Block and Foulkes address Aging, Disability, Behavioral Health at Gubernatorial Forumof Healthy

Published in RINewsToday on October 5, 2026

By Herb Weiss, contributing writer

Democratic gubernatorial candidate Helena Foulkes and independent candidate Ken Block squared off Friday, Oct. 2, at a gubernatorial candidate forum focused on issues affecting older Rhode Islanders, people with disabilities, family caregivers, and those receiving behavioral health services.

The forum, held at Rhodes on the Pawtuxet in Cranston, was sponsored by the Senior Agenda Coalition of Rhode Island, AccessPoint Rhode Island (SACRI), and the Mental Health Association of Rhode Island.

“It was an honor and a pleasure to partner with AccessPoint RI and MHARI to present this forum,” said Carol Costa, Executive Director of SACRI, emphasizing their continued dedication to the intersection of Behavioral Health, Developmental Disabilities, and Aging.

“It was a distinct honor to welcome gubernatorial candidates Helena Foulkes and Ken Block to a forum focused on issues that directly affect older adults, people living with mental health challenges, and communities across Rhode Island,” said Costa.

“We appreciate the candidates’ time and their willingness to engage thoughtfully on these interconnected priorities,” she noted. “At a moment when democracy and civic discourse matter more than ever, their participation demonstrated a meaningful commitment to respectful dialogue, public service, and the people of Rhode Island.”

Unlike many gubernatorial forums that focus heavily on taxes, housing, education, and the economy, this forum allowed the candidates to address issues that often receive less attention during political campaigns: aging in the community, long-term services and supports, nursing home care, Medicaid, family caregiving, behavioral health, and services for persons with disabilities.

Here is a video of the forum, courtesy of Pat Ford, The Coalition Radio Network. Following the video is a “transcript” of the questions and responses.

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We edited the questions and candidates’ responses for length, grammar, and clarity. We did not change the meaning of the questions or the candidates’ responses. Refer to the video here for more information.

Carol Costa announced the following at the beginning of the forum:

“Before we begin, you’re all entitled to know that Aaron Gukian committed to taking part in this forum. He accepted my invitation and we planned this program around his participation. He is not here today. I received a phone call at 3:00 PM that he would not be here. I’m not going to let that take time away from this value forum. We’ve adjusted the program, and we will move forward in a focused and streamlined way so that these candidates who have taken the time to be with this audience get the forum they deserve. But you should know he did make a commitment to this community and he did not keep it.”

Here is what Foulkes and Block told more than 80 attendees at the forum.

Opening Remarks

  • Helena Foulkes (Democrat):

I really wanted to thank the SACRI for pulling this together, the Mental Health Association of Rhode Island, and AccessPoint Rhode Island for all you do.

I want to say that I feel very strongly that the senior population in our state is an incredibly untapped resource.

The wisdom, the expertise—and we’re going to talk a lot tonight, I’m sure, about caring for many of the elder folks and others in our state who need our support. But I think we often forget how much wisdom exists and how much more we could benefit as a state by tapping into all of your expertise.

I am very excited to be looking to the senior community to help me think about things like a Senior Corps-style effort. How do we take, as I said, the wisdom and expertise and tap into your sense of volunteerism?

I’ve been crisscrossing this state for the last few years, mostly in people’s kitchens and living rooms, listening, showing up, and asking people, “What’s one thing you’d love the next governor to do for you?”

  • Ken Block (Independent):

I’m very happy to be here tonight. Helena and I have been in front of many forums this year, hosted by advocacy groups for different purposes, all providing services or looking out for the interests of different groups of people.

This group has been remarkably effective at educating me about their issues and talking with me about the challenges different groups experience as they age.

I have been on this journey with my parents as they’ve aged and passed away. My wife’s parents are now in their 80s and are experiencing a very different journey than my parents did. They’re aging in place, let’s say, challengingly.

Dealing with that remotely has been a challenge for both my wife and me. It makes me realize that while my parents and Jen’s parents have been really supported, others on the journey don’t have the level of support and family involvement we had.

That’s where groups like this, or advocacy organizations like the ones we have here representing different services that can provide the help people need, are so vitally important.

  1. As governor, what would you do to strengthen the Office of Healthy Aging (OHA) and better support healthy aging and aging in the community?
  • Helena Foulkes (Democrat):

On this topic, I absolutely am open to the idea of a cabinet-level position. I need to understand it more closely, but I would say Maryland is a place where this does exist.

I’m good friends with Wes Moore. So this is an example where, using some of my relationships and even many other governors, I’d love to understand what does great look like as we think about serving the senior population.

I also want to speak to the fact that I think we need a whole-of-government approach. Tonight, it’s really hard to give you a hard commitment on dollars given that I don’t know what the state of the budget will be.

You look at education, the Department of Labor and Training, and the Rhode Island Public Transit Authority—lots of places where seniors need access to support. And we’ve got to have, under my leadership, a government that is really focused on how we serve seniors in the state because, to Maureen’s point, it’s a huge portion of our population, higher than most other states.

I would also like to have a master plan on aging. I’m sure many of you have parts of that. I want to pull it together.

