What a difference a month makes. A month ago, my colleagues and I were going up to Capitol Hill to talk with congressional offices about the fiscal year 2021 budget. It was that time of the year again, when organizations like B’nai B’rith advocate to Congress about funding for affordable housing for the upcoming fiscal year. As always, these types of meetings were scheduled to take place over the next couple months.  Unfortunately, as everyone knows by now, the world looks very different because of the COVID-19 pandemic. Offices have been closed, meetings have become phone conferences, schools have shut their doors and cities and states have installed massive restrictions on travel. Working from home has caused me and countless other people to go a little stir crazy. However, this might give everyone a sense as to what too many seniors throughout our country experience every day. According to the University of Michigan and the American Association of Retired People (AARP), one-third of older Americans (ages 50 to 80) suffer from loneliness. 

Obviously, given the new guidelines from the Center for Disease Control regarding social distancing, problems associated with social isolation are only going to get worse. Social isolation amongst seniors can have negative impacts on their health. For example, according to the National Academies of Sciences, Engineering and Medicine, social isolation can lead to an increase risk of heart disease, depression and mortality. 

So how can we encourage older Americans to say connected with family and friends while still staying at home? Seniors who have the technology can stay in touch by using video chatting services, social media, phones and texting. Alan Teo, a physician teacher at the Oregon Health and Science University’s School of Medicine, reported that video chatting helps fight depression associated with social isolation in adults 60 and older. According to the data, video chatting (compared to instant messaging, social media and email) is the most effective form of communication to fend off depression.

In addition, seniors can communicate with other people by participating in online faith-based services. For instance, houses of worship have moved their services to the web so everyone can still participate. This a great way for seniors to stay connected with their community without having to leave their home. 

It’s not just social isolation that’s a problem for seniors during this pandemic. The most pressing issue is how we can keep our older Americans safe. Seniors are particularly susceptible to COVID-19, so guarding their safety is incredibly important. B’nai B’rith, as a national sponsor of low-income senior housing across the country, is very aware that precautions need to be taken to ensure our resident’s well-being.  Our sponsored buildings have already cancelled community events like educational classes and parties in the building. In addition, hand sanitizers have been placed throughout the properties and building staff have been given instructions on how to ensure their own safety, as well as the residents. Furthermore, buildings have encouraged everyone to practice “social distancing”. 

At the B’nai B’rith Goldberg Towers and the Pasadena Interfaith Manor in Houston, beginning in mid-March staff contacted all their residents, making sure they had food and medicine to last through the end of the month. Additionally, building staff offered to help those residents who were unable to get their food and medications. Also, there are plans in place to regularly check-in on residents through April. Lastly, staff has been instructed to wear hand gloves when entering a resident’s apartment to ensure the safety of everyone.  
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Almost everyone either has an older adult in their family or part of their social circle.  With COVID-19 sadly having no end in sight, now would be a great time to contact the seniors in your life. Even if they don’t need help getting life’s necessities, video chatting or talking on the phone for a few minutes could go a long way in their physical and mental well-being.  

Ever since the Affordable Care Act (ACA) was passed into law in 2010, members of Congress and the administration have been doing everything possible to repeal this important healthcare legislation. Another potential Supreme Court showdown impacting the ACA is on the horizon. Consequently, it got me thinking about ways the ACA impacts older Americans; in particular, how the ACA’s Medicaid expansion benefits older adults.

Medicaid is a cooperative, means-tested healthcare program that currently provides coverage to around 71 million people. It was created in 1965 to deliver medical care to various low-income populations, such as people 65 and older, children, adults and people with chronic disabilities. Because of the ACA, states have the option to expand Medicaid eligibility for people under the age of 65 with income up to 133 percent of the federal poverty level (FPL.)

So have older Americans benefited from the Affordable Care Act’s Medicaid expansion? The answer is a resounding yes!
For starters, the Urban Institute and the American Association of Retired People (AARP) report that because of the ACA’s Medicaid expansion and other reforms, the uninsured rate for older adults, ages 50 to 64, was cut in half by 2015. Also, the ACA’s premium tax credits have helped over 3 million people in this age range afford health insurance. This news isn’t just good for older adults before they turn 65, but is critical for when they are Medicare-eligible. As I reported in my blog, “Repealing and Replacing the Affordable Care Act and its Impact on Medicare,” evidence demonstrates that Medicare-eligible seniors with prior health insurance require less expensive health care than people who were uninsured before they enrolled in Medicare.

To further the point, the University of Michigan recently released a study that examined the impact Medicaid expansion had on the mortality rate of older adults (55 to 64 years old) in expansion states vs. non-expansion states. The study concluded that between 2014 and 2017, the ACA’s Medicaid expansion saved 19,200 older adults’ lives. Expansion could have prevented another 15,600 deaths in non-expansion states. Overall, I think the Center on Budget and Policy Priorities summed up Medicaid expansion best: “If all states had expanded Medicaid, the number of lives saved just among older adults in 2017 would roughly equal the number of lives that seatbelts saved among the full population, based on estimates from the National Highway Traffic Safety Commission.”

