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Key Issues in the Midterm Elections



ProblemMedicare covers more than 64 million seniors and people with disabilities in the United States, with that number expected to reach 80 million by 2030.

Workers and their employers pay into the program through payroll taxes. The Medicare Part A Hospital Insurance Trust Fund is expected to decline within four years as a result of growth in enrollment, rising health care costs and advances in medical technologies.

Parts B and D will remain fully funded. The coverage gap is of more immediate concern for many Medicare beneficiaries; Many of them have to pay out of pocket for dental, hearing and vision care, for example.

status status: The Build Back Better Act passed by the House added partial coverage for hearing aids and other hearing services for people enrolled in Original Medicare. Many Medicare Advantage private insurance plans already offer some dental, hearing, and vision benefits. To date, Congress has not initiated any meaningful debate on how to strengthen the trust fund for Medicare hospital insurance.

what do elderly voters want: “We will continue to fight” to maintain and expand Medicare coverage, Sweeney says. During the COVID-19 pandemic, Medicare expanded its telehealth coverage, something older voters want to make permanent. To future-proof the program, they also want Medicare to crack down on fraud, waste and abuse.

family care, long term care

Problem: Nearly 53 million family caregivers are the backbone of America’s long-term care system, and AARP research shows that these caregivers spend an average of more than $7,000 a year to help care for their loved ones.

(For a full report on the state of family care in the United States and potential solutions, see page 32.) Meanwhile, the COVID-19 pandemic has exposed ongoing problems in the nation’s nursing homes, where more than 200,000 residents live. And the employees have succumbed to the virus. Problems include chronic staff shortages and inadequate regulatory oversight.

status statusPresident Joe Biden called for a number of nursing home reforms in his State of the Union address, including minimum staffing requirements, increased financial penalties for poor quality services, and increased oversight of long-term care facilities.

In 2021, several states across the country passed laws to support caregivers and other long-term care services, including caregiver reimbursement programs in four jurisdictions (Arizona, the District of Columbia, Maine and Utah); funding for relief services in three states (Alabama, Connecticut, and Pennsylvania); and workplace flexibility including paid sick leave and paid family and medical leave in seven states (California, North Carolina, Maine, Nebraska, Nevada, New York and New Mexico). And in 28 states, criteria and funding for home and community-based services were maintained or expanded.

what do elderly voters wantMedicaid does not cover home and community-based services to the same extent that it covers nursing home care. There are an estimated 800,000 people on the state’s waiting list for Medicaid-covered home care.

A 2021 AARP survey found that three-quarters of adults age 50 and older want to stay in their homes and communities for as long as possible. In addition, AARP strongly supports the Credit for Caregiving Act, which would provide tax credits to family caregivers to help with their out-of-pocket expenses.

“When we think of healthcare providers, most of us don’t think of our family members,” Sweeney tells WebMD. “However, in many families, many of the primary caregivers are family members, not our loved ones, doctors and nurses. Recognizing and advancing the important work of family caregivers is a true founding principle of AARP.

Dena Banis reports on issues related to Medicare, health care, health policy and the US Congress. Additionally, she is the author of the “Medicare Made Easy” column for the AARP Bulletin. Respected for his journalistic work, Banis spent decades working for major city newspapers. Positions she has held include Washington bureau chief for the Orange County Register and a health and workplace reporter for Newsday.

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