So that’s where we need a governor who will set the expectation that I want to see – a plan. I’ll have deadlines because I want to benefit from the expertise, as I mentioned, involving you. Still, I also want to make sure we have a plan where we can hold ourselves accountable to making seniors’ lives better.

  • Ken Block (Independent):

Yes. I believe OHA should be a cabinet-level position for a simple reason: a substantial portion of our population has interests that line up directly under OHA.

And as governor, I want to make sure every large group of people who live here has a voice I can hear. Having OHA as a cabinet-level position gives me the ear I need to hear their needs.

I don’t disagree with anything Helena just said, but I would like to tackle the issue a little bit differently because I don’t think the state is being responsive enough.

I hear a lot of dismay and unhappiness with how responsive the state is to the needs of advocacy groups and the nonprofits that work with it. Several areas of dysfunction seem to be particular sticking points, especially OHHS.

So I describe myself as an operational manager. I’m a specialist in understanding where an organization doesn’t work well, where the friction points are, and what changes we need to make to improve it.

And I look at Rhode Island as a—right now, Rhode Island government’s kind of a target-rich environment.

  1. What steps would you take to reduce the number of lower-acuity residents living in nursing homes?
  • Helena Foulkes (Democrat):

I want to start on a human level around this question because I think the idea that more of our senior citizens should be able to live at home and have caregiving at home is a really great aspiration.

I think one barrier is not having the home healthcare workers we need to support folks in the state.

I speak to a lot of caregivers who don’t even talk about the dignity of their own work, how challenging it is, how low-paid it is. Most of the people I speak to don’t even have healthcare insurance themselves.

So I think we need to start by understanding what the gap is to get to this target, what the gap is in terms of the number of community healthcare workers who can do these jobs, and how do we make sure more of them get trained up, paid appropriately so that we can really be providing service.

You have Donald Trump, who is now essentially targeting many of these home-care providers and healthcare workers by threatening to send immigrants out of this country.

And I’ll use the Haitian community as one example of that. An incredible community of hardworking, loving, dedicated healthcare workers who are now unsure whether they’ll be able to stay here.

  • Ken Block (Independent):

Research shows that care for nursing home residents who need lower levels of care can be provided more cost-effectively outside nursing homes.

So from the governor’s office perspective, my job would be to make sure that we can pave the way for these alternative treatment and housing solutions, that they’re available, and that we can help families who might be taking on some of the burden of caregiving by providing resources to them to make the job easier.

As you all know, the state budget is under tremendous pressure, both from within and without. Washington, D.C., is threatening us. We have a structural deficit coming into this budget year, and Helena and I have both heard requests for what I estimate to be billions of dollars in additional funding this year from the different groups we’ve spoken to.

I have no idea how we prioritize all the different needs or how we can pay for them. It’s going to be very difficult.

But what you have done here, and what other groups have done, has demonstrated beyond a doubt that your requests are worthy.

  1. What would you do to expand home – and community-based care for persons with disabilities and behavioral health conditions?
  • Helena Foulkes (Democrat):

What I’ll add to my last answer is the idea of helping families navigate the complexity of this and thinking about this concept of “no wrong door.”

The idea is that I could go to a state website and get help figuring out how my loved one gets the best level of care in the state.

It’s really hard right now.

And what I’ve always said in my career is I don’t need to be the smartest person in the room. You all know much more about this than I do.

But what I want to do is ask all of you, as it relates to something like this, what are all the stupid things we do? What barriers do we put in your way, and how can we make it much easier for families navigating the complexities of this issue?

  • Ken Block (Independent):

With developmental disabilities, you have a challenge at some point where the severity of it is such that a home-based solution can be not only very difficult, but at times could also be maybe somewhat dangerous.

So I believe that the state government, the governor’s office, our job would be to make sure that people understand whatever services are available, whatever programs of support are available.

It’s a good idea when it works and as long as we can do it safely. That would be my biggest concern: making sure everybody can be safe.

We know that moving eligible individuals out of group homes or institutional settings and into the home environment can often lead to better results.

  1. What would you do to ensure implementation of the nursing home behavioral health per diem and protect the principles of Olmsted regardless of federal challenges?
  • Helena Foulkes (Democrat):

The last couple of years, the drumbeat around healthcare has gotten really loud. People are really worried that their primary care doc is going to retire and they won’t be able to find anyone.

We have two hospitals in our state that are on life support, I would say: Roger Williams and Fatima. We made a deal to keep them alive earlier in the year, but there’s still a real risk in those hospitals.

We have the federal government, which is just ruthlessly attacking people around healthcare in this country, with 40,000 Rhode Islanders who are going to lose access to Medicaid starting in January.

It’s so cruel. It’s so inhumane.

So a big thing that I’ve been focused on, in all honesty, is: how do we make sure people don’t get kicked off of Medicaid?

I want to use the faith-based community. I want to use senior centers. I want to go into some of the high-rises where seniors are living and bring the paperwork and resources to people, because the really sneaky thing about President Donald Trump and what he did with H.R. 1 is he’s making the paperwork so complicated that people won’t get through it and will give up.

I think healthcare will be the tsunami that will hit the next governor.

  • Ken Block (Independent):

I’m really glad Rhode Island cannot mint its own currency, because it would let politicians overcommit.

