What Older Americans Want Policymakers To Know

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This article was originally published on Bipartisan Policy Center.

Older Americans are often the focus of health care debate, but their voices are missing. BPC’s toolkit highlights their experiences and bipartisan reforms to improve affordability, access, caregiving, behavioral health, and financial security.

While older Americans are often the subject of health care debate, their voices are often missing from health policy conversations. To help center their voices, BPC drew on interviews conducted by The People Say initiative to highlight key challenges older adults experience in today’s health care system.1 Informed by older adults’ experiences, the following are bipartisan policy reforms Congress should take to strengthen services and make care more affordable for a growing aging population. This includes opportunities to strengthen caregiver support for cost-effective home-based care, increase access to behavioral health services, improve financial security, and reduce system complexities.

Strengthen Caregiver Support For Cost-Effective Home-Based Care

“Anna” is a 65-70-year-old adult enrolled in traditional Medicare and private insurance who lives in suburban Louisiana.

“…being a caregiver is a lot… I have to take care of myself and also take care of [my husband]. And taking care of him is a job by itself… and it’s hard… but I have to hire someone to come and take care of him, and… it costs a lot. And we can’t get the long-term personal care or anything, because if you own a house or your own property, then that’s out. You can’t get any assistance from the state, and that’s hard.”
– “Anna”

“Anna” is not alone. Nearly 38 million working Americans provide care for an adult or child with disabilities, and many are forced to reduce work hours or leave the workforce to provide care.2 Medicare does not cover long-term care, and many older adults cannot afford needed services, which often leaves family members to step in to provide care. A shortage of paid direct care workers adds to this challenge.

  • Congress should support unpaid family caregivers by establishing a modest Medicare respite benefit and a refundable caregiver tax credit.
  • Congress should address the direct care workforce shortage by strengthening registered apprenticeship programs and ensuring adequate Medicaid payment rates and compensations for direct care services.

For more information, see reports “A Practical Framework for Addressing the Long-Term care Financing Challenges” and “Addressing the Direct Care Workforce Shortage.”