February 12, 2025 Washington, DC – As maneuvering in Congress to pass a budget reconciliation act officially kicks off, Katie Smith Sloan, president and CEO of LeadingAge, the association of nonprofit and mission-driven providers of aging services, calls on House and Senate members to ensure the needs of older adults and the people who serve them are met.
“The contents of the multi-billion or multi-trillion dollar package that emerges from budget reconciliation will be critical to the well-being of America’s older adults and families, and our nonprofit and mission-driven community-based members who serve them.
Our country’s rapidly growing older population depends on the multitude of services and supports financed through many programs supported either fully or in part by the federal government. One primary example–but certainly not the only–is Medicaid, jointly funded by states and the federal government through a federal matching program. It is the largest public payer of long-term services and supports.
Potential cuts to the federal government’s Medicaid obligations to states, one proposal under consideration in reconciliation, would be a significant blow to those who serve older adults in nursing homes, home health and other home-and-community based care settings.
Another item of great concern: the potential elimination of tax exemption on municipal bonds, which, if included, would severely limit community-based nonprofit organizations’ access to capital and inhibit their ability to finance projects, including affordable housing for low-income older adults. Demand for affordable senior housing has long surpassed supply; the loss of municipal bonds’ tax exemption now, when the fastest growing cohort of homeless adults is those over the age of 65 and access to safe and appropriate housing for older adults is limited, is simply unconscionable.
The good news is that Congress can support older adults and providers through the reconciliation process by eliminating burdensome regulations including the nursing home staffing rule. Though well-intentioned, the mandate in its final form is misguided and unrealistic given current workforce shortages and a lack of funding to recruit, train and retain nurses and nurse aides. Repealing it could save $22 billion over 10 years. And, as mentioned above, more affordable senior homes are needed. Congress can address this by increasing the annual Housing Credit allocation to states by at least 50% and providing basis boosts for rural properties and properties that serve people with extremely low incomes.
The need to do right by older adults in the reconciliation process has never been more important: by 2050, adults 65 years and older will comprise nearly a quarter of the U.S. population. It is essential that they will have access to critically needed services and supports. Congress can help set us on the right track.”
