US Rep. Lloyd Doggett, a Texas Democrat and strong supporter of seniors
and assisted living in Congress, says long term care needs to be
included in any comprehensive overhaul of the nation‘s health care
system.
“The momentum is there for health reform,’’ said Doggett in an interview with ALE. “Whether long term care is included is a question of money. We are also eager to see what further proposals come from the White House.’’
“You cannot talk about health care for our aging population without including the long term care component,‘’ he said. “In too many states, like Texas, long term care means waiting until Medicaid can provide nursing home care. That is just not sufficient or sustainable and does not provide the type of respect and choice our seniors deserve.‘’
The Congressman has first hand knowledge of the benefits of assisted living. His late parents lived in an assisted living community in Texas before their deaths. He said he feels strongly that long term care must be in “the least restrictive environment with the maximum amount of choice’’, a goal consistent with the core principles of the assisted living industry. He views assisted living as “a growth industry’’ and said he wants assisted living providers engaged in the process of reforming the nation’s health care system because he views assisted living as a critical component of the continuum of care for seniors.
Late last year ALFA presented its Champion of Senior Living award to this longtime lawmaker in recognition of his leadership on issues of concern to seniors. He keeps the 2008 ALFA award next to his desk in his Washington office. Congressman Doggett is a member of the Budget Committee and the Health Subcommittee of the House Ways and Means Committee. Prior to his election to the House in 1994, he served as a Justice of the Texas Supreme Court and as a member of the Texas state Senate.
Last year he sponsored legislation to create a national voluntary Silver Alert network to help locate missing seniors and a bill to restore equity for prescription drug coverage for low income seniors who live in assisted living communities. He resubmitted those bills this year and is optimistic they will become law. He met with ALFA member Loren Shook, the CEO and President of Silverado Senior Living, on ALFA’s Advocacy Day in late March and graciously answered some questions posted by ALE.
What are your two top priorities for legislation affecting long term care in this session of Congress? How does the changed political climate affect the prospects of these initiatives becoming law?
My legislation offers one piece of the solution to health care reform, which is to alleviate co-payments for people who are sick and who cannot afford them. We should be lowering barriers to care, not erecting them. We cannot think about health care reform without thinking about long term care, and we have to be thinking about health care for everyone in the most integrated way possible. There is a strong appetite for reform right now and I am hopeful this will give us the flexibility to make some long-overdue changes that are good for the patient and good for the taxpayer.
With our population aging, the need for long term care will only increase in the future. What are the prospects of long term care being included in legislation which reforms our nation’s health care system? What would you like to see?
Anyone who has taken care of a sick or elderly parent appreciates the importance of long-term care. Like so many pieces of our health care system, long-term care coverage is fragmented, and access to quality long-term care is uneven. I can’t predict what will or will not be in legislation, but I am predicting that we will have legislation. No action cannot be an option this year.
ALFA is grateful for your sponsorship of legislation to create a national Silver Alert system to locate missing seniors. The bill has passed the House already. Will this bill get to President Obama’s desk this year?
I believe that it will. Indeed, but for the obstruction by one member of the Senate, it would have become law last year.
As you well know, the legislation which created prescription drug coverage as a benefit of Medicare eliminated co-payments for nursing home residents who receive Medicaid who by definition are impoverished. However, the very same person living at an assisted living is charged a co-pay. The bad economy has been particularly challenging for these poor seniors on fixed incomes. You sponsored legislation to correct this inequity. What are the prospects of reform of Part D and how likely is this fix being part of new legislation to reform the program?
We must provide relief to this vulnerable population when we take up Medicare legislation again this year, and I believe the best approach is to include a provision similar to that contained in the CHAMP Act, which the House approved in 2007.
The dramatic decline in the stock market has reduced retirement savings by 30 and 40 percent for many retirees and near retirees. Is there anything Congress can do to provide financial relief for these seniors to assure them a secure retirement?
To help ease financial strain on retirees in this lagging economy, Congress approved the Worker, Retiree, and Employer Recovery Act last December. It offers seniors who are required to take a required minimum distribution (RMD) from their retirement accounts, such as IRAs and 401(k)s. The provision allows seniors to maintain their savings and avoid a tax hit when the market is down.
The American Recovery and Reinvestment Act that passed this year provides a lump sum payment to seniors who are retired as well as to those who are working. While these are one-time payments, they will help pay a heating bill or buy groceries during this difficult economy.
A recent AARP study shows that seniors are reluctant to go into nursing homes and prefer Home and Community Based Care, which includes assisted living, by a wide margin. However, about 75 percent of all Medicaid long term care dollars go to nursing homes. Is the federal government concerned about this institutional bias and what do you think Congress can do to improve senior’s access to the care they choose and need?
One of the major challenges in health care reform will be to ensure we are spending health care dollars in the most efficient way possible, in a way that respects patient preferences and reflects best practices. CBO has estimated that we spend $700 billion a year on health care services that do not result in improved health outcomes. There is no easy answer – but it will require all groups, all industries, to be willing to change the status-quo.
About nine out of every 10 residents of an assisted living community use personal or family funds to pay the bills. With the decline of defined benefit retirement plans and a low national savings rate, the ability of many Americans to afford long term care in their old age is in doubt. Should the federal government take a more active role in encouraging retirement savings and planning for long term care? How should that be done and is it possible to make those changes at a time when the economy is so depressed?
The federal government absolutely has a role in protecting its most vulnerable citizens – we do this already through Medicare and Social Security, and we should continue evaluating other areas where the private sector is unable to meet their needs. The silver lining in this economic crisis is that it reveals our weaknesses and gives us the opportunity to strengthen our country. I’m sure the millions who lost a significant portion of their retirement are relieved they have Social Security to help them in this difficult time; imagine if we had allowed people to take all of their Social Security retirement savings and invest it into private accounts – where would we be now?
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