On Friday, November 5, 2021, the U.S. House of Representatives passed a historic bill that makes key investments in improving physical infrastructure in this country. As aging advocates we all now have a responsibility to ensure these investments are inclusive of older adults—namely, that we have safer drinking water, access to broadband, and transportation options to age in place.
While this legislation will go a long way to creating new jobs and fix our crumbling physical infrastructure, it alone won’t fix our deteriorating aging infrastructure. That is why Congress must pass the Build Back Better Act.
Not since the 1965 passage of the Older Americans Act have we seen a legislative effort that would finally invest in comprehensive policy solutions to bolster our investment in America’s infrastructure for its aging society, and better prepare us for 2040, when about one in five Americans will be ages 65 or older.
If passed, the Build Back Better Act would increase health equity, fight climate change, tackle the digital divide and combat ageism. And if properly funded, these actions will go far in addressing the long-standing social and economic needs that older adults face. Below we offer a high-level summary of this landmark legislation as it relates to aging and ASA Member priorities. You have the opportunity to let Congress know how critical it is for your work that it pass the Build Back Better Act.
Increases Health Equity:
- Makes historic investments in hearing coverage for older adults under Medicare by adding new comprehensive hearing benefits to Medicare Part B, including coverage of hearing aids for individuals with moderately severe, severe or profound hearing loss.
- Invests $150 billion to expand access to quality home-based services and care for millions of older adults and people with disabilities.
- Strengthens the direct care workforce by improving provider payment rates and giving states the resources to improve their care infrastructure.
- Invests in public health infrastructure and workforce by funding more than $9.5 billion in investments to support the construction and modernization of community health centers and the purchase or renovation of mobile clinics.
The Build Back Better Act increases health equity by lowering the cost of prescription drugs for older adults.
- Lowers the cost of prescription drugs for workers and families with a new, out-of-pocket cap of $2,000 on prescription drug costs in Medicare.
- Funds strategies to recruit and retain direct care workers, including raising wages and creating training opportunities to help address the direct care workforce shortage, permanently authorize the first-ever, universal, comprehensive paid leave benefit for all U.S. workers.
- Invests in nursing home staffing to improve quality and safety issues in nursing homes.
- Improves nursing home quality and cost data to ensure patients and families have access to accurate quality data.
- Invests in the nursing home survey and enforcement process to improve patient safety.
Fights Climate Change
- Invests $29 billion in nonprofit, state and local climate finance institutions that support the rapid deployment of low- and zero-emission technologies, including zero-emission vehicle supply equipment. At least 40 percent of investments will be made in low-income and disadvantaged communities.
- Invests $12.5 billion in home energy efficiency and appliance electrification rebates.
- Invests $3 billion in community-led projects that address environmental and public health harms related to pollution and climate change. This grant program provides direct funding to the communities most impacted by climate change and environmental injustice, funding local projects and solutions to decrease pollution and increase climate readiness.
- Invests more than $15 billion—carried out via AmeriCorps—to create climate-focused public service opportunities.
- Provides $2 billion for energy efficient and climate resilient upgrades to federally assisted housing.
Bridges the Digital Divide
- Invests $280 million in the National Telecommunications and Information Administration (NTIA) for a pilot program that will provide grants to public-private partnerships for projects that increase access to affordable broadband service in urban communities, including communities of color and to low- and middle- income consumers.
The Build Back Better Act invests in community-led projects that address environmental and public health harms elders face due to climate change.
- Invests $475 million in NTIA to provide grants for affordable connected device programs.
- Invests $100 million in the FCC to provide information and outreach to the public about the broadband and communications affordability programs administered by the FCC, such as the Emergency Broadband Benefit and Lifeline, to help connect Americans pay for phone and internet service.
- Invests $500 million in the FTC to create and operate a new bureau, including the hiring of technologists and other experts, which is dedicated to stopping unfair and deceptive practices related to privacy violations, data security incidents, identity theft and other data abuses.
Tackles Age-related Discrimination and Abuse
- Makes key investments to fund vital elder justice programs that help protect America’s older adults and people living with disabilities by funding existing Elder Justice Act programs.
- Provides increased support for state and local Adult Protective Services offices and long-term care ombudsman programs to better detect and prevent elder abuse, neglect and exploitation.
- Creates and invests in three new programs that address: social isolation; training and retention of the long-term care workforce; and, linkages between social support services, health services and legal services to more effectively address social determinants of heath in vulnerable communities.
- Tackles ageism through the Protect Older Job Applicants Act of 2021, which is not part of the Build Back Better Act, but passed the House on Nov. 4, 2021. The bill prohibits employers from limiting, segregating or classifying job applicants based upon an applicant's age. Should the House pass the Build Back Better Act, the Senate should consider adding in this bill, too.
ASA encourages Congress to pass this important bill.
Peter Kaldes is President and CEO of ASA.