House Committee Moves to Rein in Skyrocketing Prescription Drug Costs

Published in the Woonsocket Call on December 1, 2019

On Nov. 18, House Antitrust Subcommittee Chair David N. Cicilline (D-RI) and Judiciary Committee Chairman Jerrold Nadler (D-RI) introduced The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 (H.R. 5133) to put the brakes on skyrocketing prescription drug costs. The bill attacked increasing costs by prohibiting pharmaceutical companies from engaging in anticompetitive “product hopping.”

Two days later, the Committee unanimously passed the bipartisan bill to drive down the rising costs of prescription drugs. Now H.R. 5133 goes to the House floor for a vote.

“Big pharmaceutical companies have done everything they can to increase their profits regardless of who it affects. Their CEOs make millions in bonuses ever year while hardworking folks are forced to ration their medicine just so they can put food on the table for their kids,” said Cicilline, in a released statement announcing the introduction of the bill.

Since becoming Chair of the House Antitrust Subcommittee, Cicilline has sought to take on the anticompetitive behavior in the health care and pharmaceutical sectors. “This is wrong, and it needs to stop. This bill, along with the suite of legislation to lower health care costs the House has passed already this year, will put an end to anticompetitive behavior that is driving prices up while pushing the middle class further and further down,” says Cicilline in pushing for the bill’s passage.

“This bill builds on the Committee’s strong record of bipartisan legislation to confront one of the leading drivers of high prescription drug costs—efforts by drug companies to keep generic drugs off the market so that they can preserve their monopoly profits,” adds Chairman Nadler when H.R. 5133 was thrown into the legislative hopper. “The outrageous behavior of product hopping puts profits before patients and thwarts the competition that is essential to lowering prescription drug prices,” he charges. Nadler says that H.R. 5133 would “encourage drug companies to focus on delivering meaningful innovation for sick patients rather than delivering profits to their bottom line.”

Fixing the Problem

According to Cicilline and Nadler, pharmaceutical companies use a wide array of tactics when their patent on a drug is near expiration to switch patients to another version of the drug that they have the exclusive right to sell. Called “product hopping,” this anticompetitive practice extends the manufacturer’s ability to charge monopoly prices by blocking the patient’s ability to switch to a cheaper, generic alternative. Product hopping benefits the manufacturer’s bottom line at the expense of patients who are stuck paying higher prices often for many years at a time, they say.

The two Congressmen say that there is another roadblock to lowering prescription drug costs. Although antitrust agencies have made an effort to curb product hopping, the Federal Trade Commission (FTC) still faces a number of hurdles under existing law when trying to hold companies accountable for this anticompetitive conduct. The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 strengthens the FTC’s ability to bring and win cases against pharmaceutical companies that engage in all forms of product hopping.

A similar version of H.R. 5133 was considered in the Senate and it would save taxpayers an estimated $500 million according to the nonpartisan Congressional Budget Office.

A week earlier, before H.R. 5133 was passed by the and Judiciary Committee, a new report was released by AARP Public Policy Institute (PPI), giving data to Congress to enact legislation to lowering prescription drug costs. The report findings indicate that brand-name drug prices rose more than twice as fast as inflation in 2018.

According to the AARP PPI report, retail prices for 267 brand-name drugs commonly used by older adults surged by an average of 5.8 percent in 2018, more than twice the general inflation rate of 2.4 percent. The annual average cost of therapy for one brand-name drug ballooned to more than $7,200 in 2018, up from nearly $1,900 in 2006.

“There seems to be no end to these relentless brand-name drug price increases,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP, in a Nov. 13 statement announcing the release of the report. “To put this into perspective: If gasoline prices had grown at the same rate as these widely-used brand-name drugs over the past 12 years, gas would cost $8.34 per gallon at the pump today. Imagine how outraged Americans would be if they were forced to pay those kinds of prices,” says Whitman.

