such as Meals on Wheels, job training, caregiver support, transportation and elder abuse services. It expired in 2011 but continues to receive federal funds under the old legislative formula.
“The Older Americans Act is considered by many to be one of the most effective programs ever devised to address the needs of seniors,” Salway said. “Despite what we know about the Act’s success in keeping seniors healthy, independent, and out of nursing homes, the Act’s vital components have been underfunded for years.”
Salway, who works for sub-committee chair Sen. Bernie Sanders (I-Vt.), said that because of the surge in the older population and sequestration, many seniors across the country are wait-listed for Meals on Wheels, despite its proven cost-effectiveness. “You can feed a senior for an entire year for the cost of one day in the hospital.”
The most recent of three reauthorization bills introduced by Sanders, S-1562, passed out of committee with strong bipartisan support. Senate staffers are tweaking the funding formula, in hope of finding additional dollars to support program expansion.
The Senate Special Committee on Aging, chaired by Sen. Bill Nelson (D-Fla.) functions a little differently, said staffer Rachel Pryor. The committee primarily has oversight functions. “Our lens has a huge reach and is able to bring a voice to issues that might not otherwise get a voice in Congress, and to shine a spotlight on issues that other committees may not look at, like elder justice, nursing home violations, and physician transparency.”
Nelson hopes to raise the issues surrounding end-of-life planning and care, “without people freaking out about death panels,” Pryor said. Elder fraud and abuse are other hot button topics for Nelson, who also is a senior member of the Senate Finance Committee – which has jurisdiction over Medicare and Medicaid – and the Senate Commerce Committee, which oversees health insurance. Upcoming hearings will focus on prescription labeling errors, which was brought to light through constituent feedback, and long-term care.
“Things like labels not being up to date, non-matching package inserts, are very confusing for those taking multiple medications,” Pryor said. As for upcoming hearings on the Long Term Care Commission report, “If anything is set up for the Aging committee to take on, it’s that issue. It’s of critical importance to this committee and has long been in crisis stage.” She reminded the audience that rollout of Medicare Part D, which Nelson also had a hand in, did not get off to great start either, but at it’s 10-year anniversary, “things are mostly good and people are happy.”
Pryor also had high praise for Sen. Susan Collins (R-Maine), the ranking Republican on committee. “If you want to see a true example of bipartisanship, you should look at our committee.”
GSA Policy Fellow Brooke Hollister spent the past year working in minority leader Rep. Nancy Pelosi’s office on issues including retirement security. She described efforts to push through any meaningful legislation to help older adults as “frustrating.” Republicans refused to put any revenues on the table and Democrats were reluctant to fight because the President’s ambitious budget included a different way to calculate Social Security cost of living adjustments, called chained CPI. The concern was that it could open the door to some kind of entitlement reform, and the potential for lower Social Security benefits.
Hollister was more optimistic about increased Medicaid expansion: “As we see states expanding for dual eligibles, and the sky not falling, we’re hopeful that more states will follow suit.” She noted that many committee members work in silos, but “we can’t do that any longer – they’re 2 centimeters in on many different issues, and they can’t do that any longer, they have to see how these pieces all fit together.”