Policy Changes for Older Persons

Elderly Status in 1960 Little interest in expansion of programs for aged after initial passage of SS Act in 1935 First checks arrived 1940 Only activity was 1950 provision for federal government to help states pay for health care costs of poor aged

65+ population had grown from 3 million in 1900 to 17 million in Census revealed more than 30% of aged lived below the poverty line Elderly seen as part of the “invisible poor” identified in Harrington’s book, The Other America

Compassionate Stereotypes Concern arose for this group of “deserving poor” 1960 White House Conference on Aging 1961 U.S. Senate Select Committee on Aging Great public sympathy for older adults who were poor, frail, unable to keep up with inflation

Beginning of Age-Based Services and Programs 1965 Older Americans Act Created state units on aging with special advocacy functions Alabama Department of Senior Services Also created area agencies on aging, covering all of nation: the aging network

AAA Programs Coordinate local services and advocate for more Most visible were congregate nutrition sites begun in 1972 Also senior transportation and other social services

Medicare begun in 1965 Major policy innovation Fought by American Medical Association Provides health insurance for persons 65+ eligible for social security

Medicare Part A Hospital Insurance –paid for through payroll taxes on individuals and employers After deductible ($952 in 2006) pays all costs for first 60 days Some nursing home care after hospitalization

Medicare Part B Supplemental Health Insurance Optional – the older person pays a monthly premium ($88.50 in 2006) After a deductible ($124), it pays 80% of reasonable changes for doctor bills, etc. Currently does not include check-ups, glasses, dentures, hearing aids

Medicare Drug Benefit New addition Discount card available in June 2004 to give up to 15% savings Full implementation January 2006 Confusing to many, will also help many

Medicaid Also Begun in 1965 Health insurance for the poor Elderly are beneficiaries (accounted for 11.3% of recipients but 31% of expenditures in 1998) Picks up where Medicare leaves off, if the person is POOR Benefited many without social security records in beginning

Medicaid pays for long-term, custodial care Most goes to pay nursing home costs Advocates for aged want more for home health care, day care, respite care, etc.

Impact of Health Care Programs Better health care for the aged Elders can spend income on other things Phenomenal growth in health care industry Benefits to physicians unanticipated

Social Security Changes 1972 expansion of benefits by 20% Automatic indexing to take inflation into account COLA (cost of living adjustments)

SSI Program Expansion of old age assistance in 1973 Create national floor of income for the aged 65+ Supplements other income up to $603 for an individual and $904 for a couple Automatic eligibility for Medicaid

1964 Food Stamp Program Not directed at elderly population Benefits many elderly households

Result of Policy Expansions on Poverty >30% of elderly in poverty in 1960 Today, about 8.7% Would be 46.8% without Social Security Single averages $1002, couple $1648 monthly Old age poverty in US is LESS than the overall poverty rate of about 13% Is LESS than child poverty rate of 16.2%

Success of Elderly Advocacy Major changes in last 40 years of 20 th century Aging of the “baby boomers” suggests that policy gains are likely to be maintained Old people are active in the political process Bush’s 2005 plan to change Social Security failed to gain support