Boston’s Older Population: Increasing in Racial Diversity, but Quality of Life is Shaped by Racism, Discrimination

A new report from UMass Boston identifies aging equity among Boston residents

The number of Boston residents aged 60 and older has increased by more than one-third in the last eight years and more than half of older residents are persons of color. However the experiences of these older residents differ substantially depending on race, ethnicity and gender, and challenges their abilities to thrive.

A new report, “Aging Strong for All: Examining Aging Equity in the City of Boston,” by researchers at the University of Massachusetts Boston, documents disparities across three dimensions that impact quality of life — economic security, health, social engagement — and identifies opportunities for stakeholders to ensure an environment in which “aging strong” is possible for all Boston residents. Jan Mutchler

“It has never been more critical to strategically pursue greater equity in the aging experience of Boston residents,” says Jan Mutchler, PhD, director of the Center for Social and Demographic Research on Aging at UMass Boston, a professor in the Department of Gerontology and one of the study’s authors. “The numbers of older adults are increasing and stakeholders share a growing recognition of the powerful ways in which inequity, racism, and discrimination shape health outcomes and the aging experience, amplifying the need to examine and remediate disparities in aging.”

The report identifies substantial disparities across racial and ethnic groups, such as:

Economic security

  • Poverty rates are especially high among Asian Americans and Latinos, and more than one-third of these residents age 60 or older live in households with incomes below the federal poverty line.
  • Sizable gaps differentiate racial groups. For example, while a similar share of non-Hispanic White, Black and Native American people aged 66 or older receive Social Security benefits, percentages receiving Social Security are considerably lower for Latinos and Asian Americans.
  • Housing costs in Boston place a heavy burden on older residents and half or more of renters age 60 or older pay more than 30% of their incomes for housing. Fewer homeowners bear such a heavy cost burden for housing, but older Black, Latino and Native American homeowners are at amplified risk for being cost-burdened.

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Elder Index at Work: Helping Advocates Address Healthcare Affordability in Washington State

multigeneration portraitThis article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

By Taryn Hojlo

Medicare is an important resource for millions of older Americans, but that benefit isn’t free and it certainly doesn’t eliminate all other healthcare expenses elders face.

In Washington State, more than a million people were enrolled for Medicare benefits in 2018 and that number has been climbing, as it has across the country as the United States continues to grow older. Some of those people have found Medicare a particular economic challenge.

Northwest Health Law Advocates, a non-profit organization based in Seattle, is focused on older Washington residents who saw some existing healthcare-related benefits eliminated once they enrolled in Medicare. Recently, it has been using the University of Massachusetts Boston’s Elder Index to supplement research and advocacy work around the issue.

“We call it the Medicare cliff,” said Ann Vining, a staff attorney at the organization that has been advocating for affordable, quality health care for all Washington residents since 1999. “If you’re in some relatively lower income brackets, you have some access to some subsidies that you lose when you go onto Medicare.” Continue reading

Institute Talk: A Conversation with Daughterhood Founder Anne Tumlinson on Challenges of Caring for Aging Parents

Anne Tumlinson is the nationally recognized eldercare expert who founded Daughterhood, an online community providing support and advice to adult children caring for their aging parents. She is also the founder of Anne Tumlinson Innovations, a research and advisory firm focused on transforming the way care is delivered and financed.

With more than 25 years of research and consulting experience, Tumlinson has often testified in Washington and written on innovation in aging services. Previously, she led Medicaid program oversight at the federal Office of Management and Budget.

Recently she talked with Gerontology Institute Director Len Fishman about the evolution of Daughterhood, practical problems facing caregivers and policy issues that affect innovation in the field. The following is an edited version of their conversation. Continue reading

How to Measure Real Potential Cost of New Health Care Legislation for Elders

By Marc Cohen and Kris Wiitala

Both the House-passed version of ACA repeal legislation, the American Health Care Act (AHCA), and the Senate’s version currently under deliberation – the Better Care Reconciliation Act (BCRA) – include a particularly debilitating change: a per capita cap system of funding for Medicaid. This change would dramatically cut federal Medicaid funding to states. It would force states to make difficult decisions between benefit cuts, provider payment cuts and changes to eligibility requirements – or all of these in varying measure – in order to balance their budgets. Analyses have pointed out how a per capita cap system would lead to significant underfunding of long-term services and supports (LTSS), penalize adults and children with disabilities, lead to significant shortfalls in state funding and cause financial challenges for providers. Continue reading

Assessing Potential Impact of Medicaid Caps on States, Care Workers

The American Health Care Act under consideration in the U.S. Senate would create varying degrees of economic stress on individual states and could lead to the elimination of as many as 713,000 jobs held by home health and personal care aides, according to new research prepared by UMass Boston Gerontology Professor Marc Cohen.

The legislation, which has been passed by the House, would place limits on spending for Medicaid in the future. The report by Cohen, who is co-director of the LeadingAge LTSS Center @ UMass Boston, identifies which states could be more vulnerable to those cuts. Continue reading

Rhode Island: The Test Case That Never Was for Medicaid Restructuring

By Edward Alan Miller
Professor of Gerontology and Public Policy
McCormack Graduate School

Although ultimately withdrawn before a vote, the American Health Care Act (AHCA) proposed by House Republicans would have radically restructured Medicaid by converting the federal government’s open-ended commitment to match state government spending with a per-capita cap on the amount of money a state could receive for each enrollee. An alternative to per-capita caps, Medicaid block grants, is also favored by some Republicans but was not included in this particular proposal. Block grants would replace the federal government’s open-ended financial commitment with a fixed up-front annual allotment for the entire covered population.

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How Medicaid Per Capita Caps Will Affect those Needing Long-Term Services and Supports

By Marc A. Cohen, Ph.D., Michael Miller, MA, Leena Sharma, MPP

Earlier this week, the Republicans in the House of Representatives put forward their plan – the American Health Care Act (AHCA) — for the repeal and replacement of sections of the Affordable Care Act (ACA).  In addition to repealing the health-related tax and subsidy provisions in the ACA, replacing them with refundable tax credits, the plan also changes the Medicaid program from a federal-state partnership to a per capita cap program.  More specifically, Section 121 of the Act would use each State’s spending in FY2016 as a base year to set targeted spending for each enrollee category in FY2019 (and subsequent years) for that state.  Each state’s targeted spending amount would increase by the percentage increase in the medical care component of the consumer price index for all urban consumers from September 2019 to September of the next fiscal year.  The enrollee categories for which separate caps would be established include the: (1) elderly, (2) blind and disabled, (3) children, (3) non-expansion adults, and (4) expansion adults. Continue reading