It takes more than a few words to explain what the Trump administration means to older Americans.
In fact, the Journal of Aging & Social Policy has dedicated an entire edition to address the issue. Its recently published special edition, “Aging Policy and Politics in the Trump Era,” looks at the White House and Republicans controlling both houses of Congress from eleven different perspectives on senior issues.
“The role of older Americans has been critical in both shaping and reacting to this political moment,” JASP editor-in chief and UMass Boston professor Edward A. Miller, along with four co-authors, write in the edition’s lead article (free access).
“Their political orientations and behaviors have shaped it through their electoral support for Republican candidates, but they also stand as highly invested stakeholders in the policy decisions made by the very officials they elected and as beneficiaries of the programs that Republicans have targeted,” they wrote.
The JASP special edition focuses on policy implications for long-term care and housing, health care, retirement security and aging politics. It explores ways the administration’s policies are likely to undermine the social safety net for near-elderly and older Americans. It also speculates on ways policy changes might shape politics and political behavior in the future.
Long-term care and housing
In one of the JASP special edition articles, Marc Cohen, co-director of the LeadingAge LTSS Center @UMass Boston, and Judith Feder of Georgetown University and the Urban Institute, examine factors behind the political stalemate over federal financing of the growing demand for long-term services and supports.
They propose a bipartisan approach that would rely on private insurance for up-front costs and depend on a public insurance program for catastrophic coverage.
In another article, Robyn Stone discusses the role housing plays in the growing population of low-income older adults. Stone, who is also co-director of the LeadingAge LTSS Center @UMass Boston, identifies the challenges involved with growing housing stock. She reviews various federal housing programs and ultimately finds them inadequate to meet the demand for assistance among older adults.
Medicare is the topic of a JASP article by Jonathan Oberlander, a professor of social medicine at the University of North Carolina at Chapel Hill. He addresses threats the program faces but notes that efforts to reform Medicare have had historically negative political consequences. Oberlander concludes by speculating whether targeting Medicare might backfire on Republicans by increasing public support for single-payer health insurance.
UMass Boston associate professor Pamela Nadash and colleagues describe the unfolding of the Trump administration’s unsuccessful efforts to repeal the Affordable Care Act and their potential impact on the near-elderly aged 50 to 64 years old. In the end, only the tax penalty attached to the ACA’s individual mandate was ultimately repealed. The authors note the repeal may have less impact on insurance rates than expected, but point out that resulting deficits could open the door to future cuts to entitlement programs such as Medicare and Medicaid.
David K. Jones, assistant professor at Boston University’s School of Public Health, and his colleagues focus on executive branch actions that undercut the ACA. They analyze executive orders, waivers allowing states to opt out of ACA requirements and the exercise of executive branch discretion. The authors conclude that increased disparities among states will result from these actions.
In the edition’s final essay on health care, professor Jacqueline L. Angel of the University of Texas and Nancy Berlinger, a Hastings Center research scholar, explore the consequences of Trump administration policies for Mexican-origin Hispanics. Mexican immigrants tend to rely heavily on social safety net systems, a pattern that continues into older adulthood. The authors conclude that Trump era policies will disadvantage this already-disadvantaged group even more.
David Madland, a senior fellow at the Center for American Progress, and Alex Rowell, an economic policy analyst at the center, examine the three major aspects of retirement financial security – Social Security, workplace plans and private savings – and find all under stress. But they conclude that retirement security does not seem to be a priority for the White House or Congress, and that significant policy change is unlikely in the near future.
UMass Boston research assistant Michele E. Tolson and Christian E. Weller, a UMass Boston professor and fellow at the Gerontology Institute, provide important data on how much riskier the environment has become over the past two decades for people hoping for a secure retirement.
In particular, they analyze the leading threats to the ability of older adults to save for retirement: Unemployment and caregiving. The authors find that as risk exposure increases, access to risk protection markedly decreases. They describe how administration actions have undermined rather than bolstered protections from economic risk.
Robert B. Hudson, a professor at Boston University’s School of Social Work, examines why so many older Trump supporters voted against their apparent interests in the 2016 presidential election. Hudson writes that the president’s campaign promises not to cut Social Security or Medicare have not reliably aligned with his actions, creating a chaotic approach to policy that provides broad latitude to the Republican party.
Professor Colleen M. Grogan and research assistant Sunggeun (Ethan) Park of the University of Chicago investigate whether receiving Medicaid benefits directly or being close to someone who does translates into political support for the program. They suggest it may be possible to build a wide coalition of support to protect Medicaid, but caution against the potential for infighting among beneficiary groups if the debate is framed as a zero-sum game.
Leena Sharma, a senior policy analyst at Community Catalyst’s Center for Consumer Engagement in Health Innovation, and colleagues discuss exactly how such a coalition could be built. They describe why the group’s capacity to effect change has been weak and identify untapped assets such as interest groups at the state and national levels, aging service providers and faith organizations. The authors map out strategies that could produce an influential political force.
The results of the 2018 Congressional mid-term elections are likely to influence the probability of cuts to Medicare, Medicaid and Social Security, Miller and his colleagues write in the JASP lead article.
“The response of older voters to efforts by the Trump administration and its Republican allies in Congress to draw back on the federal government’s commitment to the social safety net will shape the direction of aging policy and politics in the years to come,” they write.