From DC is Justice in Getting old’s weekly roundup of nationwide information and sources about points impacting older adults. To obtain From DC in your inbox as quickly as its printed, join our mailing checklist.
Right here’s what we’re watching in Washington:
Federal Authorities Shutdown Continues
The federal authorities stays shut down after Congress was unable to barter an extension of federal funding, which expired on the finish of September. Key points embrace the extension of Reasonably priced Care Act (ACA) enhanced premium tax credit (EPTCs) which are set to run out on the finish of the yr and reversing Medicaid cuts included in H.R. 1, the reconciliation invoice handed in July. If EPTCs expire, people enrolled within the Market might see premium will increase of over 500%, and older adults ages 50-64 shall be disproportionately affected.
Because of the shutdown, non-essential authorities providers are paused. The impacts range throughout companies as outlined of their contingency plans. Importantly, public packages which are mandatorily funded, together with Social Safety, Supplemental Safety Earnings (SSI), Medicare, and Medicaid are anticipated to proceed. Moreover, most tenants receiving federal rental help ought to proceed to obtain their rental subsidies by way of November.
Nonetheless, older adults might expertise disruptions in how they obtain providers from these packages, particularly if the shutdown persists. For instance, the Social Safety Administration is pausing sure providers, akin to processing overpayments and issuing substitute Medicare playing cards. Some well being care insurance policies additionally expired, together with telehealth visits for almost all of Medicare enrollees and the Acute Hospital Care at Dwelling Initiative.
Justice in Getting old will proceed to replace our community concerning the shutdown’s potential impacts on older adults.
Threats to Everlasting Supportive Housing for Folks Experiencing Homelessness
Current reporting from Politico revealed the Division of Housing and City Improvement (HUD)’s plan to defund everlasting supportive housing (PSH) packages. PSH supplies long-term rental help with supportive providers for individuals experiencing continual homelessness. Older adults age 55 and over comprise 40% of PSH residents, who embrace individuals with disabilities and sophisticated well being situations.
Presently, HUD’s Continuum of Care (CoC) homeless help program prioritizes funding PSH, with 87% of funds supporting PSH packages. Nonetheless, HUD intends to cap funding for PSH to 30% of CoC funds to shift extra funding to non permanent types of help, akin to transitional housing. These drastic cuts would put roughly 170,000 individuals in PSH susceptible to dropping their housing and providers.
Be taught extra about PSH and HUD homeless help on this Justice in Getting old primer. Advocates also needs to urge Congress to incorporate a provision in upcoming spending payments that shield PSH funding for subsequent yr.
New Report on Potential Dangerous Modifications to SSDI and SSI
The Social Safety Administration will probably launch a proposed rule this fall that would change how age and training are thought of in figuring out incapacity within the Social Safety Incapacity Insurance coverage (SSDI) and Supplemental Safety Earnings (SSI) packages.
A new City Institute report analyzes the dangerous results of those potential regulatory modifications to SSDI and SSI, notably for older adults. In line with the report, modifications to the therapy of age and training might scale back eligibility for brand spanking new candidates to the SSDI program by 20% total and as much as 30% for individuals over age 50.
Only a 10% discount in eligibility would lead to roughly 500,000 individuals dropping advantages, together with 80,000 widows and youngsters. Older adults who’re denied and resort to early retirement for revenue would see a lifetime profit that’s 30% decrease than what they’d have acquired had they certified for SSDI.
Justice in Getting old will proceed to observe this concern and replace our community concerning the future proposed rule.
New Demonstration to Waive Medicare’s 3-Day Hospital Keep Rule for Expert Nursing Facility Protection
To be eligible for Medicare lined expert nursing facility providers (SNF), Medicare enrollees will need to have a 3-day qualifying keep as an in-patient in a hospital, which is usually a barrier to entry medically mandatory SNF providers.
The Facilities for Medicare and Medicaid Companies (CMS) is launching a brand new Remodeling Episode Accountability Mannequin (TEAM) to permit waiver of the 3-day keep beginning January 1, 2026 by way of December 31, 2030. TEAM will enable collaborating acute care hospitals to discharge eligible sufferers with out the 3-day hospital keep to a certified SNF.
Per CMS steering, to be eligible, sufferers have to be enrolled in Unique Medicare Elements A and B and have an in-patient hospital keep or outpatient hospital process for one in all 5 surgical procedures (decrease extremity joint substitute, surgical hip femur fracture therapy, spinal fusion, coronary artery bypass graft, and main bowel process).
Justice in Getting old helps efforts to eradicate these limitations to the Medicare SNF profit, together with the Enhancing Entry to Medicare Protection Act of 2025 (H.R. 3954), which might rely remark standing days towards the 3-day keep requirement.
We additionally co-counseled a profitable class motion lawsuit led by the Middle for Medicare Advocacy to safe attraction rights for sure Medicare enrollees who’re barred from SNF providers as a result of the hospital modifications their standing from “inpatient” to “outpatient.” See our flowcharts for extra concerning the expedited appeals course of that took impact February 14, 2025, and the time-limited retrospective appeals course of for people who skilled a change in standing on or after January 2009.
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