Monthly Archives for March 2025

HHS Shake-Up Sends Shockwaves Through Aging Network

Published on April 31, 2025

Taking a page from President Donald J. Trump’s to “Make America Great Again,” last week the U.S. Department of Health and Human Services (HHS) announced a major restructuring of the federal agency to “Make America Healthy Again.” The dramatic restructuring in accordance with Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”

The U.S. Department of Health and Human Services (HHS), under management of HHS Secretary Robert F. Kennedy, Jr., last week announced a major restructuring and renaming of the federal agency under the initiative “Make America Healthy Again.” This dramatic reorganization follows Trump’s Executive Order, Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” said HHS Secretary Robert F. Kennedy, Jr. in a statement announcing the massive overhaul. “This Department will do more—much more—at a lower cost to taxpayers.”

“Over time, bureaucracies like HHS become wasteful and inefficient, even when most of their staff are dedicated and competent civil servants,” Kennedy added. “This overhaul will be a win-win for taxpayers and those HHS serves. That’s the entire American public, because our goal is to Make America Healthy Again.”

During the Biden administration, HHS’s budget increased by 38%, and its staffing grew by 17%, prompting the new HHS chief to place the federal agency on the budgetary chopping block.

According to HHS, this restructuring will not impact critical services while saving taxpayers $1.8 billion per year through a reduction of approximately 10,000 full-time employees. When combined with other cost-cutting initiatives, including early retirement, and the Fork in the Road program, the total downsizing will reduce HHS’s workforce from 82,000 to 62,000 employees.

HHS also plans to streamline departmental functions. Currently, the agency’s 28 divisions contain redundant units. Under the restructuring plan announced on March 27, 2025, these units will be consolidated into 15 new divisions, including a newly created Administration for a Healthy America (AHA). Additionally, core organizational functions—such as Human Resources, Information Technology, Procurement, External Affairs, and Policy—will be centralized. The number of regional offices will be cut from 10 to five.

As part of the restructuring, several agencies will see workforce reductions. The U.S. Food and Drug Administration (FDA) will cut approximately 3,500 full-time employees, focusing on streamlining operations and centralizing administrative functions, though HHS asserts these reductions will not affect drug, medical device, or food reviewers, nor inspectors.

Similarly, the U.S. Centers for Disease Control and Prevention (CDC) will downsize by approximately 2,400 employees, refocusing its efforts on epidemic and outbreak response. The National Institutes of Health (NIH) will eliminate 1,200 positions by centralizing procurement, human resources, and communications across its 27 institutes and centers. Meanwhile, the Centers for Medicare and Medicaid Services (CMS) will cut around 300 positions, targeting minor duplication within the agency. HHS insists these changes will not impact Medicare or Medicaid services, but improve them.

Restructuring HHS to Focus on Chronic Illness Prevention

HHS’s overhaul aligns with the agency’s new priority of ending America’s chronic illness epidemic by focusing resources on ensuring safe, wholesome food, clean water, and the elimination of environmental toxins.

The Administration for a Healthy America (AHA) will consolidate five agencies—the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health—into a single entity. This unification aims to enhance health resource coordination for low-income Americans, emphasizing primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development.

Additionally, the Administration for Strategic Preparedness and Response, responsible for national disaster and public health emergency response, will be transferred to the CDC to strengthen its core mission of protecting Americans from health threats.

To combat waste, fraud, and abuse, HHS will create a new Assistant Secretary for Enforcement, overseeing the Departmental Appeals Board, the Office of Medicare Hearings and Appeals, and the Office for Civil Rights.

Furthermore, HHS will merge the Assistant Secretary for Planning and Evaluation with the Agency for Healthcare Research and Quality to form the Office of Strategy, enhancing research to inform policy decisions.
Critical programs under the Administration for Community Living (ACL), which supports older adults and people with disabilities, will be integrated into other HHS agencies, including the Administration for Children and Families, the Office of the Assistant Secretary for Planning and Evaluation, and the Centers for Medicare and Medicaid Services (CMS). HHS assures that these changes will not impact Medicare or Medicaid services.

Sounding the Alarm

Following the announcement of HHS’s restructuring plans, which would broad without a lot of detail, aging advocacy groups quickly released statements to voice strong concerns.

