Public Policy & Aging E-Newsletter
Volume 4, Number 6, November 2010
This bimonthly e-newsletter highlights key developments and viewpoints in the field of aging policy from a wide variety of sources, including articles and reports circulating in the media, academy, think tanks, private sector, government and nonprofit organizations.
The goal of this email publication is to reach teachers, students, and citizens interested in aging-related issues, especially those who may not have sufficient access to policy information disseminated both in Washington and around the country.
Want the most up-to-date access to aging policy resources? Follow us on Twitter @Aging_Society!
I. WHAT’S HAPPENING IN WASHINGTON?
A. No COLA Increase for Social Security: The government announced that Social Security recipients will not receive a cost-of-living adjustment (COLA) for the second year in a row due to the economic recession and little rise in consumer prices. Many groups oppose this decision, and are calling on Congress and the President to assist Social Security recipients with additional funds. To learn how the Department of Labor measures inflation, the shortcomings of this index, and possible alternative measures, watch the Urban Institute’s video package.
B. Working in Retirement: A 21st Century Phenomenon: The generation of workers currently in their 50s and 60s is redefining the notion of retirement. Already today, one in five workers aged 50 and older has retired fully from a former career job and is working for pay in a new role, defined as a "retirement job." This soon will become the new “normal"; fully 75 percent of workers aged 50 and older will have retirement jobs in the future, according to a new report by Families and Work Institute and the Sloan Center on Aging & Work. The study examines the reasons adults continue to work during retirement, whether they enjoy it, and future plans to continue working.
C. The Not-So-Golden Years: Confronting Elderly Poverty and Improving Seniors Economic Security: This Center for American Progress memo details the economic challenges facing older Americans, including increased elder poverty, especially among women, unemployment spikes, and a shift away from defined benefit pensions in the US. This combination of setbacks, create a difficult environment for current older persons in the U.S., and this situation will likely grow as 75 million baby boomers reach retirement with insufficient savings. The brief also explores how current policies, such as Social Security and the Older Americans Act, can be improved to reduce poverty among older adults.
II. WHAT’S HAPPENING AROUND THE COUNTRY?
A. Employment-Based Retirement Plan Participation: Geographic Differences and Trends: This EBRI issue brief examines the level of participation by workers in public- and private-sector employment-based pension or retirement plans, based on the U.S. Census Bureau’s March 2010 Current Population Survey (CPS). The brief organizes these trends around age, gender, race, geographic location, income, and education. Overall, results show that the employment-based retirement system remains a critical source of Americans’ retirement income security, and is under pressure from the recent economic downturn.
B. 2010 Market Survey of Long-Term Care Costs: This MetLife Market Institute survey provides national, statewide, and, for certain states, area-specific costs for nursing homes, assisted living, adult day services, and home care. The survey compares average private-pay, daily rates for private and semi-private rooms in a nursing home, monthly base rates in assisted living communities, hourly rates for home health aide and homemaker services, and daily rates for adult day services. The study finds increases in national averages for private room rates in nursing homes, as well as monthly rates in assisted living facilities between 2009 and 2010.
C. Hoping for Economic Recovery, Preparing for Health Reform: A Look at Medicaid Spending, Coverage and Policy Trends -- Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2010 and 2011: This annual 50-state survey released by the Kaiser Family Foundation finds that many states experienced rapid growth in their Medicaid enrollment and spending in 2010, and expect additional growth in 2011. In the survey of Medicaid officials, states reported an average increase in Medicaid spending of 8.8 percent in 2010, the highest rate of growth in eight years. Medicaid directors attributed the unexpected jump to higher-than-expected increases in eligible families due to the recession.
III. THIS ISSUE'S MAJOR POLICY STORY: Implementation of Health Care Reform
One of the big issues in the mid-term election was whether the American people really wanted to reform health care amidst a sluggish economy still in recovery. Some are supportive of the package because millions of uninsured or underinsured citizens now have basic coverage. Others worry about the cost. Still others ascribe provisions to the omnibus legislation that actually were never enacted. One way to clarify issues is to highlight aspects of the measure that are in effect or will be implemented over the next few years. We have taken special care to highlight pieces that are clear and comprehensible--though we are also aware that shifts in Congress that occurred on November 2d may call into jeopardy part of the reform legislation.
--Andy Achenbaum
A. Achieving Better Chronic Care at Lower Costs Across the Health Care Continuum for Older Americans: This Brookings Institute report explains how the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act (ACA) include payment and delivery reform measures designed to improve the overall performance of the health care system and contain the costs of expanding health insurance coverage. The report discusses how these reforms help individuals with multiple chronic diseases that face many preventable complications and poorly coordinated services.
B. Realizing Health Reform's Potential: Pre-Existing Condition Insurance Plans Created by the Affordable Care Act of 2010: The new federal health law has created temporary insurance pools called the Pre-Existing Condition Insurance Plan (PCIP) for people with medical problems who have trouble securing traditional coverage. This Commonwealth Fund issue brief surveys the program, examining "eligibility, benefits, premiums, cost-sharing, and oversight of the PCIP programs, as well as variation of the plans from state to state." It finds that many previously uninsured people with pre-existing conditions will have the opportunity to purchase more comprehensive and affordable health insurance coverage under a PCIP.