Brand-name drug price increases have consistently and substantially exceeded the general inflation rate of other consumer goods for over a decade, notes the AARP PPI data.

If brand-name drug retail price changes had been limited to the general inflation rate between 2006 and 2018, the average annual cost of therapy for one brand-name drug would be a whopping $5,000 lower today ($2,178 vs. $7,202). The report’s findings note that the average senior takes 4 to 5 medications each month, and the current cost of therapy translates into an annual cost of more than $32,000, almost 25 percent higher than the median annual income of $26,200 for a Medicare beneficiary.

“While some people will undoubtedly see a slower rate of price increases as a sign of improvement, the reality is that there is absolutely nothing to stop drug companies from reverting back to double-digit percentage price increases every year,” said Leigh Purvis, Director of Health Services Research, AARP Public Policy Institute, and co-author of the report. “Americans will remain at the mercy of drug manufacturers’ pricing behavior until Congress takes major legislative action,” adds Purvis.

With over 340 days before the upcoming 2020 Presidential and Congressional elections, Senate Democrats say that more than 250 House-passed bills are “buried in Senate Majority Leader Mitch McConnell’s (R-Ky) legislative graveyard.” The Senate’s top Republican}, referred to as the “Grim Reaper,” has blocked consideration on these bills (including prescription drug pricing bills) effectively killing them. As the election day gets closer this number is expected to increase.

President Trump and Republican lawmakers are loudly chanting that the Democrats are “getting nothing done in Congress.” This is just fake “political” news. Major reforms that would prop up Social Security, Medicare, and lower Prescription Drug prices get the legislative kibosh in the GOP-controlled Senate. It is now time to put these bills to an up or down vote in the upper chamber. The voters will send a message to Congress next November if they agree with the results. It’s time for McConnell to put down his reaper

For details, of AARP report, go to http://www.aarp.org/rxpricewatch.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Seniors Can Expect Small Increase in Their 2020 Social Security COLA

Published in the Woonsocket Call on Oct. 27, 2019

The Social Security Administration (SSA) announces Oct. 10 that Social Security and Supplemental Security Income (SSI) benefits for nearly 69 million Americans will increase 1.6 percent in 2020 (Some recipients receive both Social Security and SSI benefits).

Social Security and SSI recipients will be notified about their new benefit amount by mail in early December. This COLA notice can also be viewed online through their my Social Security account. People may create or access their my Social Security account online at http://www.socialsecurity.gov/myaccount.

According to SSA, the 1.6 percent COLA increase will begin with benefits payable to more than 63 million Social Security beneficiaries in January 2020. Increased payments to more than 8 million SSI beneficiaries will begin December 31, 2019. The Social Security Act ties the annual COLA to the increase in the Consumer Price Index as calculated by the Department of Labor’s Bureau of Labor Statistics.

The maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase from $132,900 to $137,700, says SSA.

The earnings limit for workers who are younger than “full” retirement age (age 66 for people born in 1943 through 1954) will increase to $18,240. SSA will deduct $1 from benefits for each $2 earned over $18,240.

The earnings limit for people turning age 66 in 2020 will increase to $48,600. SSA will deduct $1 from benefits for each $3 earned over $48,600 until the month the worker turns age 66.)

There is no limit on earnings for workers who are “full” retirement age or older for the entire year.

COLA Not Keeping Up with Rising Cost of Living

Over the years, Social Security’s COLA has not provided financial protection against rising costs, charge aging advocacy groups.

Social Security checks in 2019 are as much as 18 percent lower due to the impact of extremely low COLAs over the past 10 years, says an analysis recently released by the Arlington, Virginia-based The Senior Citizens League (TSCL). TSCL’s Social Security policy analyst, Mary Johnson authored this analysis.

Johnson’s analysis noted that from 2000 to 2010, COLAs routinely averaged 3 percent
annually. People who have been receiving Social Security checks since 2019, have only seen a COLA higher than 2,8 percent one time (in 2012), she said, noting that Social Security benefits have lost 33 percent of buying power since 2000.