“For decades, the federal health programs that retirees and people with disabilities depend on have been ably administered under both Democratic and Republican administrations. However, the radical cutbacks proposed by the Trump administration place the delivery of these programs in jeopardy,” warned Dan Adcock, Director of Government Relations & Policy at the National Committee to Preserve Social Security and Medicare (NCPSSM).

Adcock also noted that HHS plans to eliminate the ALC and divide its responsibilities between two offices with no prior experience in this area. “This administration has already demonstrated a reckless disregard for public interests in favor of slashing operations and staff under the guise of ‘efficiency,’” he added. “So far, all they have done is create chaos and confusion, disrupting essential programs for seniors and the disabled. We view Secretary Kennedy’s plans with alarm.”

Nancy LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer at AARP, also urged HHS to prioritize older Americans’ health needs. “HHS must ensure access to senior centers, community health centers, nutritious meals, Medicare assistance, and other vital services that countless older Americans rely on. Health is central to the lives, well-being, and financial security of AARP’s members and the more than 100 million Americans over age 50,” she emphasized.

Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, echoed these concerns. “The announcement of workforce cuts at HHS comes at a time of unprecedented growth in America’s aging population. The proposed reorganization of ACL and its integration into other agencies requires careful consideration.”

Fulmer stressed that ACL administers programs essential to older adults’ daily lives, such as meal delivery, transportation to medical appointments, and chronic disease management. Absorbing these functions with far fewer staff demands careful planning. The government’s commitment to older adults requires a cautious approach, she said.

The Center for Medicare Advocacy also expressed deep concerns, particularly regarding plans to restructure ACL and consolidate oversight of Medicare appeals. “Given what we have seen with Social Security Administration cuts and restructuring, HHS’s claim that these changes won’t impact critical services rings hollow,” said Co-Director David Lipschutz.

LeadingAge, a national association representing nonprofit aging services providers, called for HHS to ensure older adults and their caregivers are not overlooked. “Cutting staff responsible for critical agency functions raises serious concerns. How will the work our members rely on get done? How will this impact quality care for older adults?” asked President and CEO Katie Smith Sloan.

Sloan also cautioned that reducing HHS’s field offices from 10 to five could impact CMS’s ability to oversee nursing home surveys and provider compliance. “A 25% workforce reduction must be undertaken with extreme care—especially given the millions of older adults who depend on these services,” she emphasized.

For a fact sheet on the HHS restructuring, visit https://www.hhs.gov/about/news/hhs-restructuring-doge-fact-sheet.html

Seniors in hock over credit card debt. Cap attempt a rare tri-partisan (D), (I), (R) effort

Published in RINewsToday on March 24, 2025

Over two weeks ago, a new AARP survey revealed that 47% of respondents who carry credit card debt use their credit cards to pay for basic living expenses that they do not have enough money to cover.  Seventeen percent of these individuals relied on using their credit card to cover month to month expenses of daily living over the last year.

These findings, detailed in the 47-page report, “Credit and Debt and Adults Age 50 Plus,” put a spot light on credit card debt as now the most common type of debt held by adults age 50 plus, including many at all income levels. The survey results drive home the point that rising costs of basic expenses for food, housing and utilities, along with skyrocketing health care costs and unexpected financial burdens, are quickly chipping away at the financial well-being of older Americans in their retirement years.

AARP’s credit card survey also found that 37% of older adults with credit card debt report that they have more credit card debt than a year ago. Nearly half (48%) of older adults who carry a credit card balance from month-to-month owe $5,000 or more, and 28% carry a balance of $10,000 or more. Almost 9 in 10 respondents (87%) say that unexpected expenses contribute to their credit card debt.

“A concerning number of older adults carry credit card debt today just to make ends meet,” said Indira Venkat, AARP Senior Vice President of Research in a statement released on March 10, 2025 announcing the findings of this survey. “Credit card debt can jeopardize retirement security. For many retirees, who often live on a fixed income, it’s a real challenge to pay down debt without significant trade-offs,” she says.

The survey also found that older adults are the most likely to carry a monthly balance, including people ages 50-64, those with incomes under $40,000, as well as Black and Hispanic/Latino older adults. More than half (52%) of adults ages 50-64 have credit card debt. Significant portions of those ages 65-74 (42%) and 75 and older (35%) also carry credit card debt.

