It has been a busy 2017 at the Center for Senior Services (CSS), and we are pleased to report on our advocacy efforts. Throughout the year we have been advocating on a wide range of senior issues relating to health care (Medicare and Medicaid), Social Security and affordable housing. Our work included meetings on Capitol Hill, organizing tours of B’nai B’rith sponsored buildings and co-sponsoring rallies on affordable housing. During the year we were excited that our work was noted by the Jewish Telegraph Agency (JTA), The Times of Israel and the New York Jewish Week.
Our advocacy efforts went into high gear in March when the White House’s proposed 2018 “skinny” budget was released, which called for a 13 percent reduction in the Department of Housing and Urban Development’s budget. A few months later when the administration’s more detailed budget was announced, B’nai B’rith was severely disappointed that Section 202, which is housing that was developed for low-income seniors, was underfunded and the White House proposed a rental increase for residents.
Staying on top of the issue, the CSS team started visiting senator and representative’s offices on Capitol Hill that represent B’nai B’rith sponsored buildings. Specifically, we met with offices that work on the House and Senate Appropriations Subcommittees on Transportation, Housing and Urban Development. These committees are responsible for writing legislation that funds rental subsidies for the Section 202 program. During the course of these meeting we explained to staff members how damaging the White House’s budget would be for low-income Section 202 residents. While the 2018 budget has not been finalized we are hopeful that our advocacy efforts on Capitol Hill will lead to the Section 202 program being funded more.
In addition, we followed up those visits by inviting members of Congress and their staff to tour B’nai B’rith Section 202 buildings throughout the country. We are pleased to report that Reps. Jamie Raskin (D-Md.), Matt Cartwright (D-Pa.), Grace Meng (D-N.Y.) and Charlie Dent (R-Pa.), representing both political parties, toured our sponsored properties. Furthermore, three of the four members who visited B’nai B’rith sponsored buildings work on the Appropriations Committees. These tours were a fantastic opportunity for members of Congress to see the benefits of the Section 202 program, and gave residents a chance to speak with their elected representative. Residents were able to directly tell their member of Congress the vital role Section 202 housing plays in their lives.
B’nai B’rith was also pleased to co-host with LeadingAge the “Save HUD 202” Rally and partner with the National Low Income Housing Coalition for the “National Housing Day of Action” over the summer. These rallies took place on Capitol Hill and featured representatives and senators who spoke about the need for affordable housing. We were certainly delighted members of Congress who represent B’nai B’rith sponsored buildings attended the event.
Our advocacy during the course of the year didn’t just stop with affordable housing. We spoke out against the White House and Congress’ attempts to repeal and replace the Affordable Care Act (ACA). After analyzing various proposed bills, B’nai B’rith was very concerned how these policies could negatively impact seniors. For example, many of the proposed replacement bills would have cut critical funding to Medicaid, allowed older Americans to be charged more for insurance, repealed vital taxes that help fund Medicare and waive important regulations that protect health care consumers. We spoke out on these issues by releasing press releases, blogs and joined with liked minded organizations opposing this legislation in a full page advertisement in Politico.
Recently, B’nai B’rith has been very vocal against the recently passed tax reform legislation. We expressed serious reservations about this bill because of the damaging impact it could have on funding for Medicare and Medicaid attributable to rising deficits that will give cover to members of Congress to slash spending. In addition, the negative consequences repealing the ACA’s individual mandate will have on older Americans. We brought our concerns straight to congressional offices during our regular scheduled Capitol Hill visits regarding Section 202. However, we certainly applaud Congress for not eliminating the Low Income Housing Tax Credit which is critical for affordable housing construction, and the medical expense deduction which is incredibly important to countless seniors with high health care costs.
The CSS team embarks on 2018 looking to continue our success from 2017. We will certainly look to invite more members of Congress and their staff to B’nai B’rith sponsored buildings, and advocate for the Section 202 program and other policies that are vital to seniors.
B’nai B’rith International Senior Services Staff: Mark Olshan, associate executive vice president of B’nai Brith International and director of the B’nai B’rith International Center for Senior Services; Janel Doughten, associate director of the B’nai B’rith International Center for Senior Services; Breana Clark, senior program associate; Evan Carmen, assistant director for Aging Policy.
Medicaid is a cooperative, means-tested health care program that currently provides health care coverage to 6.9 million people who are aged 65 or older. 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 disabling conditions. Because of the Affordable Care Act (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).
Presently, Medicaid funding comes from the federal and state governments, with the federal government obligated to pay a pre-determined share of a state’s Medicaid costs. The federal government’s pre-determined share varies by state, however averages 57 percent. Under the current Medicaid matching structure, federal funding fluctuates in concert with the health care needs of the individual states. The current policy furthers Medicaid’s central goal by giving beneficiaries the security of a health care safety net.
Low-income seniors have greatly benefited from the Medicaid program. For example, since Medicaid states sometimes fills coverage gaps on dental, vision and hearing services Medicare does not cover, seniors are able to receive care they could not cover on their own. In addition, low-income seniors are aided in the cost sharing and out of pocket costs in their Medicare coverage. Many seniors depend on Medicaid to cover the cost-sharing in Medicare—without this coverage they would not be able to afford co-payments and would skip needed care.
In addition, Medicaid helps seniors with long-term services and supports (LTSS) by providing funding for such senior health care services like nursing facilities. In 2015, the median nursing facility annual cost was $91,250, which exceeds what most elderly people and their families can afford. Because Medicare financing for LTSS is limited, Medicaid has been a critical to rounding out funding so low-income seniors can receive the appropriate long-term health care services.
Recently, Congress had seriously considered the American Health Care Act (AHCA) as legislation to repeal and replace the ACA. While Congress was unable to pass the AHCA it is important to examine how this proposed legislation would have impacted Medicaid. Specifically, Congress was deliberating on whether to change Medicaid to a per capita cap financing structure between the federal government and the states. Under a per capita cap, federal spending on the Medicaid program would have been capped on a per-beneficiary basis. While the AHCA exempted Medicaid aid for low-income Medicare beneficiaries from the per capita cap proposal, changing any portion of the Medicaid funding to a per capita cap proposal would have added an additional layer of pressure to state budgets, and put the health care and financial security of millions of older adults at risk. For instance, a per capita cap proposal could have drastically decreased the amount of federal financing available for states to pay for nursing facilities.
From 2015 to 2035, the number of low-income older adults is expected to rise from 15 million to 27 million people. Proposals that cap the federal government’s financial responsibility will put an increasing amount of Medicaid beneficiaries at risk when they need more care as they age. State Medicaid programs operating under a fixed federal contribution could face the daunting choice of finding billions of additional dollars in their own budgets or being forced to offer even more limited health care access to their most vulnerable low-income seniors.
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