Is the Government Helping You?

April 27, 2021

Isn’t it interesting when you hear an older person strongly say, “I think the government needs to mind their own business and leave us alone. We don’t need them.”  My inside voice says, “Wait a minute.  Looking at you, I would bet you are receiving some type of government assistance. It’s the government that put these programs in place to help us.”

As older adults over 65, almost all of us (with the exception of retired federal employees*) receive and depend on programs that we have either paid into or receive due to our age.  I think younger adults are unaware of the history of how these programs came into place and why.  It’s only when a working individual begins to consider retirement that the issue becomes important.

*Public employees receive specific benefits that take the place of or exceed the public benefits discussed here.

When I speak with an individual about help for their older family member, the question of health insurance coverage is pertinent.  However, asking if the person has Medicare often will give me the response of “I think so.”  Medicaid, or Medi-Cal as it’s called in California, is often mixed up with Medicare.  Perhaps it would be helpful to understand these government benefits, how to qualify, what they cost and how it affects us overall.

Medicare – health insurance for adults 65 and older.

There are exceptions to the age requirement due to an early-age disability or health condition.  Depending on our income, Medicare may not cost us anything, or a monthly premium may be deducted from our Social Security earnings to assist with the costs. This health insurance is available to anyone living legally in the United States.  President Lyndon Johnson signed this legislation into law on July 30, 1965. Changes have been made over the years to benefit us, the beneficiaries, including adding Part D – Prescription Drug Plan.  Part D was originally proposed by President Bill Clinton in 1999, then by both political parties and Houses of Congress and President Bush during 2002 and 2003. The final bill was enacted as part of the Medicare Modernization Act of 2003 and went into effect on January 1, 2006.

Social Security – income paid to adults who worked and put into the program.

Benefits can be accessed at age 62 but if an individual is still working the longer he/she delays the beginning of Social Security benefits, the larger the monthly payment.  All working adults pay into Social Security with their employers paying a share as well.  The exceptions are public employers i.e., federal, state, local governments who may or may not pay into Social Security.  President Franklin D. Roosevelt signed this legislation into law during the Great Depression recognizing that working adults needed a cushion to help as they aged and left the workforce.

Are you a veteran?

If so, you may be receiving VA benefits due to a service-connected injury or disability you incurred while on active duty.  You may also be receiving VA healthcare benefits through a local or regional VA health facility.  There has been a stronger public opinion about benefits and services for veterans in the last few years.  As a result, Congress has worked to lessen wait times and expand services to eligible service members.  Military benefits can be traced back to the Civil War when living survivors or their widows were awarded benefits for their service.  In fact, going back to the Revolutionary War, those who fought and survived were allotted land as a benefit for serving the colonies.

What are some of the other benefits that the government helps with?

Although there are certain programs that concentrate on younger families and children, I’d like to continue to review how the government helps older adults.

Income – Social Security was never intended to be the sole source of income for older adults over 65.  The deductions and matching employer contributions throughout a person’s working years will fluctuate depending on the occupation and pay earned.  Once a person fully retires and begins receiving the monthly check, it only changes if there is a nominal cost of living (COLA) raise once a year.  Usually, this COLA is less than the national increase in the cost of living.  For some individuals, this may be the only income they can count on.

To help raise the poverty level, the government instituted SSI – Supplemental Security Income, a second monthly check to help raise the monthly income to a sustainable monthly income – a small safety net.  What’s considered sustainable?  In 2020 the monthly amount for an individual was $783./mo.  If married and the spouse is eligible for SSI, the amount is $1175./month. To clarify, SSI is supplemental to Social Security.  Thus, if a person is receiving $600/month of Social Security, he/she will be eligible for an SSI check of approximately, $283/month.  SSI can also be awarded if eligible to younger or disabled individuals. President Richard Nixon signed SSI into law on October 30, 1972.

The Older Americans Act was signed into law in 1965 by President Lyndon Johnson, has been reauthorized throughout the years, and most recently re-authorized by President Donald Trump in March 2020.  The original legislation set up for the first time a network of programs & services aimed at serving older adults.  This included the beginning of the National Aging Network, Administration on Aging, and within each state the Area Agencies on Aging.  It includes funding for home-delivered and congregate meals, ombudsman programs, legal services, and social programs such as daycare programs.  Some of these programs are offered at no cost while others charge a nominal fee or take donations.

Is that all?  No, it’s not. 

In California as in other states, Aging Services write proposals to the federal government (CMS) for what is called “waiver projects”.  The purpose is for each state to individualize the proposals to the needs of their state with reporting requirements back to the federal government that in most cases provide all or a majority of the funds for the states.  An example in California that we’ve been participating in for some years now, is a good program to help individuals on MediCal move into an approved Assisted Living Facility. This placement is in lieu of remaining in a nursing home or at risk in a community setting.  Other programs assist people with disabilities, individuals in managed care programs, and specifically coordinating care for Medicare/Medi-Cal patients commonly called “Medi-Medi” to assure quality care for beneficiaries.

What do you know about In-Home Supported Services (IHSS)?  This is a California program but common in other states with another name that supports individuals in their own home by assigning hours to help the person with daily activities such as walking, bathing, eating, getting groceries, and supervision for individuals with memory impairment who are unsafe by themselves.  Having someone come in several days a week for a few hours may just enough help the person to allow them to remain home safely longer.  In order to receive IHSS services, a person must be Medi-Cal eligible or on SSI.

There are other programs funded by federal funding “passed through” State Dept. on Aging down to Area Agency on Aging that in most cases are there to help support individuals and family caregivers in a home setting.  Again these few hours a week help support 24/7 family caregivers with some hours they are off duty and can get a bit of rest.

So I would say to those who complain about “the government & interfering with my life” to stop and think just a minute or two and see what we all as older adults are participating in and receiving.  These programs and services were put in place by our elected officials. They help us stay as healthy as possible with healthcare that allows us to have consistent medical care. Also, income such as Social Security that we and our employers over the years paid into so, we’d have a monthly income to help us in our older years.  If you know of someone who benefits from home-delivered meals or has a family member who attended Senior Day Care prior to COVID or someone in an Assisted Living with the waiver program, count your blessings that our government throughout the years – many years – many presidents from both parties considered it important enough to support us in our older years.  It’s a safety net that I for one do not take for granted.  I for one say Thank You for the collective vision of the Presidents and Congress.

Carol S. Heape, MSW, CMC is the Founder of Elder Options serving Placerville & the Sacramento Region since 1988 and an elder herself.

Categories: Care Management