Findings

Congress finds the following: (1) The United States population is aging more rapidly than ever before, with 10,000 Americans turning 65 each day. In 2034, for the first time, the Nation will have more people over the age of 65 than under the age of 18. The population experiencing the fastest growth are persons 85 and older, which is projected to grow 198 percent by 2060. (2) The Department of Health and Human Services estimates that 70 percent of Americans over the age of 65 will require some form of long-term care in their lifetime. By 2050, the number of Americans requiring paid long-term care services will triple from 8,300,000 to 27,000,000. (3) According to 2020 Census data, more than 40 percent of baby boomers do not have any retirement savings, let alone savings for their long-term care needs. A recent report by the National Council on Aging found that up to 80 percent of older adults would be unable to afford 4 years in an assisted living community or more than 2 years of nursing home care. Put another way, 47,000,000 Americans aged 60 or above do not have the financial resources to cover the future care they may need. (4) Caring for America’s aging seniors will be the single most expense domestic priority and is projected to deplete Federal and State Medicaid budgets. The United States spent over $400,000,000,000 on long-term care in 2020, nearly 10 percent of all national health care spending. (5) According to the Congressional Research Service, State and Federal programs account for 71.4 percent of all long-term care spending nationwide in 2021. Medicaid and Medicare are, respectively, the first and second-largest public payers, accounting for a combined 64.1 percent of all spending. Medicaid is by far the largest single funding source for long-term care, spending approximately $135,800,000,000 in 2020, a figure that is projected to reach $466,000,000,000 by 2050. (6) A 2023 report by AARP, indicates that at least 9 percent of seniors in skilled nursing homes nationwide have low-acuity levels that do not warrant high skilled care, but are forced into a skilled nursing home where assets can be depleted, and Medicaid can become the primary payer. The report by AARP indicated that this number is 20 percent in 5 States. (7) In 2021, the Department of Veterans Affairs testified to Congress that if veterans in need of long-term care services could choose assisted living instead of a nursing home, $69,101 per veteran per year would be saved by the Department of Veterans Affairs. (8) Strengthening cost-effective models of long-term care services, providing incentives for Americans to better afford their care costs, and developing the workforce needed to care for the Nation’s aging population will reduce Federal and State Medicaid spending. (9) Congregate care models of long-term care services, such as assisted living, are half the cost of nursing homes, and less than a third of round the clock home health aides. (10) Assisted living provides 24/7 personal care, chronic disease management, nutrition, room and board, and socialization. If assisted living were not an option, as many as 61 percent of senior residents may be forced into far-costlier skilled nursing facilities at a cost of $43,400,000,000 per year. (11) The senior living industry lost approximately 400,000 jobs between 2020 and 2022, leaving the workforce far below prepandemic employment levels. In order to care for the United States aging population, the senior care industry will need to fill more than 20,200,000 jobs by 2040.