Credit card debt results in long-term financial strain of the older card holder. Among those who are worried about their credit card debt, the survey found that 43% are very worried about how long it will take to pay off their debt. Roughly 1 in 5 expect to take more than five years to pay it off. The top drivers of credit card debt include everyday expenses, including vehicle costs, housing costs, and health care.

Fifty percent of the respondents say that health care expenses have contributed to their credit card debt, noted the survey findings. Among this group, the biggest medical expenses contributing to debt are dental expenses (46%), prescription drugs (35%), and vision care (19%)

And, twenty-three percent say they are still paying off balances on cancelled credit cards. As a result, forty-six percent say credit cards have hurt their ability to save for the future.

Bipartisan efforts on Capitol Hill to cap high credit card interest rates

With credit card interest at an all-time high, carrying high-interest credit card debt month-to-month can be risky for those who struggle with paying of the balance as the interest accrues.

This financial issue brings together two strange bedfellows— Sen. Bernie Sanders (I-Vt.)  a democratic socialist advocating for progressive policies like universal healthcare and wealth redistribution, and Sen. Josh Hawley (R-Mo.), a conservative populist focused on nationalism, traditional values, and limiting government intervention—to cap high credit interest rates.

On Feb. 4, 2025, the Senators introduced their bipartisan legislation, S. 381, the 10 percent Credit Interest Rate Cap Act, that caps credit card interest rates at 10% for five years to provide financial relief to consumers facing high interest debt.  Later, Sen. Jeff Merkley (D-OR) would become a cosponsor.

S. 381 was referred to the Senate Banking, Housing, and Urban Affairs for consideration.  A companion measure, H.R. 1944 was introduced by Rep. Alexandria Ocasio-Cortez and referred to the House Committee on Financial Services.

The legislation responds to concerns about rising credit card debt, which reached a record $1.17 trillion in the third quarter of 2024. At that time, the average credit card interest rate was approximately 28.6%, significantly higher than the proposed 10% cap.

Capping high interest rates can easily help credit older adults, burdened by credit card debt.  According to Sander’s statement, “If a consumer has a $5,000 credit card balance with a 28% interest rate and can only afford to make the minimum payment of $166 a month it would take that person over 24 years to pay off and would cost nearly $11,000 in interest. If credit card interest rates were capped to 10%, that same consumer would save over $7,000 in interest.

“During the campaign, President Donald J. Trump pledged to cap credit card interest rates at ten percent,” Sanders said. “When large financial institutions charge over 25 percent interest on credit cards, they are not engaged in the business of making credit available. They are engaged in extortion and loan sharking. We cannot continue to allow big banks to make huge profits ripping off the American people. This legislation will provide working families struggling to pay their bills with desperately needed financial relief,” he says.

“Working Americans are drowning in record credit card debt while the biggest credit card issuers get richer and richer by hiking their interest rates to the moon. It’s not just wrong, it’s exploitative. And it needs to end,” said Hawley. “Capping credit card interest rates at 10%, just like President Trump campaigned on, is a simple way to provide meaningful relief to working people. Let’s do it,” he said.

While the bill aims to alleviate the financial burden on consumers, the American Bankers Association (ABA) argues that such a cap would have a devastating effect on access to credit for individuals and small business owners who use their personal credit cards as a form of liquidity by imposing an all-in annual percentage rate cap at 10 percent.  A cap on credit card interest rates is a price control on credit that will lead to credit shortages for consumers, charges ABA.

Reaching across the aisle 

On Sept. 18, 2024, at Uniondale, New York, at a campaign rally GOP presidential nominee, President Trump, then candidate Trump, promised to cap interest rates at 10% to provide temporary and immediate relief for hardworking Americans who are struggling to make ends meet and cannot afford hefty interest payments on top of the skyrocketing costs of mortgages, rent, groceries and gas.

As duly elected President, now Trump has the opportunity to work with Senators Sanders and Hawley and Rep. Ocasio-Cortez to put an end to hefty interest payments as he promised over six months ago on the campaign trail.  Trump now can put partisan politics behind, urging the Republican-controlled Senate and House to S. 381 and H.R. 1944 a fair committee hearing and floor vote.

Hopefully, the Rhode Island legislative delegation will quickly support the bipartisan proposals in both chambers, signing on as cosponsors.

Capping high credit card interest rates might just be one way to bring the two warring political parties together on behalf of American consumers.  Let’s see.

