2021 NAELA Public Policy Priorities
I. Supporting People with Disabilities and Older Adults During the COVID-19
To date, nearly 40 percent of all COVID-19 deaths have occurred in long-term care facilities. Moreover, individuals over 85 are 630 times more likely to die from the disease than someone between the ages of 18 to 29. While the world is on the cusp of several vaccines, the epidemic will likely continue through much of 2021. For 2021, NAELA will continue to advocate on policy areas that have arisen during COVID-19, including emergency funding for Home and Community Based Services (HCBS), the rights and safety of nursing home residents and people in other congregate settings, and the different emergency Medicaid waivers (1115, 1135, 1915(c) Appendix K).
II. Addressing the Effects of Medicaid’s Institutional Bias
Far too many individuals with disabilities and older adults end up in institutional settings when they could otherwise receive HCBS services. The primary cause is that federal law guarantees institutional care and makes HCBS optional under Medicaid. As a result, individuals often fail to qualify for HCBS; find that no or inadequate HCBS exists in their area if they do qualify; or the process to get HCBS takes too long to prevent unnecessary institutionalization. NAELA will continue to work with its coalition partners to advocate for the continued implementation of key policy changes to address the effects of Medicaid’s institutional bias, such as Money Follows the Person and the requirement that states apply spousal impoverishment protections to Medicaid HCBS waivers.
III. Monitoring Tax Policy for Impacts on People with Disabilities and Older Adults
Tax policy is ever evolving, such as with the 2019 passage of the SECURE Act and the 2017 Tax Cuts and Jobs Act (TCJA). Few organizations understand how the tax code impacts people with chronic illness and disabilities outside of NAELA. The TCJA individual tax provisions expire in 2025, and Democrats are eager to reverse policies such as limits to the state and local tax deduction. Additionally, discussions over retirement tax policy changes and other items, such as to ABLE accounts will continue through this Congress.