Johnson’s findings reported that in 2010, 2011, and 2016 there was no COLA payable at all and, in 2017, the COLA was just 0.03 percent. However, in 2018, the COLA was 2 percent, but rising Part B premiums consumed the entire increase for roughly half of all beneficiaries.

Calls for Strengthening the COLA

According to the National Committee to Preserve Social Security and Medicare (NCPSSM), the upcoming COLA change will give a whopping $24 per month increase for the average beneficiary. With Medicare Part B premiums expected to rise around $8 next year, the net cost-of-living adjustment for most seniors will be only $16 per month. The new COLA brings the average monthly retirement benefit up to $1,503 — it’s just a $288 yearly raise for seniors living on fixed incomes.

NCPSSM notes that roughly half of America’s seniors rely on Social Security for at least 50 percent of their income, and 1 in 4 depending on the program for at least 90 percent of their income, the 2020 COLA increase does not go very far in helping these recipients pay their bills. A $16 per month probably won’t cover typical expenses, such as the cost of a single prescription copay, a month’s medical supplies, or transportation to a doctor’s appointment, adds the Washington, DC- advocacy group whose goal is to protect Social Security and Medicare.

“It’s ironic that as billionaires and big corporations continue to profit from the $1.5 trillion in Trump/GOP tax cuts, America’s seniors are to get by with a meager $24 monthly raise,” says Max Richtman in a statement after SSA announced the 2020 COLA increase. NCPSSM’s President and CEO. “The negligible 2020 COLA illustrates why seniors need a more accurate formula for calculating the impact of inflation on their Social Security benefits. For years, we have urged the government to adopt the CPI-E (Consumer Price Index for the Elderly), which reflects the spending priorities of seniors, including health care, as opposed to the current formula based on younger urban wage earners’ expenses,” says Richtman.

If the CPI-E were adopted, beneficiaries would see a 6 percent overall increase in benefits over 20 years compared to the current formula used, which yielded a zero cost-of-living adjustment three times during the past decade — and a mere 0.3 percent in 2017, says Richtman, noting that health care costs have increased about 6 percent in 2019 alone.

“The prices of the most commonly prescribed drugs for seniors on Medicare rose ten times the rate of inflation from 2013-2018. The cost of senior living facilities is growing at 3 percent annually – which adds up quickly over time,” adds Richtman.

Adds Webster Phillips, NCPSSM’s Senior Legislative Representative, “COLAs are out of sync with seniors’ actual expenses. Retirees have been living on very tight cost-of-living adjustments for a number of years now, which forces them to make hard decisions about their monthly budgets.”

In a statement, AARP chief executive officer Jo Ann Jenkins said, “Social Security’s annual COLA amount typically does not keep pace with all the increases in living expenses that most seniors face, including the costs of housing, food, transportation and, especially, health care and prescription drugs. AARP’s recent Rx Price Watch report found that retail drug prices increased by twice the rate of inflation during 2017, and have exceeded the inflation rate for at least 12 consecutive years,” she says.

“AARP will continue our advocacy for bipartisan solutions to help ensure the long-term solvency of the Social Security program, as well as adequate benefits for recipients. We will also continue to fight for lower health care and prescription drug costs, which are eating up a growing share of Social Security benefits,” adds Jenkins.

TSCL’s Mary Johnson says that her group calls on Congress to require a minimum COLA of no less than 3 percent every year, even in years when inflation falls below that amount. “Strengthening the COLA,” she says, “would help slow the drain of retirement savings and help keep older Americans out of poverty.”

For information about Social Security benefits and claiming strategies, those approaching retirement age may visit AARP’s Social Security Resource Center, at https://www.aarp.org/retirement/social-security/.

