Congress is set to pass an omnibus bill (H.R. 2617) that includes full-year appropriations for fiscal year 2023 and addresses numerous other policies and programs. Importantly, the bill includes extensions of two Medicaid policies that help people get support at home and investments in critical housing and homelessness programs. Here is a brief summary of some of the bill’s provisions impacting low-income older adults. | |
Medicaid - The bill extends the Medicaid Money Follows the Person program and protections from spousal impoverishment for people receiving home- and community-based services (HCBS) through September 30, 2027. These policies help make it possible for more people with disabilities to live at home instead of in nursing facilities as they age.
- Congress included provisions that will phase out Medicaid continuous coverage requirements that have been in place during the COVID-19 public health emergency. This means states can begin redetermining Medicaid eligibility and terminating coverage for people no longer eligible starting April 1, 2023. The enhanced federal matching rate to states will decrease on April 1 and phase out completely on December 31, 2023. To continue receiving the enhanced federal funding, states must abide by guardrails and procedures aimed to provide adequate notice to enrollees and minimize wrongful terminations. States must also submit monthly reports to the federal government with data on the redetermination process, including the number of renewals and terminations.
- The bill averts a Medicaid funding cliff for Puerto Rico by increasing both federal funding and the federal matching rate. It also permanently increases the federal Medicaid match rate in Guam, the U.S. Virgin Islands, the Commonwealth of the Northern Mariana Islands, and American Samoa.
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Housing Overall, the bill increases funding for Department of Housing and Urban Development (HUD) programs by more than $6 billion. - The bill very modestly increases funding for the Section 202 Housing for the Elderly and Section 811 Housing for Persons with Disabilities programs, which will support new development of affordable housing units and rental assistance opportunities to serve an estimated 2,910 additional households with older adults and people with disabilities.
- The bill also includes the largest ever one-year increase (over 13%) for homeless assistance programs. Funds will be available for new construction of permanent supportive housing, which is especially critical for older adults experiencing chronic homelessness.
- The bill expands rental assistance vouchers to an additional 12,000 households, but the expansion is still far less than the House’s proposal to extend vouchers to an additional 140,000 households.
- The bill doubles the funding (from $15 million to $30 million) of HUD’s Older Adults Home Modification Program, the goal of which is to help older adults age in place through low-cost, high-impact home modifications, and expands eligibility so that older adult renters, not just homeowners, can benefit from this program.
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Economic Security - The bill increases funding for the Social Security Administration (SSA) by $785 million, which is a little more than half of the $1.4 billion the President requested and well short of what SSA needs to ensure adequate service.
- Congress included the ABLE Age Adjustment Act, which will enable more individuals with disabilities to save money without losing eligibility for federal benefits by increasing the age eligibility for Achieving a Better Life Experience (ABLE) accounts from 26 to 46.
While these investments are important, Congress needs to take much bigger action to ensure older adults can meet their basic needs. The bill did not include long overdue updates to the Supplemental Security Income (SSI) program, such as increasing the asset limit. Congress also failed to pass additional funding for the ongoing COVID-19 response. Justice in Aging will continue to advocate for these and other priorities in the new year. | |