One of the easiest things for someone like me sitting here facing a room with people like you, on every question that asks, “Can you fund us? Can you fund us? Can you fund us?” The simple question always has the simplest answer, and the one you want to give as a candidate is, “I’ve got you.”

In this circumstance, I can’t tell you that I’ve got you. The General Assembly can’t tell you that they’ve got you. We don’t know what is coming at us.

So what I will tell you is I fully understand the need. I understand completely how important the program is. I get it. I really do.

But what I can’t tell you right now is, because I don’t know what’s coming, to make a promise now that I don’t keep is something that I really want to avoid.

I don’t want to be the guy who said, “Yep, absolutely.” And two months after I get into office, it’s like, “Oh my God, I can’t keep any of the promises that I made.”

My answer to you, with all sincere respect, is I don’t know.

  1. What role should Eleanor Slater Hospital play in meeting the long-term care needs of older Rhode Islanders and persons with disabilities?
  • Helena Foulkes (Democrat):

From talking to folks in the community, I know this sector of healthcare has been under a lot of strain for quite some time.

Getting people together and thinking about a holistic healthcare strategy in our state is a big priority of mine.

I think we’ve been putting Band-Aids on a lot of problems, but not really stepping back and asking: how do you serve people, and what assets do we have in the state that can help us do a good job for folks?

And Eleanor Slater is one component of that.

  • Ken Block (Independent):

I’m definitely open to using any existing resources that we have to address the issue.

So the direct answer to your question is I’m open to it. Yes.

  1. What steps would you take to implement Rhode Island’s 2025–2028 State Plan for Family Caregivers, including respite services, the Temporary Caregiver Insurance Program and a family caregiver tax credit?
  • Helena Foulkes (Democrat):

I think this relates to having a really solid plan that I talked about at the beginning and, in each one of these, understanding what is required. What’s the community’s priority?

If we can’t get everything done, what do you all see as most important?

It’s an incredibly stressful extra job that caregivers take on. I’ve spoken with many, many caregivers in the same generation, who are obviously working themselves, taking care of kids, and having parents.

And then you talk about the economic stress of just not being able to take time off.

I absolutely believe we need to expand caregiver assistance and support, but I need to understand, at the end of the day, what all of this costs and make sure I’m not making promises I can’t keep.

I won’t do that.

What are your mission-critical issues, and how do we actually work to get them done?

  • Ken Block (Independent):

I watched and participated firsthand in my relative’s home healthcare.

My mom was diagnosed with early-onset Alzheimer’s at age 61. We moved them to Providence, to an independent living facility. And my dad was my mom’s caregiver, and I watched the toll that it took on him.

One day I got a phone call, and he said, “Ken, your mom just kind of slumped down.”

I was like, “Oh my God.”

And he’s like, “No, she’s okay. She just slumped down, but she can’t get up, and I can’t lift her, and I don’t want to call anybody at the facility because they’re going to kick us out.”

I raced over, lifted her onto the bed, and that was it.

I realized right at that moment that my dad’s ability to care for my mom had ended.

The emotional and physical toll on caregivers is enormous. Enormous. I’ve watched it.

My dad aged 40 years while he cared for my mom.

And one of the things that I think the state has to watch out for, especially if we’re going to begin subsidizing people to provide care at home, is: how are we going to make sure that we are not putting many more people at risk because they want to take advantage of the money without regard to what the toll is really for both the patient as well as the caregiver?

We have to make sure that we are smart about it.

  1. How would you help older Rhode Islanders and persons with disabilities pay for long-term services without having to rely on Medicaid or sell their homes?
  • Helena Foulkes (Democrat):

This is a really hard problem, and I’ve met lots of families who have been put in this situation of selling the family home to put a loved one in a nursing facility.

I believe we need to raise Medicaid rates in the state. Our state has an older, poorer population than most of New England.

And Medicare, unfortunately, is fixed. The federal government sets it. It’d be great if it went up, but we can’t plan on that.

Medicaid: we have an opportunity to raise Medicaid rates by $70 million, and this last session we could have gotten a $126 million federal match. And that would make a real difference in the healthcare system.

I’ve met so many healthcare providers who live in this state and work in Connecticut and Massachusetts every day because they can make 20 or 30% more just by crossing the border.

I will also make sure someone on my team is dedicated to getting every single dollar of federal funds that we can.

And so, the needs are quite great, but a big part of it starts around funding Medicaid the way we need to.

  • Ken Block (Independent):

Medicaid is at the root of a lot of our healthcare challenges.

And in this case, the cost of assisted living is dramatically raised because the same facilities that provide higher-end services, like full-on nursing and memory care, are under-reimbursed by Medicaid, and they make up for that shortfall by sticking it to the private people who are paying for assisted living.

Everyone has to recoup costs, and we see this repeat in many different areas throughout our healthcare system over time.

So, interestingly, the answer to your question is that we have to figure out how to raise reimbursements for both Medicaid and Medicare.

If we do that, in theory, assisted-living costs should come down.

We spend a lot of money. Many different people have told me some of the money’s being well spent, some of the money’s not being well spent, and we have to make some hard decisions and assessments.