Kidnapping Scam” Hits the Ocean State

Published in the Woonsocket Call on October 6, 2019

Last Monday, local media picked up a warning issued on the Pawtucket Police Department ‘s Face Book page that called on residents to watch out for the “kidnapping scam” that has recently resurfaced.

According to a Pawtucket Police spokesperson, a Pawtucket family was targeted with the “kidnapping hoax” scam, this incident triggering the social media warning on Sept. 30, with the case being referred to the Rhode Island State Police.

The Alexandria, Virginia-based International Association of Chiefs of Police’s Law Enforcement Cyber Center (LECC), say the scammers “use fear and threats over the phone to manipulate people into wiring them money. First noted by the FBI in the Southwest border states, it has now spread throughout the country.

LECC warns that the scammers are using “increasingly sophisticated tactics” — extensive online reconnaissance utilizing social media and other digital information — to convince victims that a loved one is being held hostage.

Here’s how the “kidnapping hoax” works.

This extortion scam typically begins with a phone call, usually coming from an outside area code and sometimes from Puerto Rico with area codes (787), (939) and (856), saying your family member is being held captive. The caller may allege your son or daughter has been kidnapped and you may hear screaming in the background. Callers will typically provide the victim with specific instructions to ensure a safe return of the family member. Callers go to great lengths to keep you on the phone line until money is wired. Ransom money is only accepted via wire transfer services. The caller may claim not to have received the money and may even demand additional payments.

Advice on Keeping Out of Harm’s Way

The Pawtucket Police’s Face Book posting gives a simple tip on how you can protect yourself from this scam. Just hang up.

Or you can attempt to contact the alleged victim, either by phone, text or other social media, and request that they call you back from their cell phone. Do not disclose your family member’s name or identifying information. Also, avoid sharing information on digital profiles about yourself or your family.

The police also suggest that when responding to the scammer, request to speak to your family member, asking “How do I know my loved one is OK?” Always ask questions only the alleged kidnap victim would know the answers to.

The police warn people to not agree to pay ransom, by wire or in person. The kidnappers often have you go to multiple banks and multiple locations and have you wait for further instructions. Delivering money in person can be dangerous.

If you suspect a real kidnapping is taking place or you believe a ransom demand is a scheme, always contact your local or nearest law enforcement agency immediately, urge the police.

Rhode Island Attorney General Peter Neronha notes that the “kidnapping scam” is just a newer version of the Grandparent or Bail scam. “Most scams continue to evolve as more people start to recognize them,” he says. “All of these scams use fear to quickly manipulate people into sending their money away,” he says.

Neronha also gives advise as to how to protect yourself from becoming a victim of a scam. He says beware of scammers seeming to be legitimate organizations, agencies or companies such as the IRS, a utility company, bank or credit card, among others. If it doesn’t seem right, it probably isn’t. Don’t answer unrecognized calls or e-mails. Keep in mind that scammers can also make their number appear to be one that you may know or recognize. Finally, never give out solicited personal information.

AARP Continues its Fight Against Cybercrime.

“AARP has been fighting fraud and cybercrime for some time with education and resources – most notably the free AARP Fraud Watch Network,” says AARP Rhode Island State Director Kathleen Connell. “You can join and get email alerts and updates by registering at http://www.aarp.org/fraudwatchnetwork.
“Fraud Watch – free to both members and non-members – keeps people abreast of latest dangers, such as the nasty virtual kidnapping scam we first reported on in 2016. Some of these crimes never go away, they just get re-invented in subtle ways,” she added. “Once you’ve heard about a scam, you become far less vulnerable.

“During October’s National Cyber Security Month, AARP is getting the word out on three keys to staying safe online: Own it, secure it, and Protect it. The ‘it’ is your digital profile – the personal things about yourself that you put online. Living in the digital age means putting a lot of personal information online such as your home address, where you work, family members, and much more.

