A new paper in Health Affairs projects that many middle-income older adults will not be able to afford housing and health care a decade from now. The researchers focus on the plight of middle-income older Americans over the age of 75, who represent 40 percent of the population of people over 75.
By the researchers’ estimate, in ten years time, more than half of middle-income older adults between the ages of 75 and 84 will not have the means to move into an assisted living facility or other supportive housing when they need to. Overall, middle-income older people have annual incomes between $25,001 and $74,298. They are generally too well off to qualify for Medicaid and yet not wealthy enough to afford the costs of supportive housing. In 2029, half of them, nearly 5.5 million, will have $60,000 or less to spend each year, including their home equity. But, the average annual cost of housing and medical care is estimated to be $62,000.
The number of middle-income older adults between the ages of 75 and 84 is projected to grow substantially by 2029, from 5.57 million in 2014 to 10.81 million in 2029. Overall, the population of middle-income adults over 75 will grow from 7.9 million in 2014 to 14.4 million by 2029. They will represent 43 percent of the total population of adults over 75.
Medicare does not cover supportive housing or long-term services and supports. Medicaid generally covers these services for people with low incomes. Only a small fraction of middle-income earners (about 700,000) spend down their income and assets to qualify for Medicaid.
As the number of adults over 75 increases and their retirement income diminishes, there will be a greater need to help these middle-income older adults. Today, about 14 percent of them (1.11 million) live in supportive housing or a nursing home. Of those who live at home (1.68 million), about 25 percent of them need caregiving help. Yet, there will be fewer family caregivers. How will they get needed housing and care?
Medicare for All would fund long-term services and supports, as well as vision, hearing and dental services, while adding little to overall national health care spending. It would also give people the freedom to see the doctors they want to see and eliminate premiums, deductibles and coinsurance, guaranteeing health care for all.
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