NOTE:  The findings of AARP’s Credit Card Debit Survey are based on a survey of 4,846 adults ages 50-plus who carry over credit card debt from a previous month, whether on active cards or cancelled cards.

To read AARP’s latest Credit Card Debt Report, to go www.aarp.org/content/dam/aarp/research/topics/work-finances-retirement/financial-security-retirement/credit-card-debt-survey.doi.10.26419-2fres.00929.001.pdf

To watch former president and GOP presidential nominee, Donald J. Trump, calling for capping high interest rates on Sept. 18, 2024, go to www.c-span.org/program/campaign-2024/former-president-trump-campaigns-in-uniondale-new-york/648902

Learn more about AARP’s resources for managing money. go to  https://www.aarp.org/tools/money/?cmp=RDRCT-TOOLS-MONEYTOOLS-09262024.

Senior Agenda Coalition of RI unveils its 2025 legislative priorities at forum,

Published in RINewsToday on March 17, 2025

On March 14, 2025, hundreds of older Rhode Islanders, aging network providers, state officials, and lawmakers gathered at the Senior Agenda Coalition of Rhode Island (SACRI)’s 2025 legislative forum, “United Voices for Meaningful Advocacy” at the Crowne Plaza in Warwick. With the RI House deliberating the FY 2025 budget and key legislation impacting older adults, SACRI announced its legislative priorities.

SACRI Board Chair Kathy McKeon gave welcoming remarks, giving recognition to major sponsor Delta Dental.  Serving as master of ceremonies, Executive Director Carol Anne E. Costa kept the three hour Legislative Forum on track.

SACRI Policy Advisor Maureen Maigret gave an overview and highlighted the growing influence of Rhode Island’s aging population.

“We’re 200,000 strong and growing,” she said, noting that within five years, one in four Rhode Islanders will be 65 or older. In 21 of the state’s 39 cities and towns, older adults now make up at least 20% of the population, with some communities reaching over 30%.

The Economic Impact of Older Adults

Maigret noted that 21% of older Rhode Islanders still work, many are caregivers for loved ones, and vote in higher numbers than any other age group. About 12% are veterans, and many volunteer at senior centers, Meals on Wheels, RSVP, and The Village Common of RI.

Older adults also contribute significantly to the economy. According to AARP’s Longevity Economic Outlook report, those aged 50 and older generate 40% of the nation’s GDP. In Rhode Island, retirees inject $4 billion into the economy through Social Security benefits.

However, many older adults struggle financially. “The ‘forgotten middle’ falls through the cracks,” Maigret said, referring to those with low incomes who don’t qualify for Medicaid or other public benefits. Long-term care costs are rising, and even with home equity many middle-income adults will not be able to pay for long-term.

Census data reveals that one in four Rhode Island households headed by someone 65 or older  have incomes less than $25,000 annually, and nearly half have  less than $50,000. The average Social Security benefit is $23,995, with men receiving $26,372 and women $23,565.

Shaping SACRI’s 2025 Legislative Agenda

Survey results from SACRI’s October 2024 Conference guided this year’s priorities. Among 241 respondents (42% aged 75 and older), top concerns included healthcare costs and access, economic security, housing, and community supports.

SACRI’s top priority is expanding the state’s Medicare Savings Program (MSP) by increasing income and asset limits. “Expanding MSP eligibility would provide an extra $185 monthly, or $2,200 annually, to thousands of older adults,” Maigret said. The federal government would cover the cost of those newly eligible. This extra income could help with food, utility bills, or rent and a boon to the state’s economy, she said.

With primary care practices closing due to retirement and low reimbursements, SACRI is pushing for a rate review to ensure competitive payments.

Though fewer than 5% of older Rhode Islanders live in nursing homes, Maigret stressed the importance of addressing the industry’s staffing shortages,  and substandard care, SACRI supports increasing wages for direct care staff, rewarding high-performing nursing homes, ensuring financial transparency, and preventing Medicaid cuts.

To address the housing crisis, SACRI advocates for fair allocation of state housing funds for housing for older adults and persons with disabilities. With public housing waitlists up to five years long, this is essential. SACRI is also pushing to expand income eligibility for the property tax relief program to $50,000 and mandating accessibility features in new developments.