“Keeping that information safe requires a bit of work. First, you need to own it by understanding what you’re putting out there (such as what you’re posting on social media). Next, you have to secure it with strong passwords or using a password manager and enabling two-step authentication where available. Lastly, you need to protect it by staying current with the latest security updates on your devices and using Public Wi-Fi safely,” Connell said.

Another site Connell recommends is staysafeonline.org.

Caregivers Find it Difficult to Shop at Retail Stores

Published in the Woonsocket Call on September 22, 2019

Survey findings from a recently released national study, by the Washington, DC-based AARP and NORC at the University of Chicago, will send a strong message to America’s businesses.

With the graying of America, retail stores must change the way they do business in order to attract customers who provide unpaid family caregiving to their loved ones.

The study, “Family Caregiver Retail Preferences and Challenges,” and its survey findings were presented at the AARP Executive Summit, The Price of Caring, on September 10 in Washington, D.C. The summit’s mission was to highlight public- and private-sector solutions to support Americans who care for an older or ill loved one.

In-store Shopping is a Struggle

While juggling a multitude of caregiving tasks, caregivers say a lack of accommodations for their frail family members is a problem for shopping at retail stores. The study’s findings reveal that in-store shopping is a struggle for one-third of the nation’s 40 million unpaid family caregivers. Many leave their loved ones at home or choose to shop online, despite strongly preferring the in-store experience.

A whopping 93 percent of caregivers surveyed say they shop for the person they care for. Among these caregivers, most report shopping monthly for groceries (87 percent), basic household items (65 percent), toiletries (61 percent), prescription drugs (58 percent) and other health products (52 percent for persons they regularly care for.

“Americans who take care of loved ones are often strapped for time, and many face logistical challenges doing something as simple as going to the grocery store,” said Nancy LeaMond, AARP executive vice president and chief advocacy & engagement officer, in a September 10th statement announcing the study’s findings. “Retailers can score big with caregivers if they make it easier for them to bring their loved ones along when they shop,” says LeaMond.

The AARP survey findings detail simple but important changes retailers should consider to enhance the shopping experience of caregivers. Businesses can provide dedicated parking spots and ample comfortable reserved seating for older shoppers to rest, wider aisles that easily accommodate both wheelchairs and shopping carts, longer store hours, and train their staff to specifically work with caregivers.

The Pros and Cons of In-Store and On-Line Shopping

The survey findings in the 26-page study reveal that 82 percent of the caregiver respondents prefer to shop in-store because of the ability to touch the products and they don’t have to wait for a product’s delivery or pay for shipping charges. But 84 percent say they shop online for ease and convenience, despite preferring an in-store experience. Forty three percent of the respondents say a major reason they leave their loved one at home when shopping is because the store environment is too difficult for the recipients of their care.

More than 56 percent of the caregiver respondents say that when shopping on behalf of their loved ones they spend at least $50 per month. Forty one percent note they spend more than $250 or more a month when shopping for a loved one.

Businesses Must Listen to the Shopping Needs of Caregivers

We listen to a lot of caregivers and it seems clear that, regardless of the challenge, the help they want most is for somehow to find a convenient, time-efficient and accommodating means of getting what they need, when they need it,” said Rhode Island AARP State Director Kathleen Connell. “In retailing, convenience is a huge competitive advantage these days. But there are aspects of convenience that – for caregivers – go beyond finding what you need on Amazon and having it delivered the next day or two,” says Connell.

“Some caregiver needs are in the ASAP category and they head for brick and mortar retail establishments. Shopping for food and clothes, picking up a prescription or medical supplies, even simple things such as picking up dry cleaning feel like ‘emergencies’ because time is so. Imagine this in the context of being with someone in a walker or wheelchair,” notes Connell.

Connell urges retailers to take this report to heart. “There is an incredible amount of goodwill to be earned if you think about caregivers, as well as those in their care, and give them the consideration that makes their tasks a little easier.”

