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

Medicare Enrolled will see Lower Costs on Select Drugs in 2026

Published in Blackstone Valley Call & Times on December 2, 2025

With Medicare Open Enrollment ending next week, the Centers for Medicare & Medicaid Services (CMS) has announced that last year’s Medicare negotiations produced a net savings of 44%—about $12 billion—on 15 widely used prescription drugs that treat cancer and other serious chronic conditions.

The new Maximum Fair Prices (MFPs) for these 15 drugs will take effect on January 1, 2027. Combined with the 10 drugs already negotiated—whose MFPs take effect January 1, 2026—a total of 25 drugs will have negotiated lower prices. These medications, used to treat conditions such as cancer, diabetes, asthma, and cardiovascular and neurological disorders, represent some of the highest Medicare Part D spending.

The Beginning of Drug Price Negotiations

Three years ago, after President Biden signed the Inflation Reduction Act (IRA) in August 2022, CMS began developing the process for Medicare’s first-ever drug price negotiations. On March 15, 2023, the federal agency issued its initial program guidance and received more than 7,500 public comments from consumer groups, patient advocates, drug manufacturers, and pharmacies. Revised guidance followed on June 30, 2023.

On August 29, 2023, CMS released the first list of 10 high-cost drugs selected for negotiation—marking the first time in Medicare’s history that it could negotiate directly with pharmaceutical companies.

Pharmaceutical industry groups and several companies attempted to block the law in court. In response, 70 organizations and 150,000 petition signers urged Merck, Bristol Myers Squibb, Janssen Pharmaceuticals, Astellas Pharma US, the Pharmaceutical Research and Manufacturers of America (PhRMA), and the U.S. Chamber of Commerce to drop their lawsuits. Multiple organizations also filed amicus briefs supporting the law.

Three years in process, and with courts ultimately allowing the program to proceed, that first round of 10 drugs with negotiated prices will take effect in 2026.

CMS Drug Negotiations Added 15 Drugs

On January 17th, CMS announced it had selected 15 additional drugs for the second cycle of negotiations under Medicare Part D and on November 25th, it was announced that agreements had been reached on all of them. These medications are among the most costly and most commonly used by Medicare beneficiaries, treating conditions such as cancer, diabetes, and asthma. The new round of negotiations is expected to save Medicare billions and strengthen the program’s long-term sustainability.

“This year’s results stand in stark contrast to last year’s,” said CMS Administrator Mehmet OzMD, in announcing the second cycle of negotiations.  “Using the same process with a bolder direction, we have achieved substantially better outcomes for taxpayers and seniors in the Medicare Part D program — not the modest or even counterproductive ‘deals’ we saw before.”

“Whether through the Inflation Reduction Act or President Trump’s Most Favored Nation policy, this is what serious, fair, and disciplined negotiation looks like,” adds CMS Deputy Administrator and Medicare Director Chris Klomp. “I’m deeply proud of our team, who execute exceptionally well to bring affordability to the country in everything we do.”

Between January 1 and December 31, 2024, approximately 5.3 million Medicare Part D enrollees used one or more of these 15 drugs. Total gross Part D spending for them was $42.5 billion, representing about 15% of all Part D drug costs.

Anthony Wright, executive director of Families USA, praised the newly released negotiated prices, stating that they show what is possible when “policymakers put patients before corporate profits.” Wright emphasized that these reductions build on the work of establishing the Drug Price Negotiation Program, which aims to provide financial relief to older adults and people with disabilities.

Wright noted that the first and second rounds of negotiated drugs together account for about one-third of Medicare Part D spending, with price reductions ranging from 38% to 85%. In 2027, beneficiaries using these drugs are projected to save $685 million in out-of-pocket costs. He added that the savings support both individual beneficiaries and the long-term sustainability of the Medicare program.

Despite pharmaceutical companies’ continued attempts to limit the program—through lawsuits and legislative provisions such as those in H.R. 1—Wright said the negotiation program remains “the most effective tool currently available to lower drug prices.”

“The Medicare Negotiation Program changed the trajectory of drug pricing in the United States, helping to reduce Big Pharma’s monopoly pricing power, which dictated prices to Americans on Medicare for two decades,” said Merith Basey, executive director of Patients for Affordable Drugs in a statement. “This second round of negotiations — now under President Trump — marks another major milestone, delivering continued savings for patients and taxpayers,” he said.