Furthermore, the study stated, “The estimated impact of the expansions increases over time, suggesting that prolonged exposure to Medicaid results in increasing health improvements.” Researchers reported that mortality reduction rates in Medicaid expansion states can be attributable to better health outcomes in the areas of cardiovascular disease, diabetes and early detections for breast and cervical cancers. I think it’s fair to conclude that government programs that expose more people to health care lead to healthier outcomes.

Strengthening the argument, last November, Kaiser Health News’ Laura Ungar, authored a fascinating article entitled “The Deep Divide: State Borders Create Medicaid Haves And Have-Nots” documenting the differences in health care between the states of Illinois and Missouri. While these two states lie right next to each other, only separated by the Mississippi River, the difference between their two Medicaid programs couldn’t be more different. For instance, the state of Illinois has reaped the benefits of Medicaid expansion by being able to provide health coverage to an additional 650,000 people, while Missouri’s decision not to expand Medicaid has denied health care coverage to 200,000 people. 

The article further highlights the point with a human interest story about Patricia Powers, a resident of Missouri, who lost her health insurance. Because she was unable to afford health insurance, she never visited a doctor and was unaware of the cancerous tumors in her breasts. In addition, she discontinued taking medicine for high blood pressure and anxiety, because it was cost prohibitive. What makes the story even more tragic is that if she lived in Illinois, she would have qualified for Medicaid. Eventually, in her early 60s, the cancer was discovered upon visiting Casa de Salud, a low-cost medical clinic in Missouri. Since Powers was ultimately diagnosed for breast cancer, she became eligible for Medicaid that allowed her to receive treatment for the disease.  

What makes the decision by some states not to expand Medicaid maddening is that often it’s significantly easier and cheaper to treat patients when the medical problem is in its infancy. Jorge Riopedre, president and CEO of Casa de Salud said, “Even if you didn’t care about the human cost, you should care about the economic cost. Treating a disease at its first stage is always going to be much cheaper than treating it at its advanced stage.”

Thankfully, Medicaid expansion advocates in the state of Missouri are trying to get the issue on the November 2020 ballot. We can only hope that after election day, thousands more Missourians will be eligible for health care coverage.
The benefits of the ACA don’t just stop with improving the rate the of insurance. They also extend to protections for people with pre-existing conditions and curtailing what insurance companies can charge older adults compared to younger people in the marketplace.
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Despite the millions of Americans that have benefited from the ACA, it continues to be under attack.  If the congressional ACA fights of 2017 taught us anything, it’s that Congress is no closer to agreeing on healthcare than they are on immigration, taxes or any other “hot button” issue. The benefits of the ACA in the older adult community can’t be denied any longer. However, we can only hope that once again, this legislation can withstand judicial scrutiny.

As my friends and family are aware, I am an avid sports fan. I can speak fluently about the teams I root for and the great sports moments I have witnessed. Whether it’s going to the World Series with my father at Yankee Stadium or watching football with friends, I sometimes feel like I am an encyclopedia of sports knowledge. That is why I was recently excited to learn about the National Senior Games. The National Senior Games are a sports competition for people 50 and older.  Like the Olympics, various athletic contests are conducted, ranging from swimming, basketball, bowling, archery, badminton, cycling, golf, horseshoes, pickleball, softball, track and field, etc. The games first started in 1987 in St. Louis, Missouri, with 2,500 people competing.  Since then, the games have been held every other year, most recently in 2019, in Albuquerque, New Mexico, where over 13,000 people competed.

Throughout the history of the games, competition amongst aging Americans have brought us success stories that have been both heartwarming and remarkable. One of the greatest athletic achievements during the games’ history belongs to Julia “Hurricane” Hawkins.  Hawkins, at the ages of 101 and 103, competed in the 100 meter dash.  She finished in 39.62 seconds at 101, and 6 seconds slower at 103. To put this feat into perspective, 100 meters is 109 yards, which is longer than a football field. While sports conversations have produced great debate amongst friends and colleagues, I think we can all agree at 103, her increase in time is understandable. In order to stay in shape Hawkins trains on the street by her house.  However, as she told the New York Times, by her own admission, “As I get older, I feel like I only have so many 100-yard dashes left, and I don’t want to waste them in practice.” Amazingly, she only got into running at age 100, because she previously participated at the games as a competitive biker. Sports have always provided a great outlet for individual accomplishments, I think it’s fair to say none more so than Hawkins’ participation at the National Senior Games.