The AARP survey was conducted by NORC at the University of Chicago and is based on a nationally representative survey of 1,127 Americans who provide unpaid care for an adult age 18 or older. The survey was funded by AARP and used AmeriSpeak®, the probability-based panel of NORC at the University of Chicago. Interviews were conducted between Aug. 1-19, 2019, online and using landlines and cell phones. The overall margin of sampling error is +/- 4.1 percentage points at the 95% confidence level, including the design effect. The margin of sampling error may be higher for subgroups.

To read the full report, visit: http://www.aarp.org/caregivershopping.

For more details about AARP’s Caregiver Shopping study, contact Laura Skufca, AARP Research, Lskufca@aarp.org.

Putting the Brakes on Skyrocketing Prescription Drug Costs

Published in the Woonsocket Call on August 25, 2019

A few days ago, AARP Rhode Island released new state specific data detailing the impact of high prescription drug prices for Ocean State residents, specifically those living with cancer, prediabetes or diabetes, and heart disease. The Washington-based AARP unveiled the infographic at the National Academy for State Health Policy (NASHP) annual conference as part of AARP’s nationwide Stop Rx Greed campaign to lower drug prices for all Americans.

“While prescription drug prices continue skyrocketing, Americans are being forced to choose between filling life-saving medications or paying rent and buying food,” said AARP State Director Kathleen Connell in an August 21 statement announcing the release of the drug cost data. “So far in 2019, 29 states have passed 46 new laws to rein in drug prices. It’s critical that state and federal lawmakers continue this momentum to stop Rx greed.” says Connell.

Across the nation, 28 percent of consumers ages 19 to 64, say they are being forced to choose between filling costly life-saving prescriptions and paying their rent, buying food and affording other critical essentials, according to AARP research. In 2016, 25 percent of Rhode Islanders stopped taking a prescription drug prescribed by their health care provider due to cost.

The AARP Rhode Island-specific Infographic zeros in on three commonly used prescriptions to treat cancer, diabetes and heart disease to detail the spiraling increases in drug costs.

Between 2012 and 2017, the retail price of Revlimid, used to treat cancer, increased from $147,413 per year to $247,496 per year. In Rhode Island, 112,403 people are living with cancer.

Lantus, a form of insulin used to treat diabetes, increased from $2,907 per year to $4,702 per year. There are 82,318 people with diabetes in Rhode Island.

Finally, Aggrenox, a heart disease medication, increased from $3,030 per year to $5,930 per year. In Rhode Island, 31, 756 people have heart disease.

Specialty Drug Prices Continue 12-Year Surge

The AARP-state specific infographic released this month follows on the heels of an earlier AARP Public Policy Institute report released in June, reporting that the prices of widely used specialty prescription drugs grew more than three times faster than general inflation in 2017.

The researchers found that the average annual price for a single specialty drug used on a chronic basis is now nearly $79,000, compared to $27,824 in 2006.

Specialty drugs often require special administration and handling and are used to treat conditions that often affect older populations, including cancer, rheumatoid arthritis, and multiple sclerosis.

According to the findings of the AARP report, the average annual cost for a single specialty drug was almost $20,000 more than the median U.S. household income ($60,336), more than three times the median income for beneficiaries ($26,200, and over four-and-a-half times higher than the average Social Security retirement benefit ($26,200).

The report also found that the average annual p rice for one specialty medication would have been $29,843 in 2017 – almost $50,000 lower – if the retail price changes for these products had been limited to general inflation between 2006 and 2017.

“Prescription drugs are not affordable when their prices exceed the patient’s entire income,” said Debra Whitman, AARP’s Executive Vice President and Chief Public Policy Officer. Unfortunately, drug prices seem to be in a never-ending race to the top, leaving more and more people unable to afford the medications they need,” she says.

The researchers also noted that revlimid, used to treat cancer, had the highest annual price surge of the 30 top selling specialty drugs at 21.4 percent, going from $203,928 in 2016 to $247,497 in 2017. Revatio, a pulmonary hypertension medication, had the single highest retail price increase (48 percent) among the 97 most widely used specialty drugs.

