Res. No. 850
Resolution calling on the United States Congress to pass, and the President to sign, legislation that would expand Medicare to include long-term services and supports for seniors and individuals with disabilities
By Council Members Hudson, Schulman and Louis
Whereas, Medicare, established in 1965, is a federal health insurance program primarily serving individuals aged 65 and older, as well as certain younger people with disabilities, covering over 67 million Americans as of 2023; and
Whereas, Despite its broad coverage, Medicare does not include long-term services and supports (LTSS), including assistance with activities of daily living such as eating, bathing, and dressing and instrumental activities of daily living such as preparing meals, managing medication, and housekeeping, except under narrow circumstances, leaving a critical gap in care for seniors and people with disabilities; and
Whereas, LTSS is often covered by each state’s Medicaid program with varying income eligibility requirements and coverage, creating healthcare disparities and bureaucratic hurdles for millions of older Americans in receiving much-needed care; and
Whereas, According to the Kaiser Family Foundation (KFF), only about 6 million people receive Medicaid LTSS out of the 67 million Medicare enrollees; and
Whereas, According to the United States (U.S.) Department of Health and Human Services, about 70% of individuals aged 65 and older will require some form of LTSS in their lifetime yet only 44% of 6 million Medicaid LTSS enrollees are 65 or older, per KFF; and
Whereas, The average annual cost of a full-time home health aide in the U.S. was $64,200 in 2023, as reported by Genworth’s 2023 Cost of Care Survey, nearly double the annual income of half of Medicare beneficiaries, which KFF estimated to be below $36,000 in 2023; and
Whereas, Families often shoulder the financial and emotional burden of caregiving, with over 53 million Americans providing unpaid care to loved ones, resulting in lost wages, diminished savings, and increased stress, per the American Association of Retired Persons and National Alliance for Caregiver report entitled “Caregiving in the United States 2020”; and
Whereas, New York State (“NYS” or “State”) has been a leader in expanding long-term care for seniors and individuals with disabilities, boasting the third-largest number of dual Medicare and Medicaid enrollees in the nation, and spending $1,520.59 per state resident on long-term care-the second highest in the U.S., according to the Fiscal Policy Institute (FPI); and
Whereas, In the NYS Fiscal Year 2024 Budget Briefing Book, Governor Kathy Hochul described the growth in Medicaid LTSS spending as unsustainable, prompting the State to impose eligibility restrictions such as an asset look-back period and a higher functional threshold for individuals to qualify for home or community-based setting LTSS, to reduce LTSS expenditures; and
Whereas, Considering the aging population in New York City (NYC) is projected to grow over 1.4 million by 2040, per the NYC Department for the Aging, expanding Medicare to include LTSS would alleviate financial strain from the states, provide relief to families, support unpaid caregivers, and enable seniors and individuals with disabilities to age with dignity and independence in their own homes; now, therefore, be it
Resolved, That the Council of the City of New York calls on the United States Congress to pass, and the President to sign, legislation that would expand Medicare to include long-term services and supports for seniors and individuals with disabilities.
LS #18048
1/30/2025
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