The National Senior Games also provides a venue for rivalries to be renewed. In the 1970s, Bob Shannon and Jeff Johanson, both swam for competing high schools in the San Francisco area.  They would compete against each other in medleys and relays and eventually at the College of San Mateo, where both were teammates on the water polo team. As luck would have it, they ran into and competed against each other at the last National Senior Games.  According to the National Senior Games Association, Shannon said, “Besides going for my personal best, I’m now thinking, ‘It’s on!’ There’s no way he’s beating me in the 50 backstroke, and I knew he was thinking he would beat me in the breaststroke.” As it turns out, Bob beat Jeff in the backstroke and Jeff bested Bob in the breaststroke. Both also left the games with some additional accomplishments. Bob beat his swim time from high school, and Jeff won the silver medal in the 200 yard breaststroke.

The National Senior Games has provided countless more inspirational stories.  Older Americans participating in these competitions have used sports as a motivational vehicle to rebound from injuries, mourn the loss of a loved one or provide an outlet for a passion project during retirement. Fortunately, America is taking notice with ESPN, The New York Times, Sports Illustrated and CNN all having covered the games.
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While writing the article, I couldn’t help but notice that softball was on their list of participating sports.  As someone who plays softball throughout the spring and summer, I can’t help but wonder if I might be fortunate enough to play in the National Senior Games down the road.  While I don’t think my athletic feats will ever rise to the level of Julia “Hurricane” Hawkins, I wouldn’t mind trying my luck someday! 

​Evan Carmen, Esq. is the Legislative Director for Aging Policy at the B’nai B’rith International Center for Senior Services. He holds a B.A. from American University in political science and a J.D. from New York Law School.  Prior to joining B’nai B’rith International he worked in the Office of Presidential Correspondence for the Obama White House, practiced as an attorney at Covington and Burling, LLP, worked as an aide for New York City Council Member Tony Avella and interned for Congressman Gary Ackerman’s office. Click here to read more from Evan Carmen.

When my grandfather was 91, my parents sat him down and broached the idea of him giving up his car keys.  As you can imagine, that idea was not met with a lot of enthusiasm.  However, my parents felt that because of his physical limitations, safety required him to stop driving.  After a long discussion and a lot of convincing, he handed over the keys. I bring this story up because I recently learned our country arguably has more safeguards in place that govern who can drive a vehicle than those that govern who can own a firearm. Obviously, the purpose of this blog is not to advocate for the confiscation of guns from all people, but to discuss when conditions like dementia make gun ownership amongst our older American population a deadly problem.

So, how much of an issue is firearm ownership amongst seniors around the country? The Pew Research Center reported 45 percent of seniors live in a household with a firearm, and the United States Census Bureau indicated that 4.3 million seniors have dementia.  Also, the Center for Disease Control and Prevention stated that in 2016, about 8,200 older Americans (65+) committed suicide. Furthermore, according to the New York Times, amongst men in this age group who committed suicide, three quarters of them used a gun.  Dr. Yeates Conwell, a psychiatrist and director of the Office for Aging at the University of Rochester School of Medicine, said, “Suicide risk is elevated in people with dementia.”

In 2018, Kaiser Health News and PBS NewsHour studied aging Americans, dementia and gun ownership. While there is no formal office which keeps records on this matter, the investigation was able to study over 100 instances in the United States since 2012, where someone with dementia killed themselves or someone else with assistance of a firearm. Often, the shooter suffered from confusion, paranoia, delusion or aggression, frequently associated with dementia. Regrettably, their victims were the people closest to them, including caretakers, spouses and children.

For instance, according to the report, Larry Dillon of West Virginia, upon turning 65, started exhibiting several signs of concerning behavior such as being frightened of intruders entering and burning down his house. In addition, Dillon went to bed at night with a 9 mm semiautomatic Glock pistol in his nightstand.  Consequently, Dillon’s daughter made an appointment with a neurologist. However, it was unfortunately too late. One night, Dillon heard what he thought were people breaking into the house, so he took his Glock and fired bullets into the room where his wife and granddaughter were watching television. Sadly, his wife died, and his granddaughter has experienced horrific trauma witnessing the event. After a medical examination, a diagnosis revealed that Dillon had Lewy body dementia, which manifested itself in warning signs like vivid visual hallucinations.

Statistics and stories like these have caused the American Medication Association to declare gun violence a public health crisis! They have called for common sense reforms like banning assault style weapons and removing guns from those people who pose a high risk for violence.

