As the heads of two of the country’s most prominent organizations working on behalf of older Americans from diverse communities, we celebrate President Biden’s signing of the Inflation Reduction Act recently passed by Congress. The new law will provide essential new benefits to elders by lowering drug costs under Medicare thanks to a new annual cap of $2,000 on prescriptions and empowering Medicare to negotiate prices for key drugs. The law will also extend lower insurance premiums under the Affordable Care Act. And it will lead to historic progress on climate change, which the American Society on Aging has identified as one of the key challenges facing our country’s older population.
We can’t overstate how important these steps are. According to the US Department of Health and Human Services, out-of-pocket healthcare costs increased 41 percent for those over 65 between 2009 and 2019. Older Americans spend twice as much of their income on healthcare than the general population, despite being covered by Medicare. As we know from our work, among those who will benefit the most from the new law are those most in need, including Black and brown elders and LGBTQ elders who suffer from higher levels of health problems and poverty.
At the same time, we must emphasize as strongly as we can that this law, as important as it is, is only a first step and much more needs to be done. Specifically, the President’s original Build Back Better Bill adopted by the U.S. House of Representatives included desperately needed support for our nation’s direct care workforce and funding targeted to programs designed specifically to address the unique needs of older adults from marginalized and neglected diverse communities. We cannot and will not forget about these essential initiatives – the steps that were not included in the Inflation Reduction Act but must be taken up and advanced by Congress and the President.
Care, health, and support services that do not meet diverse elders’ acute needs end up excluding older generations in our communities. For example, in our work, we see up close and in person the harsh consequences for Hispanic older adults when their higher levels of diabetes, Alzheimer’s, and other health conditions associated with aging are ignored by our government’s policies. Similarly, we see how LGBTQ+ elders struggle mightily to access essential services in the face of rampant discrimination and unwelcoming care providers. The results are often catastrophic, as we saw with Black and brown older people dying at two to three times the rate of the population in general during the COVID pandemic. Government has an important role to play in addressing these issues, and Congress and the Biden Administration must take up that role.
It is also important to remember that our communities’ elders will not have the support they need until the professionals who care for them are treated fairly and paid a decent wage. The workers in the care economy are the backbone of our country’s commitment to our elders – treating and paying them as though their work doesn’t have value is bad for care professionals and bad for older Americans, whose care suffers due to the inevitable revolving door of poorly paid care workers.
While some may see this as an ambitious agenda, we see effectively addressing these issues as essential and indispensable. They must be brought back to the table and acted upon by Congress and the administration. We know from painful experience that unless programs and policies take explicit account of diverse elders’ needs, they will leave our communities’ elders behind.
The Covid-19 epidemic, which killed a shockingly disproportionate number of diverse elders, showed clearly that we have a moral mandate to invest in care and services for those older Americans most in need. We must build on the progress achieved in the Inflation Reduction Act by addressing the profound inequities that stand between diverse elders and what they need to age with the support and dignity they deserve. The time to act is now. Elders from diverse communities – among the most marginalized and neglected of older Americans – can’t wait any longer.
Michael Adams, CEO of SAGE, the world’s largest advocacy organization for LGBTQ+ elders, and Dr. Yanira Cruz, CEO of the National Hispanic Council on Aging.