The policy challenges confronting LeadingAge members in a new Administration are daunting. It is truly a new day in Washington and we must re-frame our advocacy messages to reflect this new reality. We have listened to our members and state partners about their concerns and we are focusing on 3 primary issues:

  1. Preserving the financing and structure of Medicaid
  2. Funding more affordable housing
  3. Delaying implementation of Requirements of Participation for Nursing Homes

There are certainly other issues we are working on—such as the CNA training lock-out and protecting against cuts to non-defense discretionary spending. However, when the stakes are high, priority and focus are essential.


The threat to Medicaid is serious. The proposals under consideration include turning Medicaid into a block grant for states or providing states with a per capita cap on beneficiaries. While both proposals include more flexibility for states, they come with a price: deep cuts to federal funding, which would undoubtedly result in reduced benefits and provider payments and cuts in eligibility.

As we know from experience, once a program’s structure is changed to a block grant, there is no turning back. Medicaid affects the people you serve, the services you provide, and your workforce and their families. The impact of these proposals would be significant. And guaranteed coverage could be a thing of the past.

Affordable Senior Housing

There is simply not enough affordable housing today. Funding for programs we have used in the past has dried up and we are left with the Low Income Housing Tax Credit program (LIHTC), which is complex and requires rent subsidies to ensure that it remains affordable. This vehicle is insufficient and we need to do more.

We need to use every argument we can muster to bring attention to this issue, including the risk of a rapidly increasing senior homeless population and the need to invest in community infrastructures.

Nursing Home Requirements of Participation

As our members who manage nursing homes know, complying with the new Requirements of Participation (ROPs) is a huge undertaking. The ROPs are hundreds of pages long and lack the kind of clarity that is necessary to ensure an organization is in full compliance.

We are urging the Administration to delay implementation until CMS can provide sufficient guidance to allow nursing homes to comply. The time and effort to sort out what is expected is taking precious time away from resident care and services. This is unacceptable. While delay is a decision that is within the purview of CMS, we are encouraging members of Congress to put pressure on CMS as well.

On each of these 3 priority issues, we have asked members to write or call their members of Congress, visit district offices, and take advantage of the President’s Day recess to invite policymakers to their communities.

I am thrilled that our combined advocacy efforts in the past 2 months on these priority issues has resulted in more than 10,000 calls and letters.

I attended a breakfast meeting recently with a member of the United States Senate. She acknowledged the groundswell from citizens who are reaching out to policymakers, telling their personal stories, and describing the impact of proposed policies on people, programs, and communities. And, it’s not just one story that gets their attention; it’s the collective impact of hearing thousands of them.

We will continue to ask for your support because we need to be as loud as possible on Capitol Hill and in state capitals across the country. Look for more Action Alerts as we continue to raise our voices on these issues.

So much of what we believe in and have come to depend on is at risk. Those who are ultimately harmed are those we serve, those who serve them and those who we will serve in the years to come. Thank you for being our echo. We will be yours.