Fortunately, seventeen states have passed red flag laws, which allow the government to be more proactive to ensure that firearms are not in the possession of individuals who are determined by the court to be a risk to themselves or other people. Many times, the court is alerted to concerning behavior because of friends or family of the individual. Recently, red flag laws having been gaining traction throughout the country, with 12 states having passed legislation since the tragic shooting at Marjory Stoneman Douglas High School in Florida. Obviously, further action is desperately required.  Presently, Senators Richard Blumenthal (D-Conn.) and Lindsey Graham (R-S.C.) have advocated for a federal red flag law that would provide financial resources to states that choose to implement the policy.  However, predictably, this legislation, along with countless other gun control efforts, has stalled, with the White House and too many members of Congress woefully neglecting their responsibilities by failing to pass common sense gun violence laws.  Until the federal government can govern on this matter, I hope the remaining 33 states pass their own red flag statutes to curb the epidemic of gun violence.   
What makes the federal government’s inaction on this matter even more disappointing is that there is overwhelming public support.  In 2017, the Pew Research Center indicated that 89 percent of the United States supports regulating firearm purchases to people with mental illnesses. Politically, this sounds like a slam dunk. However, to the surprise of nobody, we still don’t have red flag laws on the books that govern the entire country. 

So what’s the holdup?  For starters, gun advocate groups have been a major roadblock to responsible gun safety legislation.  These groups argue that red flag laws allow the government to take away firearms from citizens who have yet to commit a crime. Kaiser Health News and PBS NewsHour reported that Dr. Arthur Przebinda from the group Doctors for Responsible Gun Ownership “balks at any formal assessment of firearm use among people with dementia, saying it could lead to “a totalitarian system that decides when you can have rights and when you cannot.”

Dr. Przebinda is taking an absolutist stance on a law which could save lives.  Exactly what is his argument? Everyone can own a gun? I hope everyone accepts that young children shouldn’t own guns because they don’t have the appropriate cognitive abilities. So why would we accept adults with limited cognitive abilities be allowed to own a gun?  It’s absurd to argue that we should wait for people to die before taking proactive measures regarding an individual’s firearms, if they show clear signs of dangerous behavior. Let me be clear, I am not arguing for the confiscation of everyone’s guns. I am advocating for a process which respects due process and gets firearms out of the hands of someone the government believes doesn’t have the mental capacity to own a gun. Is that such an unreasonable position? Taken one step further, I can’t falsely yell “fire” in a crowded theatre because it puts people’s safety into danger, so why should someone who exhibits behavior that threatens themselves or other people be allowed to own a gun? I will take my chances we won’t spiral into a totalitarian government.

Florida is one of the states which has enacted red flag laws and Kendra Parris, a local attorney, has represented individuals in court who are at risk of losing their guns.  Parris told the Pew Charitable Trust in regard to due process and red flag laws,  “Rather than find clear and convincing evidence, [courts are] basically saying, ‘Better safe than sorry.”  I find Parris’ observations fantastic news! No gun owner should lose their property without due process. However, let’s neutralize any potential danger, and then the court can rule on the matter. Around 40,000 people die a year from gun violence. I can sleep at night having the court securing everyone’s safety and applying due process second.  

Organizations like the National Rifle Association (NRA) have argued that households that have firearms and people with dementia can safely secure their gun with trigger locks and gun safes.  However, the Alzheimer’s Association believes the NRA’s recommendations don’t go far enough, because people with dementia will still believe they are in danger and look for ways to crack safety precautions. The organization suggests the best way to protect your family is to not have the gun in your home.

So in the absence of further laws, what can people do? Well, the good news is that there is momentum in the medical community to help stop gun deaths.  In 2017, after the Las Vegas shooting that left 58 people dead, over 1,300 health care providers promised to start talking with their patients about guns when certain risk factors are identified. In addition, the Veterans Health Administration and Alzheimer’s Association both suggest asking about firearms when evaluating a patient for dementia. However, the medical community has been too limited for years because the Center for Disease Control (CDC) was basically unable to do gun violence research. Regarding the past twenty years, Giffords: The Courage to Fight Gun Violence’s (an organization led by former Congresswoman Gabby Giffords) website states, “In 1996 Congress took away dedicated federal funding for gun violence research from the CDC. For more than 20 years, federal investment in gun violence research has remained virtually absent at the nation’s primary health protection agency, despite gun deaths increasing for the past three years in a row to levels not seen in decades.” Fortunately, Congress, in the last government spending bill, finally appropriated $25 million to study gun violence.
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As we look to the future, the University of Colorado School of Medicine predicts by 2050,  8 to 12 million people will live in the U.S. who suffer from dementia and own a gun. As a country, we can’t be afraid to pass basic common sense gun violence legislation that could save countless lives. Congress and the White House must find the political courage to stand up to outside influences that believe common sense gun reform legislation is by definition against the Second Amendment. Until that day, hopefully, the individual states can lead the charge to ensure a safer America. 