So I don’t think we can take the Medicaid budget from $5 billion to $7 billion. We don’t have the capacity for that.

But in that $5 billion, let’s make sure every penny is spent right. And the pennies that aren’t spent right, then we have to put them towards the things that solve the most problems.

  1. Would you support Medicaid reimbursement rates that reflect the cost of care and fair compensation for direct-care workers, while helping build and sustain the long-term care and behavioral health workforce?
  • Helena Foulkes (Democrat): Yes.
  • Ken Block (Independent): Yes.
  1. Would you support using 30% of state housing bond funds for older adults and persons with disabilities, increasing accessible housing units, and publicly tracking accessible and supportive housing?
  • Helena Foulkes (Democrat): Yes.
  • Ken Block (Independent): No.
  1. Would you support a small monthly telephone fee, similar to 911 funding, to sustainably fund Rhode Island’s 988 Suicide & Crisis Lifeline and broader behavioral health crisis response system?
  • Helena Foulkes (Democrat): Yes.
  • Ken Block (Independent): No (opposed burying another fee in the utility bill. Supports program but not the proposed way to pay for it.)
  1. Would you support eliminating the Medicare Savings Program asset limit and providing an annual cost-of-living adjustment to the state’s SSI Supplemental payment?
  • Helena Foulkes (Democrat): Yes.
  • Ken Block (Independent): No answer given because he didn’t have a cost estimate.
  1. Would you support developing and providing resources for a Rhode Island Multi-Sector Plan on Aging?
  • Helena Foulkes (Democrat): Yes.
  • Ken Block (Independent): Yes.
  1. Would you support legislation creating an Office of Elder Advocate?
  • Helena Foulkes (Democrat): Yes.
  • Ken Block (Independent): Yes.
  1. What would you do to improve transparency and accountability in the delivery of human services?
  • Helena Foulkes (Democrat):

Yes, we need much more transparency across the state.

Think about bridges and roads, the lack of transparency there. And it really breeds mistrust.

One thing I feel deeply, as I’ve been listening to people over the last few years, is that people have lost faith in government. They’ve lost faith that those of us who are working in government are committed to making life better.

And I know there are so many dedicated public servants, but it is so trust-corroding when we’re hiding information.

So I support anything we can do to increase transparency and make sure people have access to the information.

What programs are working really well? What programs aren’t working?

I was also a big proponent of the Inspector General because I thought, look at the billions of dollars that we got during the Biden administration. We don’t even know where that money went.

What worked? What didn’t work? What should we keep doing? What should we stop doing?

Those are really basic questions we’re not answering today, and I’m very committed to transparency.

  • Ken Block (Independent):

Pretty much my entire adult life has been spent following the data and letting it take me wherever it leads.

I’ve been more frustrated than happy with Rhode Island state government’s ability to provide data. And I know many people have asked the state for information.

They’ve been frustrated, and sometimes people within government can’t even get the data that they need to make decisions.

So this is an area where I literally eat—this is what I do professionally.

I’d like to see a whole—this is really nerdy stuff—but I want to see a bunch of dashboards and other tools that will ultimately help us understand much better than we can now where we’re spending the money and where the data is, so we can make informed decisions.

We can’t make good decisions without the underlying information to tell us what to do.

The challenges that are in front of us are daunting, but they’re fixable. We have seen other states tackle hard problems. We can tackle hard problems.

On the transparency side of things, we have not covered ourselves in glory, and I’ll issue executive orders immediately upon becoming governor that get right at the issue of transparency and make sure that, moving forward, our government is accountable to you.

Government doesn’t serve itself. Government serves, temporarily, the people who elected it into power.

Closing Remarks

  • Helena Foulkes (Democrat):

Thank you all so much for being here, for the great questions, and for your time and energy on these topics.

I want to be a governor for everyone. One reason I did so well in the Democratic primary is that I know Rhode Islanders are ready for change. They’re hurting. Everywhere I go, people talk about how much pain there is in this state, but at the same time, how much people love it here.

I’m optimistic we can do great things together.

When I think about our state, I want it to be a place where our children and grandchildren can live a good life.

I want this to be a place where people can afford healthcare. They can send their kids to a good school. They can have bridges and roads that actually work for them.

So many basic things aren’t working, and I think people lose hope. They lose faith that government can work.

Last night I was talking to a young man, and I always say, “What do you want the next governor to do?” And he said, “I want someone who will be honest with us.”

I’ve never thought I was the smartest person in the room. I will absolutely be leveraging your expertise. You can expect to hear from me, and I’ll be an advocate and a champion for the people that you’re serving.

  • Ken Block (Independent):

Thank you for the opportunity to come here tonight, and thank you for the advocacy work that you do. Thank you for the services that you provide. Thank you for caring so much about the issues that have come out here.

Our government doesn’t work without people outside government making sure it doesn’t forget what it’s supposed to do.

You have seen in both of us tonight the hesitancy and the challenge when we talk about the funding and what’s coming at us.

We’re all feeling the pinch throughout the healthcare system. We are under tremendous stress from the physicians, the providers, all the way across.

For me, as someone looking to buy private health insurance, it’s probably close to $4,000 a month for my family of four.

