A live and interactive discussion with one of the leading voices in elder care policy that will provide insights into the complex world of aging services during this period of policy uncertainty. Howard Gleckman, a senior fellow at the Urban Institute and author of Caring for Our Parents will provide a comprehensive analysis drawing on his expertise in tax policy, elder care, and healthcare.

• https://howardgleckman.com/
• Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America's Most Urgent Health Crisis Hardcover – May 26, 2009 by Howard Gleckman (Author)

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Gleckman began by addressing **Social Security**, highlighting President Trump's promise not to cut benefits directly. However, he cautioned that the administration's actions, such as limiting access through closed offices and phone line difficulties, are already impacting beneficiaries and applicants, particularly those seeking disability benefits, where waiting times are expected to exceed a year. More critically, Gleckman stressed the looming **insolvency of the Social Security trust fund within the next nine years**, which could lead to an automatic 23% cut in benefits if no action is taken. He criticized the political stalemate on this issue, noting that inaction is akin to "taking Social Security off a cliff".

Turning to **Medicare**, Gleckman noted Trump's similar pledge not to cut benefits directly. However, he anticipated potential cuts to providers, which could further strain access to care. A significant focus was placed on **Medicare Advantage (MA)**, with the administration recently announcing a substantial 5.3% increase in payments to MA plans. Gleckman pointed out the inconsistency with the stated goal of cutting government spending. He discussed the possibility of MA becoming the default Medicare option, as suggested by Project 2025. While acknowledging potential benefits of coordinated care in theory, Gleckman raised concerns about network limitations, complexity, and prior authorizations in current MA plans. He also touched upon the negotiation of drug prices initiated by the Biden administration and the uncertainty of Trump's future stance on this, while noting the current administration's decision to not cover GLP-1 drugs for weight loss under Medicare and Medicaid.

The **Older Americans Act (OAA)** and the **Administration for Community Living (ACL)** were also highlighted as being at risk. Gleckman predicted budget cuts for OAA programs like Meals on Wheels and adult day programs. More alarmingly, he discussed the announced plan to **abolish the ACL** and divide its functions among other HHS offices, along with the firing of half of its staff, including grant program administrators. This could severely disrupt the functioning of vital community-based services due to a lack of federal oversight and support. Gleckman also noted the potential impact of federal employee layoffs in the Washington D.C. area on the tax base and consequently on local senior service programs.

Gleckman concluded by emphasizing the **unpredictability of the Trump administration** due to its impulsive and chaotic management style. He urged communities to proactively work together to support older adults and their caregivers during these uncertain times. He echoed the sentiment that individual storytelling and engagement with lawmakers are crucial for conveying the real-world impact of potential policy changes. The interactive nature of the discussion allowed participants to voice their concerns and ask questions, highlighting the community's eagerness to understand and navigate the evolving landscape of aging services.