Who reading this blog has ever ordered a pizza online? It’s a simple task, right? You go onto the pizza place’s website, you put in your order and the delivery person shows up at your door within an hour. Sounds easy, and it’s something we all take for granted.  Now imagine trying to order a pizza online if you are visually impaired.  That’s exactly the problem Guillermo Robles of Los Angeles faced ordering food online from Domino’s Pizza, because the website did not have the software needed for visually impaired people to hear the information audially. Consequently, Robles filed a lawsuit in federal court claiming his rights were violated under the Americans with Disabilities Act (ADA) since he couldn’t access Domino’s website. Obviously, this isn’t a problem unique to Robles. According to the National Institute of Health, the estimated number of legally blind people in the United States is around a million. In addition, about three hundred and fifty thousand seniors in our country are blind.

According to the ADA, “No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any private entity who owns, leases (or leases to), or operates a place of public accommodation.” In court, Robles argued that the ADA applies to websites and physical locations, while Domino’s asserted the ADA only governs  physical locations.

Furthermore, Domino’s contends the ADA does not apply to the internet because the federal government has failed to issue guidance on how to make websites accessible for the disabled community. In addition, the United States Chamber of Commerce and the National Federation of Independent Business in a brief supporting Domino’s, argued that Robles wasn’t discriminated against because he had access to a telephone. In contrast, Robles contends that ordering online allows customers to view a more expansive menu, avoid background noise and phone delays. Also, according to Robles, Domino’s pizza only displayed a telephone number readable by screen-reading software after he brought litigation.

During litigation, the 9th Circuit Court of Appeals ruled that the ADA applies to Domino’s website because the internet connects customers with the bricks and mortar of the restaurant. While Domino’s petitioned the Supreme Court to hear the case, the request was recently denied. With other federal courts around the country having ruled on similar litigation, it seems like only a matter of time before the Supreme Court will have to weigh in.  

In 1991, when the ADA was signed into law by President George H.W. Bush, lawmakers clearly had no way of knowing how intertwined commerce would be with the internet. However, that doesn’t mean the ADA doesn’t apply to the web. The lawsuit brought by Robles isn’t just about pizza; it goes directly to how visually impaired people are able to participate in the 2019 economy.  Joe Manning, the attorney for Mr. Robles, said, “The blind and visually impaired must have access to websites and apps to fully and equally participate in modern society - something nobody disputes.”

Leaving the law aside, I think that Christopher Danielsen from the National Federation of the Blind said it best. “There is a ton of space for innovation in this area…Rather than refusing to take the money of those of us with disabilities, why not innovate and take our money?” 

Regardless of whether the Supreme Court ultimately decides to hear a case like this, wouldn’t it be nice if businesses in a 21st century economy took a proactive approach to make their website as accessible as possible to all people?  

Sometimes it’s hard to believe that the first primary/caucus for the Democratic nomination for president is still five months away. Politicos around the country have watched the candidates at debates, state fairs and on cable news. It’s not even Halloween and it can feel like we are in the bottom of the ninth inning of the 2020 election cycle, when in reality it’s probably the first inning.  How many of us have heard the pundits give their opinion on the race, only to hear someone else give the exact opposite opinion! While it’s impossible to know who will win the Democratic primary, examining previous voting trends provides clues as to which type of candidates might fare better come next year.  

As I mentioned in my previous blog “Seniors and Voter Participation,” older Americans can always be counted on to vote! For example, according to the U.S. Census Bureau, 66 percent of seniors voted in the 2018 midterm election, compared to 36 percent of young people.  However, voter participation amongst younger voters jumped 79 percent compared to the previous 2014 midterm election, (U.S. Census Bureau). In addition, in the previous two presidential elections voter participation hovered around 70 percent for seniors (U.S. Census Bureau) and 46 percent (U.S. Census Bureau) for young people. Clearly, older Americans are a more reliable voting block than younger voters. Still, young people have become more politically engaged.

Furthermore, what drives young and older voters to the polls to elect a Democrat presidential nominee? According to Yougov/HuffPost and Gallup polls, a person’s age can be an important factor in determining what traits they look for in a presidential nominee.  For example, older voters are more likely to care about electability, while young voters want their party’s nominee to more closely share their ideological views.   

State senator Dick Harpootlian from South Carolina told the Atlantic, “I think older voters would tend to be more pragmatic, and by that I mean simply the assessment going on is, What’s the goal of this election? The vast majority of Democrats, I think, are pragmatic about that. Who is our best choice to go toe to toe with Donald Trump in 2020?.”  Conversely, Lauren Camera in US News and World Report wrote about young people, “They aren't party-ticket voters, they aren't impressed by electability, and candidates can't win their support by crafting specific policies on issues that matter to them. They respond instead to candidates they think share their values and vision for how the country should work and who it should work for…”
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Who is more likely to vote in the 2020 Democratic primaries? Based on previous elections, I think it’s fair to say seniors will make up a good percentage of the primary voting electorate.  How many young people vote remains to be seen. Young people are voting at higher rates, but will they vote in enough numbers to swing the race for one candidate?  Voter turnout is generally lower in primaries compared to general elections.  However, given how polarizing politics has become, it’s certainly possible that voter turnout throughout 2020 could hit record highs. At this point the only thing about the Democratic primaries I know for sure is that I am not sure who is going to be the party’s nominee. 

