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Where Trump and Biden Stand on Issues Important to Older Americans

With the presidential election only a few weeks away -- and early voting already underway in many states -- it is important for voters to know the candidates’ positions on issues like Medicare, Medicaid, and Social Security. 

Social Security
President Trump has issued an executive order deferring payroll (including Social Security) taxes until the end of the year as a form of economic relief, and he has said he will forgive repayment of the tax if he is reelected.  This could reduce the solvency of the Social Security Trust Fund if the funds are not reimbursed from another source.

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Former Vice President Biden has proposed increasing Social Security payments for low-income beneficiaries as well as increasing survivor’s benefits. To pay for this, he has proposed requiring workers earning $400,000 and above to pay increased payroll taxes. 

Medicaid
President Trump has argued in favor of repealing the Affordable Care Act (ACA), which expanded Medicaid to low-income adults in many states. His administration is currently supporting a lawsuit before the Supreme Court that will decide the law’s fate. He is also allowing states to fundamentally change their federal funding for Medicaid. Under the plan, states can ask for a waiver that would convert their Medicaid programs into a form of block grant and cap federal funding. States with block grant waivers could impose higher copays and cut benefits, such as denying coverage for prescription drugs, in order to contain costs. The coronavirus relief package, which the President signed into law, offers protections for Medicaid eligibility during the pandemic. 

Vice President Biden wants to retain and strengthen on the ACA, including Medicaid expansion. He also proposes increasing funding for home- and community-based services as an alternative to nursing home care and providing federal support for state Medicaid programs during the economic crisis brought on by the coronavirus pandemic. 

Medicare
President Trump supports repeal of the ACA, which has consequences for Medicare beneficiaries, including reduced services and possible increased costs. His FY2021 budget includes proposed cuts to Medicare spending. The President has also capped Medicare Part D insulin copays for some beneficiaries and expanded benefits that Medicare Advantage companies can offer their enrollees.  

Vice President Biden has proposed lowering the age of Medicare eligibility to 60. He also supports adding vision, hearing, and dental benefits to Medicare and lowering prescription drug costs by allowing the government to negotiate prices with drug companies. 

Long-Term Care
President Trump’s support for repeal of the ACA and federal caps on Medicaid spending could limit funding for long-term care. His FY2021 budget called for extensive cuts to Medicare and Medicaid, which primarily fund long-term care. He has also proposed loosening regulations on nursing homes, including infection control requirements.

In July, Vice President Biden unveiled a plan to lower the cost of caregiving.  The plan includes increased federal funding for Medicaid home- and community-based services along with tax credits for informal caregivers and increasing the wages of paid caregivers. He supports increasing the tax benefits for people who purchase long-term care insurance. Biden has also called for more oversight of nursing homes.  

 


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Medicaid 101
What Medicaid Covers

In addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.

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How to Qualify for Medicaid

To be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.

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Medicaid’s Protections for Spouses

Spouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.

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What Medicaid Covers

In addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.

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How to Qualify for Medicaid

To be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.

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Medicaid’s Protections for Spouses

Spouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.

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Medicaid Planning Strategies

Careful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.

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Estate Recovery: Can Medicaid Take My House After I’m Gone?

If steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.

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Help Qualifying and Paying for Medicaid, Or Avoiding Nursing Home Care

There are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.

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Are Adult Children Responsible for Their Parents’ Care?

Most states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.

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Applying for Medicaid

Applying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.

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Alternatives to Medicaid

Medicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.

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ElderLaw 101
Estate Planning

Distinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.

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Grandchildren

Learn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.

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Guardianship/Conservatorship

Understand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.

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Health Care Decisions

We need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.

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Estate Planning

Distinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.

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Grandchildren

Learn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.

READ MORE
Guardianship/Conservatorship

Understand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.

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Health Care Decisions

We need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.

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Long-Term Care Insurance

Understand the ins and outs of insurance to cover the high cost of nursing home care, including when to buy it, how much to buy, and which spouse should get the coverage.

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Medicare

Learn who qualifies for Medicare, what the program covers, all about Medicare Advantage, and how to supplement Medicare’s coverage.

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Retirement Planning

We explain the five phases of retirement planning, the difference between a 401(k) and an IRA, types of investments, asset diversification, the required minimum distribution rules, and more.

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Senior Living

Find out how to choose a nursing home or assisted living facility, when to fight a discharge, the rights of nursing home residents, all about reverse mortgages, and more.

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Social Security

Get a solid grounding in Social Security, including who is eligible, how to apply, spousal benefits, the taxation of benefits, how work affects payments, and SSDI and SSI.

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Special Needs Planning

Learn how a special needs trust can preserve assets for a person with disabilities without jeopardizing Medicaid and SSI, and how to plan for when caregivers are gone.

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Veterans Benefits

Explore benefits for older veterans, including the VA’s disability pension benefit, aid and attendance, and long-term care coverage for veterans and surviving spouses.

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