“Specialty drugs account for the majority of the prescription drugs that were approved by the FDA in recent years,” said Leigh Purvis, Director of Research at AARP Policy Institute. “Given the remarkably high prices associated with such products, it is imperative that policymakers finally enact meaningful changes that target drug manufacturers’ pricing behavior,” she said.

Putting the Brakes to Skyrocketing Drug Costs

Last March, AARP launched its ‘Stop Rx Greed Campaign’ to find Federal and State solutions to slash skyrocketing drug prices. The goal of AARP’s sustained campaign is to help drive down drug prices for all Americans by advocating for a variety of legislative, executive, and regulatory actions at both the federal and state level.

“Americans are paying the highest prescription drug prices in the world,” said Executive Vice President and Chief Advocacy & Engagement Officer Nancy LeaMond, in a statement kicking off this advocacy initiative. “It’s time for pharmaceutical companies to stop deflecting blame and acknowledge that the root cause is the price they set for their products,” she says.

The Stop Rx Greed campaign will include national television, radio and digital ads, editorial content, emails to members, social media posts, ongoing advocacy and grassroots activity in D.C. and the states, and a petition calling on Congress and the Administration to take action now.

As part of the campaign, AARP is actively supporting a number of policy solutions at the national and state level to help lower drug prices. The aging advocacy group supports allowing Medicare to negotiate for lower prescription drug prices and states to negotiate lower prices with drug companies. AARP also calls for giving state Attorneys General authority to crack down on outrageous price increases and clamping down on pay-for-delay and other loopholes that keep
lower cost generic drugs off the market. Finally, AARP endorses capping prescription drug out-of-pocket costs and preserving state pharmacy assistance programs.

Congress is now considering legislation to put the brakes on rising pharmaceutical calls. As the 2020 election approaches the GOP-controlled Senate must work across the aisle with Senate Democrats to craft and pass bipartisan legislation to lower drug costs. It’s time for Senate Majority Leader Mitch McConnell, who vows to block any Democratic priories coming out of the Democratic-controlled Houses to the Senate, to put Senate companion bills on the floor for a vote. It’s time for the Kentucky Senator to put the needs of older Americans first, rather than political wins.

For more details about AARP’s Stop Rx Greed initiative, go to http://www.aarp.org/politics-society/advocacy/prescription-drugs/.

Study Calls for Action on Creating Senior Housing for Middle-Income Seniors

Published in the Woonsocket Call on August 18, 2019

A recently released report sends a stark warning to federal and state policy makers and to the private senior housing sector. The report forewarns that in the coming years, a large number of middle-income seniors, who need assisted living with supportive services, will be priced out of this level of care.

Seniors housing in the United States is paid out of pocket by seniors with sufficient assets. A relatively small percentage of Americans have long-term care insurance policies to defray the costs. For seniors with the lowest incomes, Medicaid covers housing only in the skilled nursing setting, but increasingly also covers long-term services and supports in home and community-based settings. Programs such as low-income housing tax credits have helped finance housing for economically-disadvantaged seniors.

The researchers call on the government and the senior housing sector to step up and to assist the projected 14.4 million middle-income people over age 75, many with multiple chronic conditions, who won’t be able to afford pricey senior housing.

According to this first-of-its-kind study that appears in the April 24 2019 edition of Health Affairs, 54 percent of middle-income older Americans will not be able to meet yearly costs of $60,000 for assisted living rent and other out-of-pocket medical costs a decade from now, even if they generated equity by selling their home and committing all of their annual financial resources. The figure skyrockets, to 81 percent, if middle-income seniors in 2019 were to keep the assets they built in their home but commit the reset of their annual financial resources to cover costs associated with seniors housing and care.

Accompanying the senior housing study are two perspective pieces in Health Affairs on how society can adapt to aging and supporting aging in communities.