 
Recently, I received an early morning phone call from my parents in Europe.  While I talk to my parents once a week when they are on vacation, I never receive calls first thing in the morning. I thought to myself that something must be wrong. Making things worse, trying to communicate with my parents was difficult since the phone connection on their cruise was terrible. However, I was able to understand them saying, “Grandpa is in the hospital.”  Fortunately, my parents established a better connection and explained my grandfather’s medical situation and that the matter was not an emergency. While not an emergency, at ninety-four, anytime he is in the hospital it’s not small potatoes.

The next few days I was in constant communication with my grandfather, his doctors and my parents.  I feel like I got a crash course in medicine, learning about different medications and procedures. Trying to talk with the professionals about the intricacies of his medical situation, and then communicating that information to my parents, often through email, proved to be a challenging, yet doable, task.

After a few days, with his condition still not improving, I decided the best course of action was for me to travel to New York and visit him in the hospital.  While packing for my trip, my wife turned around to me and said, “You know, you should write a blog about children and grandchildren who are caregivers for their elderly parents or grandparents. Look at how much time you have spent on the phone over the past few days getting updates on your grandfather’s condition. Can you imagine being a caregiver for a family member day in and day out?”  

Consequently, it got me thinking. Who are the millions of people that dedicate their lives to helping their family members in need? Often, caregivers are responsible for helping their family members with mobility issues, cooking meals, shopping, laundry, bathing, companionship and transportation.

Firstly, there about 44 million people who provide unpaid family care to a disabled child, spouse, sibling or parent. Secondly, according to the American Association of Caregiving Youth, there are 1.4 million children between 8 and 18 who are caregivers, and the Center for Retirement Research at Boston College, reports that 10 percent of older Americans in their 60s and 12 percent of seniors in their 70s whose parents are living, serve as caregivers. The number of children and seniors who are caregivers was not a statistic I was expecting to discover. It’s hard to imagine someone who is 8 or 79 serving as a caregiver.    

While people often are happy to be caregivers for loved ones, the devotion comes with a price. For instance, there is a financial burden placed upon caregivers who are performing unpaid labor. Sadly, the financial costs run deeper than simply not receiving a paycheck because often caregivers are forced to quit their paying job or reduce their hours. This is problematic because it causes people to have reduced pay, which can have lasting consequences on people’s pensions, Social Security earnings and 401k accounts. Furthermore, when adults serve as caregivers, it can lead to problems for their own health. Research discovered that caregivers, despite going to doctor’s visits with family members, are less likely to take preventive health care measures such regularly monitoring their blood pressure and having mammograms and colonoscopies. For children, the negative effects of being a caregiver can manifest themselves when they conflict with homework, socialization with peers and a student’s ability to concentrate in class.

So now that we know a problem exists for caregivers, how can we provide a fix? As I mentioned in a previous blog, “Paid Family Leave: It Impacts Seniors Too!,” Senator Kirstin Gillibrand (D-N.Y.) and Congresswoman Rosa DeLauro (D-Conn.) introduced legislation in Congress that would provide people paid leave in the event they have to look after a sick parent. While this would only help people who are temporary caregivers, at least it’s a start. Other ideas include a caregiver tax credit or allowing caregivers to earn a credit towards future Social Security earnings.
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Upon reflection, my week of monitoring my grandfather’s medical condition was easy, compared to the countless tasks caregivers are required to perform every day. Fortunately, my grandfather got better and returned home! Unfortunately, all too often, countless children and seniors must assume a caregiver role that requires them to make sacrifices for a loved one. Hopefully, through public awareness and legislative fixes, we can make policy changes that ensure the financial, physical and emotional wellbeing of caregivers of all ages! 

Recently, the White House has considered changing how the federal government calculates the poverty line by altering how inflation is measured. As a result, this change would potentially result in fewer people falling below the poverty line. While the idea of having fewer people in poverty sounds great, this proposal would actually cause a smaller number of people to qualify for badly needed government assistance.

The poverty line is critical because it’s used to determine if people are candidates for specific benefits associated with programs like Medicare, Medicaid, the Affordable Care Act (ACA) and Supplemental Nutrition Assistance Program (SNAP). Presently, individuals who make less than $12,490 a year are under the poverty line, which includes 4.7 million seniors.

Let’s take Medicare as an example. The administration’s change to the poverty line’s calculation would increase the costs of prescription drugs and premiums for low-income seniors. This would impact approximately 250,000 seniors who use prescription drugs and could force 150,000 elderly people to pay more than $1,000 for continued coverage for doctors’ visits.