Aging in place is another priority. SACRI calls for adding $600,000 ($10 per person age 65 and older) to the state budget to support community senior centers and enacting a caregiver tax credit to assist Rhode Island’s 112,000 caregivers, who spend an average of $7,000 out of pocket annually.

SACRI also seeks to increase Medicaid’s asset limit from $4,000 to $12,000 to help older adults on Medicaid remain at home. Additional funding for volunteer programs and continuing the “Ride to Anywhere Pilot” are also on SACRI’s agenda.

Maigret also noted SACRI is in close contact with the state’s Congressional delegation to oppose any harmful Medicaid cuts or changes in Social Security.”

Lawmakers Respond

Bringing greetings from House Speaker Joe Shekarchi, Rep. Lauren Carson (D-Dist. 75, Newport), who chairs the Special Legislative Commission on Services and Programs for Older Rhode Islanders, acknowledged the political power of older voters. “In the 2024 primary, 87% of voters were over age 85. I paid close attention to that,” she said.

Carson emphasized the importance of protecting Social Security, Medicare, and Medicaid. “Social Security is a promise. We paid into it. We can’t lose that program,” she said.

She highlighted legislative victories from 2024, including a $10 million investment to stabilize nursing homes, raising the pension exemption from $20,000 to $50,000, and launching the “Digital Age” initiative to bridge the digital divide. However, she stressed that more work remains.

Carson is also leading efforts to eliminate ageist language from state statutes, replacing terms like “elderly” and “senior citizen” with “older adults.” “We’re living diverse lifestyles beyond age 60, and our language should reflect that,” she said.

Representing Senate President Dominick J. Ruggerio (D-Dist. 4, North Providence, Providence) Senator Jacob E. Bissaillon (D-Dist. 1, Providence), chair of the Senate Committee on Housing & Municipal Government, echoed Carson’s concerns. He warned that state lawmakers must protect hard-won progress in light of potential federal cuts and a $250 million state budget shortfall.

Bissaillon called for addressing the housing crisis. “There are 150,000 Rhode Island households paying over 33% of their income on housing. We need 20,000 more affordable units and 2,000 permanent supportive housing units,” he said. He also supports eliminating the state income tax on Social Security and pointed to the Senate’s newly established Artificial Intelligence and Emerging Technologies Committee noting it is important aims to protect older adults from cyber scams. “It’s critical that Rhode Island keeps pace with technology,” Bissaillon said “We have our work cut out for us,” he concluded.

Following the legislative priorities session, Carlson called to order a meeting of the Special Legislative Commission on Services and Programs for Older Rhode Islanders.

At this time, Elizabeth Dugan, PhD from the University of Massachusetts Gerontology Institute presented highlights from the 2025 RI Healthy Aging Data Report scheduled for full release on May 1st.

A Final Note…

It was obvious today that older voices must be heard,” said Director Mary Lou Moran of the City of Pawtucket’s Division of Senior Services, emphasizing the importance of SACRI’s Legislative Forum . She noted that the event provided a valuable opportunity for seniors, aging advocates, and organizations to gather and share the latest information, resources and more importantly hear from the State’s legislative leaders.

Moran expressed her support for SACRI’s  advocacy for the State to allocate $10 per person aged 65 and over to communities  to fund senior centers and senior programs. “Senior centers play a vital role in helping older Rhode Islanders age in place within their communities and offer innumerable opportunities for social engagement, healthy living opportunities, and act as a reliable resource for not only them but for their families and their caregivers” she explained.

Moran also strongly supports SACRI’s efforts to increase the income eligibility for the state’s Medicare Savings Program (MSP). By participating in MSP, individuals can have their Part B Medicare premium covered, and for some low-income participants, the program also helps with prescription drug costs. “Reducing the cost of Part B premiums and, for some[]  who are income eligible, covering  prescription drug expenses allows older adults to redirect those savings toward essentials like rent,  utilities, and food,” she added. 

To watch SACRI’s Leadership Forum held on March 14, 2025, go to:                                                                https://capitoltvri.cablecast.tv/show/10954?site=1.    

To view Larson’s  Special Legislative Commission on Services and Programs for Older Rhode                                                            Islanders held at SARCI’s Leadership Forum, go to:                                                                          https://capitoltvri.cablecast.tv/show/10955?site=1.

To learn more about SACRI, go to https://senioragendari.org/