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Congress ended 2022 by passing a bipartisan omnibus bill that will help Americans save for retirement and access mental health care.
Among the wins for older Americans are new Medicare coverage for mental health services, increased Older Americans Act funding, and extended access to Medicare telehealth coverage.
NCOA will continue to advocate for additional needed funding for Older Americans Act programs and Medicaid home- and community-based services, as well as Supplemental Security Income program improvements.
Congress ended 2022 by passing an omnibus bill with several key policy items important to older adults, including provisions that will help Americans save for retirement and access mental health care.
The bipartisan measure—formally known as the Consolidated Appropriations Act of 2023—includes most of the priorities identified by the Leadership Council of Aging Organizations (LCAO), which NCOA chairs. Below are some highlights.
The act extends Medicaid’s Money Follows the Person and spousal impoverishment protection programs until 2027, which will enable more older adults and people with disabilities to move out of institutions and back into the community and protect spouses from having to spend into poverty to gain coverage.
Unfortunately, Congress did not make these initiatives permanent as NCOA had requested, so our fight will continue. NCOA had advocated that the package include a major investment in Medicaid home care and direct care workers, which the House passed last year.
The act also provides five years of funding for Puerto Rico’s Medicaid program with a 76% federal match and a permanent enhanced federal Medicaid match of 83% for all other U.S. territories.
The law expands access to mental health services by addressing barriers to the mental health workforce, continuing to fund crisis support, and providing grants to outpatient community-based organizations providing necessary mental health service capacity.
It expands Medicare coverage for behavioral health services to include marriage and family therapists and licensed mental health counselors, which will help meet the growing demand for this type of care. The act also funds telephonic assistance and mobile crisis units via the National Suicide Prevention Lifeline Program and intensive outpatient mental health care.
The legislation provides two additional years of Medicare telehealth waiver flexibilities, and it guarantees access to telehealth even if a patient has not met an insurance plan’s deductible.
The law features several reforms to help Americans save for retirement, including many of the priority requests from LCAO that NCOA also supported:
Unfortunately, the act does not include NCOA-supported efforts to modernize and strengthen the Supplemental Security Income (SSI) program, for example, by raising decades old asset eligibility thresholds.
Although the law does not set an end date for the COVID-19 Public Health Emergency, it:
States can start Medicaid eligibility redeterminations as early as April 1, 2023 and have 14 months to complete them. The enhanced match to states will decrease on April 1 and phase out by Dec. 31, with strengthened beneficiary protections to mitigate improper disenrollments. Watch for additional information from NCOA on this provision.
Congress also made long-overdue investments in key aging programs (see a full list in our Aging Program Funding Table), including:
Despite this progress, we are disappointed that the act still fails to adequately fund Older Americans Act programs and other aging services to keep pace with inflation and the increased demand for services. It was appropriate that historic investments of pandemic relief were directed to aging services because older adults were disproportionately affected by COVID-19. But demand remains high for these interventions that empower older adults to live independently in their own homes and communities, and funding has not kept pace with the need.
We look forward to working with the new Congress in 2023 to ensure every American has the resources they need to age with health and financial security.