Sadly, changing the poverty line calculation would also decrease the benefits for older Americans associated with Medicaid. At the moment, millions of adults have qualified for Medicaid expansion through the ACA, including older adults between 50 and 65. Under the administration’s proposal, changing how inflation is measured for the poverty line would cause 250,000 people to lose their Medicaid expansion coverage over a 10-year period.

Unfortunately, the negative impact of changing the poverty line calculation does not stop with healthcare. The Low Income Home Energy Assistance Program (LIHEAP) helps people in this country with their energy bills, like those for heat and air conditioning. According to a 2018 survey by the National Energy Assistance Directors’ Association, seniors are in 46 percent of households that receive LIHEAP. Are we really suggesting cutting benefits from low-income seniors who need help with their energy bills, especially in states with extreme weather like Florida and Minnesota?  

When Congress passed tax cut legislation in 2017, B’nai B’rith argued that ballooning deficits could cause lawmakers to campaign for cuts to important social programs like Medicare and Medicaid. Our press release from December 2017 stated, “Perhaps the biggest danger this Congressional tax plan includes is the likelihood of future cuts to critical federal programs such as Medicare and Medicaid to help pay down what most economists say will be a massive increase in the deficit that will result from these tax cuts. Experts predict that the ensuing revenue short-fall would have to be made up by drastic cuts to programs fundamental to seniors in need.”

So here we are! The U.S. budget deficit ballooned to $738.6 billion during the first eight months of the 2019 fiscal year, and, as we predicted, proposals have been rolled out that cut benefits from older Americans.
  
Seniors living below the poverty line are not likely to gain full-time employment to pull themselves up by their bootstraps. Consequently, I hope the administration rethinks this policy so our country can help meet the challenges faced every day by older Americans.

​​Evan Carmen, Esq. is the Assistant Director for Aging Policy at the B’nai B’rith International Center for Senior Services. He holds a B.A. from American University in political science and a J.D. from New York Law School.  Prior to joining B’nai B’rith International he worked in the Office of Presidential Correspondence for the Obama White House, practiced as an attorney at Covington and Burling, LLP, worked as an aide for New York City Council Member Tony Avella and interned for Congressman Gary Ackerman’s office. Click here to read more from Evan Carmen.​​

As everyone is aware from the news, student loan debt is an enormous problem in this country. A whopping 44 million people have incurred a total of $1.5 trillion in debt.  And yes, you read correctly, that’s trillion with a T! Most people associate this crisis with young people in their 20s and 30s. However, there is a rapidly growing population of older Americans who are being crippled by student loan debt. Surprising as it may sound, student loan debt is hurting seniors at an alarming rate.

Now, you are probably saying to yourself, how can that be? How is it possible that people 60+ have not paid back debt incurred in their 20s? First, the student loan debt drowning older Americans was not incurred during their 20s. Seniors with debt tend to be:

1) individuals who took out or cosigned loans to help finance their child or grandchild’s college education, or

2) people who went back to school during the Great Recession in 2008 to improve their marketability for future employers.

These two factors have led to financial hardship on senior citizens.

For example, the Wall Street Journal reported that people age 60+ owe $86 billion in student loan debt, and that between 2010 and 2017, this group’s student loan debt rose by 161 percent. Richard Cordray, former director of the Consumer Finance Protection Bureau (CFPB), said, “It is alarming that older Americans [age 60+] are the fastest growing segment of student loan borrowers…We are concerned that student loans are contributing to financial insecurity for many older Americans.” According to a report issued by CFPB during the Obama administration, an increasing number of seniors are seeing their Social Security benefits taken to pay back student loan debts, despite this being their only income every month.  In addition, the report states that the increasing debt on the backs of older Americans has caused them to save less for retirement.

Recently, the American Association of Retired People (AARP) reported about Kevin and Tonya Bower from Kelso, Washington.  They took out $75,000 in student loans to pay for their daughter’s college education, as well as their own. They both returned to college during their 40s because of the negative impact the Great Recession had on their careers. Kevin returned to public school to get a bachelor’s degree in business, organizational management and leadership, while Tonya returned to school for a two-year degree in web and graphic design. Although the couple refinanced their loans, they have been forced to reduce their 401(k) contributions due to their $700 monthly loan payments.  

Obviously, the government’s ability to garnish your Social Security if you are delinquent on your federal student loans is problematic for seniors who are financially struggling. Thankfully, Senators Rob Wyden and Sherrod Brown have introduced legislation that would end the federal government’s practice of taking away Social Security benefits to pay back student loan debt. They feel that Social Security should not be used as a vehicle to pay back student loans. Senator Brown said, “Americans work hard to earn their Social Security and we cannot allow it to be stolen away by student debt…instead of going after seniors and the disabled, the government should be working to address the skyrocketing cost of higher education and provide Americans with relief from the crushing levels of student debt.” When a senior’s Social Security benefits are partially seized by the government, the effect can be particularly painful if the senior was unable to personally save for retirement. 