That is unaffordable for the vast majority of Rhode Islanders. That’s way more than most Rhode Islanders pay on the mortgage.

So, we have what I lovingly call a mess.

And a problem of this magnitude requires a detailed thinker, somebody who’s going to pull the experts together and drive the conversation, and look to provide some structure on something that’s very unstructured right now.

And we have to find savings wherever we can, and put that money to better use.

SSA Trustees Report Calls on Congress to Fix Social Security and Medicare

Published in RINewsToday on June 22, 2026

Congress faces the urgent legislative task of ensuring the long-term viability of the nation’s Social Security program. As in previous years, the Social Security Board of Trustees’ 2026 report warns that without congressional action, the OASI and DI Trust Funds will pay full benefits only through 2034. Afterward, payroll tax revenue will cover about 83% of scheduled benefits, highlighting the need for timely Congressional intervention.

Federal law requires that trust fund-financed programs such as Social Security and Medicare pay out only as much in benefits as they receive in revenues once their trust fund reserves run out.

According to the Social Security Administration (SSA), about 21% to 22% of the U.S. population currently receives Social Security benefits. The released Trustee’s report notes that at the end of 2025, Social Security paid benefits to more than 70 million Americans: 56 million retired workers and their dependents, 8 million disabled workers and their families, and 6 million survivors of deceased workers. Medicare covered an estimated 69.3 million people.

The Trustees also said that recent congressional actions, including the Social Security Fairness Act and changes to the taxation of Social Security benefits, weakened the program’s long-term financial outlook.

The Social Security Board of Trustees is the group that issues the annual report on the financial health of Social Security’s trust funds — the Old-Age and Survivors Insurance fund and the Disability Insurance fund.

It has six seats:

1.    Secretary of the Treasury — also the Managing Trustee

2.    Secretary of Labor

3.    Secretary of Health and Human Services

4.    Commissioner of Social Security

5.    Public Trustee appointed by the President and confirmed by the Senate

6.    Public Trustee appointed by the President and confirmed by the Senate

As of the 2026 Trustees Report, the current government-position trustees are:

·         Scott Bessent, Secretary of the Treasury and Managing Trustee

·         Keith E. Sonderling, Acting Secretary of Labor

·         Robert F. Kennedy Jr., Secretary of Health and Human Services

·         Frank J. Bisignano, Commissioner of Social Security

The two public trustee seats are currently vacant

Demographic Changes Strain Social Security Finances

The annual Trustees Report, released on June 9, said several long-term demographic trends strain the financial stability of Social Security, as fewer workers pay payroll taxes into the program to support a growing population of beneficiaries.

Americans live longer and collect benefits for more years, while millions of Baby Boomers continue to retire. Birthrates stay below historical levels, so fewer workers enter the labor force.  Lower levels of immigration increase financial pressure by reducing the number of workers who pay payroll taxes.

The combined Social Security trust funds are currently projected to pay full benefits through 2034. However, the outlook for the Old-Age and Survivors Insurance (OASI) Trust Fund has weakened slightly. Trustees project OASI reserves will be depleted in late 2032. At that point, revenues are expected to cover only about 78% of scheduled OASI benefits, compared to the overall 83% coverage for all Social Security benefits after combined depletion.

The Trustees Report also notes that Social Security’s disability program remains financially stable. The Disability Insurance (DI) Trust Fund is expected to stay adequately financed throughout the 75-year projection period and pay full benefits without interruption.

Taking a Look at Medicare

Also released on June 9, the 2026 Medicare Trustees Report found that Medicare remains financially stable in the near term but faces significant long-term funding shortfalls caused by rising health care costs and an aging population.

According to the Trustees, Medicare spending will grow faster than revenues dedicated to financing the program. The health care needs of retiring Baby Boomers, growing Medicare enrollment, rising medical costs, and increased spending for services used frequently by older adults—including skilled nursing care, home health care, and hospice services—largely drive this increase.

The Medicare Hospital Insurance (HI) Trust Fund, which pays for Medicare Part A services, is projected to be depleted in the second quarter of 2033—three months earlier than last year’s prediction. After depletion, Medicare Part A would be able to cover about 89% of its costs from incoming revenue. Part A covers inpatient hospital stays, skilled nursing facility services, home health care, and hospice care.

Congress must act within the next seven years to prevent significant reductions in Medicare payments to providers. Addressing the projected shortfall before the 2033 trust fund depletion is essential to avoid an estimated 11% funding gap.

Unlike Part A, Medicare Parts B and D are not expected to face trust fund insolvency because they are financed through a combination of beneficiary premiums and general federal revenues.

Max Richtman, President & CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), says a range of proposals could help extend the solvency of Medicare’s Hospital Insurance (HI) Trust Fund without reducing benefits.

Among the options, says Richtman, are raising the Medicare tax rate on earned and investment income above $400,000 from 3.8% to 5%, and closing loopholes that allow some high-income business owners to avoid Medicare taxes by structuring income in ways that escape both payroll taxes and the Net Investment Income Tax (NIIT). NCPSSM also supports redirecting revenue from the 3.8% NIIT—currently deposited into general federal revenues—directly to the HI Trust Fund, he says, noting that the group estimates this change could generate roughly $500 billion over 10 years.