The study, “The Forgotten Middle: Many Middle-Income Seniors Will Have Insufficient Resources For Housing And Health Care, was conducted by researchers at NORC at the University of Chicago, with funding provided by the National Investment Center for Seniors Housing & Care (NIC), with additional support from AARP, the AARP Foundation, the John A. Hartford Foundation, and The SCAN Foundation.

Learning About the Needs of the Emerging ‘Middle Market’

“We still have a lot to learn about what the emerging ‘middle market’ wants from housing and personal care, but we know they don’t want to be forced to spend down into poverty, and we know that America cannot currently meet their needs,” said Bob Kramer, NIC’s founder and strategic adviser in a April 24, 2019, statement. “The future requires developing affordable housing and care options for middle-income seniors. This is a wake-up call to policymakers, real estate operators and investors,” he adds.

The report notes that significant financial challenges are expected to coincide with many middle-income seniors seeking seniors housing and care properties due to deteriorating health and other factors, such as whether a family member can serve as a caregiver. The study projects that by 2029, 60 percent of U.S. middle-income seniors over age 75 will have mobility limitations (8.7 million people), 67 percent will have three or more chronic conditions (9.6 million people), and 8 percent will have cognitive impairment (1.2 million people). For middle-income seniors age 85 and older, the prevalence of cognitive impairment nearly doubles.

The researchers say that this ‘middle market’ for seniors housing and care in 2029 will be more racially diverse, have higher educational attainment and income, and smaller families to recruit as unpaid caregivers than today’s seniors. Over the next 10 years, growth in the number of women will outpace men, with women comprising 58 percent of seniors 75 years old or older in 2029, compared to 56 percent in 2014, they say.

Bringing the Public and Private Sector Together

“In only a decade, the number of middle-income seniors will double, and most will not have the savings needed to meet their housing and personal care needs,” said Caroline Pearson, senior vice president at NORC at the University of Chicago and one of the study’s lead authors.

“Policymakers and the seniors housing community have a tremendous opportunity to develop solutions that benefit millions of middle-income people for years to come,” says Pearson.

Researchers say there is an opportunity for policymakers and the seniors housing and care sector to create an entirely new housing and care market for an emerging cohort of middle-income seniors not eligible for Medicaid and not able to pay for housing out of pocket in 2029.

The study’s analysis suggests that creating a new ‘middle market’ for seniors housing and care services will require innovations from the public and private sectors. Researchers say the private sectors can offer more basic housing products, better leverage technology, subsidize ‘middle-market’ residents with higher-paying residents, more robustly engage unpaid caregivers, and develop innovative real estate financing models, among other options.

As to the public sector, the researchers call on government to create incentives to build a robust new market for middle-income seniors by offering tax incentives targeted to the ‘middle market,’ expanding subsidy and voucher programs, expanding Medicare coverage of nonmedical services and supports, creating a Medicare benefit to cover long-term care, and broadening Medicaid’s coverage of home and community-based services.

“This research sets the stage for needed discussions about how the nation will care for seniors who don’t qualify for Medicaid but won’t be able to afford seniors housing,” said Brian Jurutka, NIC’s president and chief executive officer. “This discussion needs to include investors, care providers, policymakers, and developers working together to create a viable middle market for seniors housing and care,” he says.

Adds, Lisa Marsh Ryerson, President of AARP’s Foundation, “All seniors want to live in affordable, safe and supportive housing, and more than 19 million older adults are unable to do so. We must act now to implement innovative solutions – including robust aging-in-community efforts – to accommodate what is sure to be an increasing demand for housing that meets the needs of older adults.”

Is Rhode Island prepared to meet the senior housing needs of the state’s middle-income seniors in 2029? If not, the state’s federal delegation, lawmakers, state policy makers and the senior housing industry must begin to chip away at this looming policy issue.

To view the study, go to http://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05233.