A strong supporter of seniors and assisted living, U.S. Rep. Lloyd Doggett (D-TX) says long-term care must be part of any comprehensive overhaul of the nation’s health-care system. More importantly, he says assisted living providers must be part of that process.

“The momentum is there for health-care reform,” Doggett says. “Whether long-term care is included is a question of money. We are also eager to see what further proposals come from the White House. You cannot talk about health care for our aging population without including the long-term care component.” Congressman Doggett has first-hand knowledge of assisted living’s benefits; his late parents were residents at an assisted living community in Texas. He says he feels strongly that long-term care must be in “the least restrictive environment with the maximum amount of choice,” a goal consistent with the core principles of the Assisted Living Federation of America and leading assisted living companies.

“In too many states, like Texas, long-term care means waiting until Medicaid can provide nursing home care,” Doggett says. “That is just not sufficient or sustainable, and does not provide the type of respect and choice our seniors deserve.”

Congressman Doggett is a member of the Budget Committee and the Health Subcommittee of the House Ways and Means Committee. Prior to his election to the House in 1994, he served as a Justice of the Texas Supreme Court and as a member of the Texas Senate. Last year, he sponsored legislation to create a national voluntary Silver Alert network to help locate missing seniors and a bill to restore equity for prescription drug coverage for low-income seniors who live in assisted living communities. He resubmitted those bills this year and is optimistic they will become law.

The Assisted Living Federation of America recently presented Doggett with its Champion of Senior Living award in recognition of his leadership on senior issues. He displays the award in his Washington office, where Assisted Living Executive recently interviewed the long-time lawmaker on the issues facing seniors and providers of senior care and housing.

AL Exec: What is your top priority for legislation affecting long-term care in this session of Congress?

Doggett: With our population aging, the need for long-term care will only increase in the future. My legislation offers one piece of the solution to health-care reform, which is to alleviate co-payments for people who are sick and who cannot afford them. We should be lowering barriers to care, not erecting them.

AL Exec: What are the prospects of long-term care being included in legislation that reforms our nation’s health-care system?

Doggett: Anyone who has taken care of a sick or elderly parent appreciates the importance of long-term care. Like so many pieces of our health-care system, long-term care coverage is fragmented, and access to quality long-term care is uneven. I can’t predict what will or will not be in legislation, but I am predicting that we will have legislation. No action cannot be an option this year.

AL Exec: ALFA is grateful for your sponsorship of legislation to create a national Silver Alert system to locate missing seniors. The bill has passed the House already. Will this bill get to President Obama’s desk this year?

Doggett: I believe that it will. Indeed, but for the obstruction by one member of the Senate, it would have become law last year.

AL Exec: As you know, the legislation that created prescription drug coverage (Part D) as a Medicare benefit eliminated co-payments for low-income nursing home residents. However, comparable assisted living residents do not receive the same benefit, and the economic downturn has been particularly challenging for those seniors. You sponsored legislation to correct this inequity. What are the prospects of Part D reform?

Doggett: We must provide relief to this vulnerable population when we take up Medicare legislation again this year, and I believe the best approach is to include a provision similar to that contained in the CHAMP Act, which the House approved in 2007.

AL Exec: The dramatic decline in the stock market has reduced retirement savings by 30 to 40 percent for many retirees and those approaching retirement. Is there anything Congress can do to provide financial relief for these individuals?

Doggett: To help ease financial strain on retirees in this lagging economy, Congress approved the Worker, Retiree, and Employer Recovery Act in December. It offers an alternative for seniors who are required to take a required minimum distribution (RMD) from their retirement accounts, such as IRAs and 401(k)s. The provision allows seniors to maintain their savings and avoid a tax hit when the market is down.

The American Recovery and Reinvestment Act that passed this year provides a lump sum payment to seniors who are retired as well as to those who are working. While these are one-time payments, they will help pay a heating bill or buy groceries during this difficult economy.

AL Exec: About nine in 10 assisted living residents use personal or family funds to pay for their housing and care. With the decline of defined benefit retirement plans and a low national savings rate, the ability of many Americans to afford long-term care is in doubt. Should the federal government take a more active role in encouraging retirement savings and planning for long-term care?

Doggett: The federal government absolutely has a role in protecting its most vulnerable citizens. We do this already through Medicare and Social Security, and we should continue evaluating other areas where the private sector is unable to meet their needs. The silver lining in this economic crisis is that it reveals our weaknesses and gives us the opportunity to strengthen our country. I’m sure the millions who lost a significant portion of their retirement are relieved they have Social Security to help them in this difficult time; imagine if we had allowed people to take all of their Social Security retirement savings and invest it in private accounts. Where would we be now?

AL Exec: A recent study shows that seniors are reluctant to enter nursing homes and prefer home and community-based care, such as assisted living. However, about 75 percent of all Medicaid long-term care dollars go to nursing homes. Is the federal government concerned about this institutional bias, and what do you think Congress can do to improve seniors’ access to the care they choose and need?

Doggett: One of the major challenges in health-care reform will be to ensure we are spending health-care dollars in the most efficient way possible, in a way that respects individual preferences and reflects best practices. The Congressional Budget Office has estimated that we spend $700 billion a year on health-care services that do not result in improved health outcomes. There is no easy answer, but it will require all groups, all industries, to be willing to change the status quo.

Loren Shook, an officer on the Assisted Living Federation of America's Board of Directors and president, CEO, and chairman of Silverado Senior Living, meets with Congressman Lloyd Doggett on the latest issues affecting the senior care business.

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