In addition, Richtman recommends building on the prescription drug reforms in the Inflation Reduction Act by expanding Medicare’s ability to negotiate drug prices, accelerating negotiations as more medications are added, and extending inflation-rebate requirements to commercial insurance plans. Savings from these measures, he says, would be credited directly to the HI Trust Fund, further strengthening Medicare’s long-term outlook.

Reactions From Advocacy Groups and Lawmakers

In a statement, AARP CEO Dr. Myechia Minter-Jordan warned that the 2026 projections show Congress still must close a financing gap of nearly 20%, or Americans could face benefit reductions they cannot afford.

“This should be a wake-up call: Congress needs to act. Americans have worked hard and paid into Social Security their entire lives, and they deserve to count on it when they retire,” she said. “They planned for retirement, followed the rules, and now Congress must keep its promise by strengthening, not cutting, Social Security,” Minter-Jordan added, urging lawmakers to work across party lines to strengthen the program.

“The Social Security Trustees Report is a clarion call for Congress to strengthen the program now before the looming depletion of the trust fund becomes a full-blown crisis,” said NCPSSM’s Richtman in a released statement.

“If Congress fails to act, the combined retirement and disability trust fund reserves will run dry in 2034, and beneficiaries will suffer an automatic 17% cut—a scenario few want to see happen. Lawmakers should not wait until the last minute when options become more limited and remedies more costly,” he said.

Richtman also argued that benefit reductions are not necessary to restore Social Security’s financial health and that beneficiaries living on fixed incomes should not bear the burden of strengthening the program.

In a statement, Nancy Altman, president of Social Security Works, likewise emphasized that the Trustees Report demonstrates the consequences of inaction.

“As the Trustees Report plainly states, if there is insufficient revenue, Social Security benefits will be automatically cut,” Altman said.

On June 15, 2026, House Speaker Mike Johnson said during a Louisiana radio interview that Republicans would like to address the growth of mandatory federal spending programs in future budget discussions, including Social Security. He argued that the federal budget is increasingly driven by automatic spending commitments and said that Social Security and other entitlement programs “have to be adjusted and fixed.”

Responding to Johnson’s remarks, Altman argued that some Republican proposals would move Social Security toward privatization, a characterization that supporters of those proposals dispute. She also criticized proposals that would reduce future benefits rather than increase revenues to strengthen the program.

Public opinion surveys consistently show strong bipartisan support for preserving Social Security benefits. Altman argued that proposals to reduce benefits through means testing or other changes would be unpopular with voters and called on congressional candidates to explain how they would address the program’s long-term financing challenges.

During a June 10 morning hearing of the Joint Social Security and Work & Welfare Subcommittee with Social Security Commissioner Frank Bisignano, held in room 1100 at 100 Longworth House Office Building, Rep. Jason Smith (R-MO) noted that Social Security benefits have only been modified twice in 40 years, most recently in 1983, with only minor changes under his chairmanship of the House Committee on Ways and Means in 2025.

“Congress needs to get its act together to address Social Security and the insolvency that’s coming instead of poking blame at other people when it is our duty, our responsibility,” Smith said, urging bipartisan cooperation between Republicans and Democrats to reform the program. He called for the protection of vulnerable populations who depend entirely on Social Security for retirement and a dignified standard of living, particularly in the rural communities they represent.

“This latest report from the trustees is proof that Congress must step up now to protect Social Security before it’s too late. It’s only going to cost more and be more difficult to solve the longer we wait,” said Sen. Bill Cassidy (R-La.) in a statement issued on June 10, outlining his plan to rescue Social Security by creating a sovereign wealth fund independent of the Social Security Trust Fund.

Cassidy joined Sens. Thom Tillis (R-N.C.), Dick Durbin (D-Ill.), and Tim Kaine (D-Va.) in issuing a bipartisan statement following the release of the Trustees Report. The senators said that “Congress shouldn’t delay any longer” and urged lawmakers to begin debating and voting on proposals to strengthen Social Security’s long-term solvency.

Putting Social Security on the Ballot

The Trustees’ Report makes it very clear that Social Security and Medicare are not facing an immediate financial crisis. Both programs will continue paying benefits for years to come. However, these reports also warn Congress that delaying action will make the eventual policy solutions more difficult to achieve and potentially more disruptive.

Many Republican proposals focus on slowing future benefit growth through measures such as raising the retirement age, modifying cost-of-living adjustments, or expanding means testing, while many Democrats favor increasing revenues by requiring higher-income Americans to contribute more into the system.

Over a year ago, lawmakers introduced a major bill to rescue Social Security and Medicare. Senator Sheldon Whitehouse (D-RI) introduced the Medicare and Social Security Fair Share Act (S. 1690) to ensure both programs remain stable in the future. The plan raises money by closing tax loopholes for ultra-wealthy Americans, but it completely shields anyone making under $400,000 a year from paying higher taxes. Representative Brendan F. Boyle (D-PA) brought the exact same bill to the House floor at the same time.

Legislative proposals, such as Whitehouse’s, to adjust the taxable wage cap or apply payroll taxes to certain forms of investment income have also been offered as ways to ensure Social Security’s fiscal solvency.

