Physicians Among Bipartisan Leaders Calling for Expanded Access to PACE

This article was originally published on NPA Online.

WASHINGTON, DC – June 10, 2024 – The Program of All-Inclusive Care for the Elderly (PACE) is widely seen as a model of care that allows seniors to remain living at home instead of in a nursing facility, with a better quality of life and clinical outcomes. Most PACE participants are eligible for Medicaid. Seniors who are covered only by Medicare are eligible to enroll as well, but few do. Concerned about the barriers to enrollment for Medicare beneficiaries, the National PACE Association (NPA) held a Capitol Hill briefing on June 7 to urge lawmakers to increase access to PACE for older adults whose income levels disqualify them from Medicaid.

Legislators from both sides of the aisle spoke during the briefing, as well as a representative of the Bipartisan Policy Center and a private citizen seeking access to PACE. In attendance were U.S. Sen. Tom Carper (D-DE); U.S. Sen. Bill Cassidy (R-LA), MD; U.S. Rep. Brad Wenstrup (R-OH-2), DPM; and former Kansas Gov. Jeff Colyer (R), MD. Other speakers were Lisa Harootunian, associate director of Health at the Bipartisan Policy Center; and Linda Henderson, for whom PACE Part D costs are a barrier to enrolling in the program.

Currently, more than 76,000 seniors participate in PACE, with 164 programs in 32 states and the District of Columbia. PACE empowers older adults and people with disabilities to live at home and in their communities despite being eligible for nursing home care. All of their health care, nutrition, transportation and other needs are identified and addressed in an individualized care plan by a dedicated interdisciplinary team.

A key barrier to enrolling in PACE for Medicare beneficiaries is the exorbitant Part D premium for prescription drugs. Part D costs are significantly higher for PACE participants than the millions of other Medicare beneficiaries – 22 times higher on average. Two bills now before Congress – the PACE Part D Choice Act and the DUALS Act of 2024 – would eliminate this burden on PACE participants. Both have bipartisan support.

The legislators and other speakers at the recent Capitol Hill briefing expressed their support for both bills.

“Leading the charge to expand access to PACE is a team of bipartisan senior lawmakers and experts – many of whom are also physicians,” said Shawn Bloom, president and CEO of NPA. “PACE is a nonpartisan issue. It is a health care solution. PACE allows seniors to live independently in their homes with all of their health and long-term care needs met. We need the legislation to pass in order to level the playing field for this critical segment of our population.”