Flag flies next to upper part of Capitol Building

Senate Democrats announced a $3.5 trillion budget agreement on Tuesday, and although details are limited on how the package specifically might affect aging services providers, senior living leaders remain hopeful.

The Senate Budget Committee announced an agreement on a reconciliation bill that would expand Medicare benefits — including funding dental, vision and hearing coverage for older adults — boost federal safety net programs and combat climate change over the next 10 years, according to The Washington Post

Democrats used the reconciliation process — which requires a simple majority — earlier this year to adopt a $1.9 trillion American Rescue Plan stimulus bill. The goal now is to push a broad budget resolution through the Legislature before the August recess, with details coming later. No details on how the measure would be funded were released, although it is expected to include tax increases on business and wealthy individuals. 

A bipartisan group of senators is continuing work on an almost $1 trillion measure on traditional infrastructure, including roads, bridges and water systems. 

Marsha Greenfield, LeadingAge vice president of health legislation, said during a membership call on Wednesday that the key question is how aging services will be part of the infrastructure legislation. Although bill language has not been released, hints exist about the content, including the likelihood that the $400 billion expansion package in the Better Care, Better Jobs Act may be included. Greenfield said an expectation also exists that additional low-income housing and rental assistance will be included.

Linda Couch, LeadingAge vice president of housing policy, said during the membership call that it is unclear from summary documents whether affordable senior housing is included in the measure. Couch said a “once-in-a-lifetime” investment in expansion of the affordable senior housing supply is on the line and urged members to contact legislators to make aging services priorities known.

A LeadingAge spokesperson said the organization is hopeful that the budget packages reflect the needs of older adults and aging services providers and said that the association will “continue to pound the virtual pavement” as committees prepare to act on the reconciliation bill.

“COVID shone a bright light on historic resource inadequacies and inequities for older adults and the providers who serve them,” the LeadingAge spokesperson told McKnight’s Senior Living. “LeadingAge priorities for the infrastructure package, including the $400 billion for home- and community-based services, a large expansion of affordable housing through Housing and Urban Development’s Section 202 Supportive Housing for the Elderly program, and improving Medicare for older persons by adding dental, vision and hearing benefits, should be well-positioned for inclusion in the $3.5 trillion agreement.”

American Seniors Housing President David Schless told McKnight’s Senior Living “there is much to like about the budget plan for older adults.” Those on waiting lists for HCBS, he added, will benefit from the significant infusion of resources to expand the program and to increase wages and benefits for caregivers,” as well as investments in broadband to ensure telehealth capabilities.

“However, the price tag and politics remain sticking points in this two-package approach to the finish line,” Schless said. “The bipartisan plan calls for repurposing unused COVID-19 relief funds to pay for the new spending. ASHA is forcefully advocating that the Provider Relief Funds remain off limits.”

Schless said the budget proposal calls for increases to the corporate tax rate as well as some other rollbacks of the Trump-era Tax Cuts and Jobs Act of 2017 and increased taxes or the repeal of real estate investment tax treatments. 

Overall, he said, ASHA has stressed to congressional leadership that any HCBS expansion maintain assisted living as an eligible setting for those who choose to participate in that program, and that Congress also should consider the long-term care funding needs of baby boomers above the Medicaid threshold with limited resources. ASHA also is encouraging leaders to include immigration reform in its proposals to help address the significant industry workforce shortage, Schless said.

The American Health Care Association / National Center for Assisted Living called the agreement a “bold plan to invest in America’s future” and encouraged Congress to prioritize older adults and caregivers in the legislation.

“We must strengthen every aspect of the long-term care continuum, attract qualified and dedicated caregivers, and address Medicaid shortfalls so we can improve care and protect access for our nation’s most vulnerable,” AHCA/NCAL Senior Vice President of Government Relations Clif Porter told McKnight’s Senior Living.

Maggie Elehwany, Argentum senior vice president of public affairs, told McKnight’s Senior Living that investment in aging services is critical to ensuring that older Americans continue to have choices for necessary care and services.

“It’s essential that it addresses the significant challenges senior living communities continue to face from COVID-19-related losses and due to mounting workforce shortages,” Elehwany said.

Argentum President and CEO James Balda pointed out he is still awaiting word from the administration on the fourth phase of the Provider Relief Fund, which is needed to support providers dealing with extensive costs and losses due to COVID-19.

“Without this funding, we’ll certainly continue to see more closures throughout the industry,” Balda told McKnight’s Senior Living.