A new voter education campaign is highlighting the financial challenges facing Social Security. Led by NCPSSM’s Richtman, the “Social Security is on the Ballot” initiative aims to build public support for legislative solutions, including Sen. Whitehouse and Rep. Boyle’s proposed Fair Share Act, to help secure funding for the program.

There are many issues competing for voters’ attention this year,” explains Richtman, “But few will have such a profound effect on your future. Voters should insist [at the ballot box] that the fundamental promise of Social Security be preserved – as the program is strengthened for the future,” he said.

This multi-faceted campaign will encompass social media, short web videos, special editions of our “You Earned This” podcast and radio show, mailings, and grass-roots engagement/activism.

For over 70 million older Americans who rely on their Social Security and Medicare benefits, the Trustees’ Reports deliver a very clear message: Congress must act sooner rather than kicking the proverbial can down the road (as it usually has). As the projected trust fund depletion dates draw closer, lawmakers will need to work across the aisle to strengthen these programs and ensure they remain financially sound for current beneficiaries and future generations.

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For a copy of the 2026 Social Security Trustees Report, go to The 2026 OASDI Trustees Report

For a copy of the 2026 Medicare Trustees Report, go to 2026 Medicare Trustees Report

Expanding Medicare on political agendas: In-home Health Care critically important

Published in RINewsToday on October 14, 2024

This week Vice President Kamala Harris unveiled a “Medicare at Home” proposal on ABC’s The View that would expands Medicare to assist older Americans to age in place at home by covering some of the cost of in-home care. The proposal targets adults who are part of the ‘sandwich generation,’ estimated to be 105 million Americans who are raising children along with taking care of their elderly parents.

The Medicare benefit to assist caregivers would propose to have cost-saving benefits for the federal government by allowing seniors to stay at home rather than being sent to costly nursing homes. It would also reduce hospitalizations, too.

Harris told about her personal experience as a caregiver, providing care to her mother, Shyamala Gopalan, a biomedical scientist, who died of cancer in 2009 at the age of 70. Caring for a parent can translate into “trying to cook what they want to eat, what they can eat,” she said. “It’s even trying to think of something funny to make them laugh or smile,” she added.

“We’re talking about declining skills” of older people, “but their dignity, their pride, has not declined,” Harris added.

“There are so many people in our country who are right in the middle. They’re taking care of their kids and they’re taking care of their aging parents, and it’s just almost impossible to do it all, especially if they work,” Harris said.  “…we’re finding that so many are having to leave their job, which means losing a source of income, not to mention the emotional stress,” she said, explaining why there is a need to expand Medicare to cover more in-home care services.

Harris’ Issues on her website – Protect and Strengthen Social Security and Medicare

“Vice President Harris will protect Social Security and Medicare against relentless attacks from Donald Trump and his extreme allies. She will strengthen Social Security and Medicare for the long haul by making millionaires and billionaires pay their fair share in taxes. She will always fight to ensure that Americans can count on getting the benefits they earned”.

The Costs

The Brookings Institution recently estimated that a “very conservatively designed” program would cost $40 billion a year. They noted that “controlling demand in such a program is nearly impossible – for reference, Medicaid, which covers far fewer adults than Medicare, actually spent $207 billion on long-term services and supports in 2021”.

In addition, “Home health is such a hotbed of fraud,” said Theo Merkel, a health policy expert at the Paragon Health Institute and the Manhattan Institute. “If the proposal is adopted, taxpayers could end up paying for everyone who stays at home with their Medicare-eligible family member as a government paid Service Employees International Union member.”

The Cato Institute, a libertarian think tank headquartered in Washington, D.C., charges that Harris’ new Medicare home care benefit is “uncompassionate, fiscally reckless, and a corrupt attempt to buy the votes of Medicare enrollees and their middle-aged children in an election year.”

Examining the Differences…

According to Matthew E. Shepard, Communications Director for the Center for Medicare Advocacy, the new Harris proposal is quite different from the existing home care benefits that Medicare’s 65.5 million enrollees receive. ”The new proposal focuses on Long Term Services and Supports, something of a term of art in the health care world. While details are scarce, it would provide, we believe, ongoing affordable home care aide service without a need for skilled care or that strict definition of homebound,” said Shepard.  The proposal’s funding would come from increased savings in Medicare Part D as the list of negotiable drugs grows  [a historic provision of the Inflation Reduction Act which is lowering the cost of senior’s medication]  savings currently estimated at $6 billion in 2026, and which will only grow as more drugs are added, he noted.

“We are going to save Medicare that money, because we’re not going to be paying these high prices [for drugs] and that those resources are then put to use in a way that helps a family,” Harris said.

The Trump proposal

The Trump/Vance campaign quickly issued a statement taking credit for already making a commitment to America’s seniors receiving at-home care, saying that Harris’ Medicare expansion policy was just following his lead. Former President Trump released his home care platform last summer, according to an Oct. 8th statement. “Specifically, President Trump will prioritize home care benefits by shifting resources back to at-home senior care, overturning disincentives that lead to care worker shortages, and supporting paid family caregivers through tax credits and reduced red tape,” noted the statement.