“The lower negotiated prices are more than numbers on a page. For patients who’ve been forced to work multiple jobs, cut pills in half, or choose between filling a prescription and buying groceries, these lower prices will bring long-overdue relief, flexibility, and stability,” added Basey.

“The requirement that Medicare negotiate lower prices for prescription drugs continues to pay dividends for older Americans and taxpayers,” adds Richard Fiesta, executive director of the Alliance for Retired Americans. “The announcement of lower drug prices for 15 high-priced drugs is a win for more than 5 million seniors who take these drugs to treat asthma, diabetes, lung disease and other serious conditions, and will soon pay less for their medications,” he says.

“The 4.4 million members of the Alliance are pleased that the Trump Administration has followed the law, negotiated these prices, and defended this law in court,” Fiesta says, calling on Congress to increase the number of drugs subject to price negotiations.

While the White House along with aging groups praise the impact of IRA’s Medicare drug negotiation provisions, the Pharmaceutical Research and Manufacturers of America (PhRMA) issued a statement calling it “flawed.”

“Whether it is the IRA or MFN, government price setting for medicines is the wrong policy for America. Price setting does nothing to rein in PBMs who decide which medicines are covered and what patients pay. In fact, many patients are facing additional coverage barriers and paying more out-of-pocket for medicines because of the IRA, warns Alex Schriver, Senior Vice President of Public Affairs.

“These flawed policies also threaten future medical innovation by siphoning $300 billion from biopharmaceutical research, undermining the American economy and our ability to compete globally,” states Schriver, noting that PhRMA members are stepping up to make medicines more affordable by enabling direct purchase at lower prices and investing in U.S. manufacturing and infrastructure.

Lower Drug Cost Legislation Introduced

Congressman John B. Larson (D-CT), a senior member of the House Ways and Means Committee, praised the latest CMS announcement, estimating that both negotiation rounds will save older Americans more than $2 billion per year in out-of-pocket costs. Larson noted that families and seniors continue to struggle with rising prices, especially for prescription drugs.  The lawmaker pushed to enable Medicare to negotiate drug prices to lower drug costs by the enactment of IRA.

Last week, House Democrats introduced the Lower Drug Costs for American Families Act, aimed at closing loopholes in H.R. 1 and further reducing prescription drug prices. The bill (H.R. 6166), introduced November 20 by Ranking Members Frank Pallone Jr. (Energy and Commerce), Richard Neal (Ways and Means), and Bobby Scott (Education and Workforce), has been referred to all three committees.

Key provisions of the bill would:

  • Extend Medicare’s price negotiation authority to all Americans with private insurance—covering more than 164 million people with employer-sponsored plans and over 24 million enrolled in Affordable Care Act plans
  • Apply inflation-based rebate protections to private insurance markets, potentially saving $40 billion over 10 years
  • Increase the number of negotiated drugs from 20 to 50 per year
  • Extend the $2,000 annual out-of-pocket prescription drug cap to privately insured patients
  • Cap insulin costs at $35 per month for those with private insurance
  • Close the orphan-drug loophole that allows companies to avoid negotiation
  • Require consideration of international drug prices to ensure Americans do not pay three to five times more than patients in other countries

Continue the Momentum

According to CMS, the agency will announce the specifics on 15 drugs for the third round of Medicare price negotiations by February 1, 2026. This new round will include drugs paid under Medicare Part B for the first time and will begin with negotiated prices effective January 1, 2028. CMS has already released final guidance for the program and will also use this process to select drugs for renegotiation in previous cycles. IRA also establishes an ongoing process where more drugs will be selected for negotiation in subsequent years.

A Dec. 2024 AARP survey found that almost 3 in 5 adults age 50 and older expressed concern about their ability to afford prescriptions over the near future.  Respondents included both Medicare beneficiaries and younger persons. About 96 percent of the respondents call on the government to do more to lower pharmaceutical prices.

AARP noted that this survey was taken right before a new $2,000 cap on out-of-pocket drug expenses took effect in 2025.

With the announcement of lower drug costs that result from Medicare’s round 2 drug negotiations, there is an  opportunity to build on this momentum for real change. Lawmakers can legislate to put the public’s health above profit by giving consumers more power to negotiate, making competition stronger, and keeping patients from having to pay too much out of pocket.

It is now time for Congress to act.

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 LawMcCourt 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.