Some people might argue that older Americans shouldn’t be taking out loans for their children and grandchildren to attend college. Why can’t these kids just attend public school?  Unfortunately, according to U.S. News & World Report, even public colleges for in-state residents cost around $40,000 for a four-year education.  For families living paycheck to paycheck, saving up for even state school can be a daunting challenge. 
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Education, no matter the age of the student, should not come with debt that makes a real retirement unattainable.  Government at all levels should be doing more to ensure that older Americans can provide education for themselves and their family without risking their golden years. 

​Evan Carmen, Esq. is the Assistant Director for Aging Policy at the B’nai B’rith International Center for Senior Services. He holds a B.A. from American University in political science and a J.D. from New York Law School.  Prior to joining B’nai B’rith International he worked in the Office of Presidential Correspondence for the Obama White House, practiced as an attorney at Covington and Burling, LLP, worked as an aide for New York City Council Member Tony Avella and interned for Congressman Gary Ackerman’s office. Click here to read more from Evan Carmen.​​

Throughout my time working at B’nai B’rith, I have had the opportunity to tour a majority of our sponsored senior housing properties around the country. Recently, I visited B’nai B’rith Covenant House in Sheboygan, Wisconsin, helping to welcome Rep. Glenn Grothman to the building.  Before the congressman visited, I spoke with residents of the building and noticed how eager they were to advocate for seniors programs like affordable housing. What impressed me the most was that residents were more concerned with building additional senior housing across the country, which would help more seniors, and less worried about current rental reform proposals that could negatively impact them. It was reassuring that their first instincts were to address the affordable housing crisis facing low-income seniors who did not already have the benefit of subsidized safe and affordable housing, as they did.  

Over the past few years I have written numerous blogs detailing how policy proposals debated here on Capitol Hill, could impact older Americans. However, I thought it might be appropriate to highlight one of the faces behind HUD affordable housing for seniors. While visiting Covenant House, I had the pleasure of speaking with Evelyn Brazelton.

Evelyn has been happy to call Covenant House home since August 2018. While originally from Wisconsin, she never stayed in one town long enough to establish roots. Since her father worked on farms as a field hand, the family continuously moved around the state so her dad could find work. Evelyn said that because of the constant moving, coupled with her shy personality, she was never able to establish real friendships with other children. She always considered herself dedicated to family and at 19 married her high school boyfriend.

Evelyn was blessed to have five children and was a homemaker until she was 40, when she started attending technology  school with a focus on math and banking. This allowed her to work as a commercial loan assistant for a bank and at a dentist’s office tasked with accounting and receptionist duties.  
 
Prior to returning to Wisconsin, Evelyn lived with her children in California and Minnesota. Like so many seniors, she did not want to be a burden on her kids, and initially looked for HUD affordable housing in California. Unfortunately, while not surprising, the waiting list for senior housing in California was a year. Evelyn is no different than countless seniors in our country whose only source of income is Social Security, and who were unable to save enough for retirement and are placed on HUD senior housing waiting lists. Just look to B’nai B’rith housing communities across the country where waiting lists to get into our sponsored Section 202 properties can be a year or longer, or even closed. 

Finally, while living with her son in Minnesota, Evelyn got the call that Covenant House had a vacant unit she could call home.

Evelyn has absolutely loved her time living in Covenant House. For instance, she adores the small community feel and, because of her bad back, she appreciates how the building is customized for older persons. Furthermore, she enjoys developing friendships with the other people in the building.

Evelyn has been sick with anemia and she raves about the support in the building from her fellow residents. She talks about how friends in the building go with her to doctor appointments and bring her food. In return, Evelyn tries to be supportive of others in the building who are dealing with health concerns and donates excess clothing to other residents.

Like many residents at Covenant House, Evelyn wants to know why additional HUD senior housing is not being created. With of the aging of the large baby boomers demographic, she doesn’t understand why our government is not prioritizing housing.

Every building in the B’nai B’rith community has someone like Evelyn. Her story, while interesting, is also common throughout HUD senior housing.  She is someone who raised a family and had a professional career, but was unable to save enough for retirement. Programs like HUD senior housing make life just a little easier for older Americans. Consequently, Congress and the White House should be taking Evelyn’s advice, and do everything possible to create more affordable housing for seniors.    

Evan Carmen, Esq. is the Assistant Director for Aging Policy at the B’nai B’rith International Center for Senior Services. He holds a B.A. from American University in political science and a J.D. from New York Law School.  Prior to joining B’nai B’rith International he worked in the Office of Presidential Correspondence for the Obama White House, practiced as an attorney at Covington and Burling, LLP, worked as an aide for New York City Council Member Tony Avella and interned for Congressman Gary Ackerman’s office. Click here to read more from Evan Carmen.​​