C. Implementing the CLASS Act: Six Decisions for the Secretary of Health and Human Services: This RTI International policy brief analyzes some of the major issues to be decided when implementing the CLASS Act, the voluntary public insurance program for long-term care established by the Patient Protection and Affordable Care Act. Topics covered include eligibility and substance of benefits, how to ensure beneficial selection by individuals, and how the CLASS insurance program will interact with private long-term care insurance.
D. Implementing the Affordable Care Act: New options for Medicaid HCBS: The National Academy of State Health Policy (NASHP), with support from The SCAN Foundation, released a policy brief focused on health reform provisions that give states additional options for financing Medicaid home and community-based services and supports. The brief analyzes scenarios whereby states, which have significant roles in executing many aspects of the Affordable Care Act, might implement a combination of new Medicaid state plan options, enhanced Medicaid matching payments, and demonstration projects to expand community-based care.
E. The Future of Nursing: Leading Change, Advancing Health: The nursing profession is the largest segment of the nation’s health care workforce. Working on the front lines of patient care, nurses play a vital role in helping realize the objectives set forth in the Affordable Care Act. This Institute of Medicine report highlights how and why nurses should play a fundamental role in transforming the health care system. The report describes a number of barriers that prevent nurses from being able to respond effectively to rapidly changing health care settings and an evolving health care system, and argues that these barriers must be overcome to ensure that nurses are well-positioned to lead change and advance health.
IV. WORTH NOTING
A. GSA’s 63rd Annual Scientific Meeting Less Than Two Weeks Away: This year’s Annual Scientific Meeting will take place in New Orleans from November 19th-23rd. Policy sessions include “Congressional Aging Issues Update” by Capitol Hill Staff and “Speak Out! Social Security & Women.” View this handout for more policy-related sessions. GSA also will host Aging Means Business, a one-day business and aging forum that brings together top-ranked national academic experts on economics, gerontology, and consumer behavior to engage in dialogue with business leaders about ways to better serve, target, and engage this growing senior market.
B. Health Reform Interactive Timeline: This interactive timeline from the Kaiser Family Foundation explains how and when the provisions of the health reform law will be implemented over the next several years. Users can expand or hide all the changes occurring in a year, click on a provision to get more information about it, and customize the timeline by selecting specific topics.
C. National Resource Center on LGBT Aging: Collaboration between Services and Advocacy for GLBT Elders (SAGE), aging- and GLBT-focused organizations, and government agencies resulted in the launch of the National Resource Center on LGBT Aging. This Center is the country's first and only technical assistance resource center aimed at improving the quality of services and supports offered to lesbian, gay, bisexual, and transgender (LGBT) older adults. It provides training, technical assistance, and educational resources to aging providers, LGBT organizations, and LGBT older adults.
V. WHAT'S HAPPENING ABROAD?
A. The Global Aging Preparedness Index: The Center for Strategic and International Studies released an index that measures how well 20 countries are prepared to care for a growing aging population. In their accompanying report, the authors offer a reform guide that analyzes the benefits of seven reform strategies, including reducing public pension benefits and increasing immigration. The policies discussed emphasize the challenges and inevitable trade-offs when caring for the elderly in a time of economic crisis.
B. World Alzheimer Report 2010: The Global Economic Impact of Dementia: This Alzheimer’s Disease International (ADI) report examines the rising costs of dementia care from a global perspective, explains differences found between countries, and proposes policy solutions to meet these needs. According to report findings, nearly two-thirds of all people with dementia live in low- and middle-income countries. Considering the anticipated 85 percent increase in dementia care costs to 2030, ADI acknowledges the need for cost-effective packages of medical and social care to assist people with dementia and their caregivers across the course of the illness.
C. French Senate and National Assembly Pass Pension Bill and the Public Protests: Demonstrators have taken to the streets of France in France are asserting their disapproval of government plans to raise the minimum retirement age from 60 to 62, and the full-pension retirement age from 65 to 67. Introduced by President Sarkozy to reduce the deficit, the bill has been met with extreme opposition since its announcement in September. Both the Senate and Senators the National Assembly voted in favor of the bill. Sarkozy hopes to enact the law on November 15th. Click here to read a BusinessWeek article about the votes and resulting protests.
VI. PERSPECTIVES ON POLICY: ROB HUDSON, EDITOR, PP&AR
The latest issue of Public Policy & Aging Report explores environmental ingredients and interactions that affect—often negatively—the health and happiness of older (and younger) Americans. These factors range from elements of the “environment” as it is often depicted—air, water, and land quality—to physical structures, such as neighborhoods, to patterns of social interaction. The lead article by Schettler and Valenti emphasizes the need for citizens and policymakers to employ an “eco-social” model when addressing how environmental factors affect health outcomes. Schettler, Gottlieb, and Sirois direct their attention to the food environment, highlighting the damage created by contemporary agricultural practices. Thompson, Palmigiano, Schettler, and Valenti call attention to the chemical environment and its associations with chronic illnesses. Gray, Harrell, and Sykes address the negative effects the “built environment” may have, especially on older people. The concluding article by George and Whitehouse identifies interpersonal and intergenerational engagement as a “psycho-social” environmental construct, and suggest that there can be “creative social solutions to the challenges of the aging brain.”
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Newsletter Editors: Dani Kaiserman, Sarah F. Wilson, and Greg O'Neill, National Academy on an Aging Society; Andy Achenbaum, University of Houston.
The Public Policy and Aging E-Newsletter is supported in part by a grant from the AARP Office of Academic Affairs.
