Aging Policy and Politics in the Trump Era

Posted on August 28, 2018 by Jodi Boyne

How are Trump Administration policies likely to affect the social safety net for older Americans? Twelve articles in a recently published special issue of the Journal of Aging and Social Policy offer a variety of responses to that question, including articles authored by Robyn Stone and Marc Cohen, co-directors of the LeadingAge LTSS Center @UMass Boston. 

The state of aging policy and politics in the Trump era is the first article in the 12-part series, which also features articles that explore aging policy and politics relating to long-term care and housing, health care, retirement security, and aging politics.   

The absence of an effective insurance mechanism to protect people against multiple risks and the impact of the growing financial risk on state Medicaid budgets is examined in Financing long-term services and supports: challenges, goals, and needed reforms authored by Cohen and Judith Feder. 

Cohen and Feder explain the choices and trade-offs policy makers face in designing new ways to pay for long term services and support, and then outline their proposal to develop a new public-private partnership that combines catastrophic public insurance with front-end private long term services and supports insurance. 

Robyn Stone examines the role of federal policy in the addressing the housing challenges of low-income elders. Stone points to promising new strategies that use publicly assisted housing to serve as a platform for identifying and addressing the health and social challenges of older residents. She sees increased investments in housing plus services models as a possible solution to the growing affordable housing crisis facing older Americans with low incomes. Those investments could come through partnerships between health systems/insurers and housing developers/operators. 

“As Medicare Advantage Plans, Medicare Accountable Care Organizations, and other health insurers and health care systems strive to be more efficient and reduce health care costs attributed to low-income, high-risk elderly beneficiaries, they may be willing to pay for the service coordination and wellness services delivered in housing,” writes Stone. “Over time, and assuming that Medicare allows more flexibility in how dollars are used, some plans may also see the value in providing rental subsidies and even construction funds to help build more affordable senior properties for their high-cost, high-risk enrollees,” she concludes.