En español | The Older Americans Act (OAA) was born in 1965 alongside its more famous siblings, Medicare and Medicaid, as part of a historic effort by lawmakers to take care of those over 65.
The OAA has been a safety net, filling in the gaps left by Social Security and Medicare to help people live independent lives. Its seven primary sections provide for services like home-delivered meals, support for family caregivers, transportation to medical appointments, protection from elder abuse, and job training. This year the OAA gets a turn in the spotlight as Congress does a periodic reauthorization. This is a chance for lawmakers to refine programs for older Americans and to set funding goals.
How does the OAA affect us?
OAA's Wide Reach
- 1.3 million people served by the OAA in 2016
- 145 million meals delivered to homes by programs like Meals on Wheels, and paid for by the OAA
- 24 million rides provided to places like doctors’ offices
- 40 million hours funded to pay personal-care aides
- 10.6 million hours of adult day care subsidized
- Helping those in need About 11 million Americans receive direct assistance from programs provided under the act, from Meals on Wheels to transportation to doctors’ offices. “The spectrum of services provided through the OAA — in conjunction with Medicare, Medicaid and Social Security — ensures that our nation’s older Americans are not left behind in their golden years,” says Rep. Bobby Scott (D-Va.), chairman of the House Education and Labor Committee. The legislation also pays for personal-care assistance and adult day care. “This law helps your family, friends and loved ones,” says Megan O’Reilly, AARP vice president of federal health and family. “If you don’t know someone today, you could know someone tomorrow who will benefit from this law.”
- Fighting elder abuse The act provides guidance and limited funding to protect vulnerable older people from abuse or neglect in nursing facilities and beyond.
- Helping people stay in their homes Approximately 90 percent of older people want to stay in their communities, rather than move to institutionalized care. “The fear of having to enter a nursing home, with its associated loss of independence and threat of impoverishment, weighs heavily on the minds of many older persons and their caregivers,” former AARP Senior Vice President Joyce A. Rogers said in a letter to lawmakers. OAA funding for programs to support independent living “is a drop in the bucket compared with the national budget,” says Dan Adcock of the National Committee to Preserve Social Security and Medicare. Along with services, the act funds research and programs that promote independence.
- Supporting caregivers The act provides grants to states to cover services such as counseling and training.
- Providing jobs for the needy The OAA promotes part-time work opportunities for low-income adults in places like hospitals, schools and senior centers.
- Focusing on an older population The law sets goals for retirement income, employment opportunity, access to health care, and long-term care services.
- Taking the side of Americans over 60 The OAA sets up federal and local agencies to advocate for older citizens.
AARP Public Policy Institute, 2019
What’s going to change?
Supporters say more money is needed to keep pace with the ballooning 60-plus population. Funding for the act has gone up just 1.1 percent annually, on average, since 2001, to $2.06 billion this year. “The changing demographics of our country are such that we have to devote more resources, become more innovative and pay more attention to issues that affect older Americans,” says Sen. Susan Collins (R-Maine), chairwoman of the Senate Special Committee on Aging.
Here are some ideas being considered.
- Tackling malnourishment Food programs help save money on medical costs. The OAA could do more screening for malnutrition and strengthen programs for meals brought to homes or served in places like senior centers, where communal meals can combat isolation. “We can help seniors achieve better health outcomes if we can bring them together,” Collins says.
- Assisting caregivers More than 40 million Americans provide unpaid help to loved ones. “There is so little respite care available to give a break to that caregiver,” Collins says. “We really need to look at that.”
- Combating Alzheimer’s disease The number of Americans with the disease is expected to nearly triple to 14 million by 2050. Collins is hoping for more resources.
- More mobility assistance Collins says she’d like to see pilot programs on improving transportation for older Americans.
The last OAA reauthorization took Congress five years. This time, despite the rancorous mood in Washington and a divided government, supporters hope it can pass before the current authority runs out, on Sept. 30. (Even if the authority runs out, Congress can keep paying for the programs.)
“This program is motherhood and apple pie; it usually enjoys wide bipartisan support,” Adcock says.
Still, just to get OAA funding back to 2010 levels would require a 30 percent increase. Meanwhile, 10,000 people a day turn 65. “Because of those two curves going in opposite directions, area agencies on aging have waiting lists,” Adcock says. If the funding doesn’t grow, the waiting lists will, he adds.