One of Trump’s 20 point platforms is “Fight for and protect social security and Medicare with no cuts, including no changes to the retirement age”. In the accompanying 16-page document, which, supports Medicare it says, “President Trump has made absolutely clear that he will not cut one penny from Medicare or Social Security. American citizens work hard their whole lives, contributing to Social Security and Medicare. These programs are promises to our Seniors, ensuring they can live their golden years with dignity. Republicans will protect these vital programs and ensure Economic Stability. We will work with our great Seniors, in order to allow them to be active and healthy. We commit to safeguarding the future for our Seniors and all American families. We will strengthen Medicare. Republicans will protect Medicare’s finances from being financially crushed by the Democrat plan to add tens of millions of new illegal immigrants to the rolls of Medicare. We vow to strengthen Medicare for future generations.”

 Dementia caregiving already set to quadruple in 2025

AARP notes on their website that one expansion of caregiver coverage, “a program for dementia patients and their caregivers that launched this year will quadruple in 2025, serving more of the country. The program, called Guiding an Improved Dementia Experience (GUIDE), provides a 24/7 support line, a care navigator to find medical services and community-based assistance, caregiver training and up to $2,500 a year for at-home, overnight or adult day care respite services. Patients and their caregivers typically won’t have copayments”.

Praise for expanding Medicare benefits

“We have long championed the expansion of federal support for long-term care,“ says Max Richtman, President and CEO, National Committee to Preserve Social Security and Medicare (NCPSSM), noting that Harris’ proposal gives that cause an enormous boost.

“Expanded Medicare coverage for home health care also would provide relief to millions of ‘sandwich generation’ Americans, who are struggling to provide care for their elderly relatives while also raising children.  Those ‘sandwich generation’ members are not Medicare beneficiaries, but would most definitely benefit from Harris’ long-term care plan,” says Richtman in an Oct. 8 statement.

According to Richtman, the plan also would add hearing and vision coverage to traditional Medicare. “Proper hearing and vision care are essential to healthy aging — but too many beneficiaries forgo it due to cost and lack of coverage. It is long past time that those coverages be added,” he added.  

Co-Director David Lipschutz says that the Center for Medicare Advocacy (CMA) strongly supports the proposed enhancement of Medicare coverage for on-going home care. “Access to services and supports in the home for those who are unable to independently perform activities of daily living would provide immeasurable help to millions of beneficiaries and their families and is an important step forward for the Medicare program,” says CMA’s Lipschutz. To maximize access to care for people who need it, expansion of home care coverage in Medicare should be combined with enforcing the benefit that exists now, he suggests. 

“Recognizing that most older persons and those with disabilities prefer to remain at home when they need help with daily living tasks, the Senior Agenda Coalition has worked for years to increase access to home and community-based care at the state level as these services are one of the biggest gaps in Medicare,” says Maureen Maigret, Policy Advisor for Senior Agenda Coalition of RI.  To include them in Medicare will lift a financial burden on both recipients and family caregivers as home care costing at least $35/hour that  can be out of reach for far too many who need these services to stay at home,” she says.

“We have not seen many details about the plan, but it would be important to make sure that Medicare provider reimbursement levels are sufficient to allow direct care staff to earn livable wages in order to have workforce sufficient to meet the demand,” note Maigret. “This new Medicare home care benefit should also be a boon for states as it can prevent persons from spending down their resources to a level where they become eligible for state Medicaid and need costly nursing home care,” she says.  

In a new paper for O’Neill Institute for Georgetown Law, McCourt Professor Judith Feder and Nicole Jorwic explore how adding a home care benefit can help beneficiaries and family caregivers. “While this new benefit would not reach the full population in need of long-term care, paired with investments in Medicaid, it’s a good strong start-and given our nation’s resources, clearly within our means,” say the authors. 

“A support system that relies on unpaid family members and underpaid workers is simply not sustainable for the future,” warn the authors.

“Our failure to make Medicare “whole” by addressing Long Term Services and Support needs is not about a shortage of resources, it’s about a shortage of political will. It’s time the nation stepped up,” they say.

Pay attention to Caregiver voters

AARP is nonpartisan and does not take a position on campaign proposals, though AARP has previously said financial relief is needed to help individuals age in place at home and support family caregivers, says Sarah Lovenheim, AARP’s vice president, external relations.

According to AARP’s “She’s the Difference” survey released last month, 96% of woman aged 50 and over say they are highly motivated to vote in the upcoming elections, making them one of the most driven and key voting groups.

“Any political candidate would be wise to pay attention to the concerns and needs of caregivers today. Voters over age 50, who disproportionately make up America’s 48 million plus caregivers, could make or break elections up and down the ballots,” says Nancy LeaMond, AARP’s executive vice president and chief advocacy and engagement officer. “From recent battleground polls, we know that roughly one-third of swing voters over age 50 identify as family caregivers,” she notes.

“Supporting family caregivers is an urgent need – not only for families struggling to get by but for our country’s future,” warns LeaMond.

Regardless of who wins the election, a Medicare at home proposal cannot happen without Congressional support. As the presidential campaign winds down, older voters must make it extremely clear to lawmakers seeking their vote how they feel about expanding Medicare benefits.