What kinds of welfare programs are available
to aging Americans? There are three
types of welfare programs. Social assistance is a
minimal means-tested benefit for the poor, paid
for by income taxes. Social insurance provides
benefits as an automatic right to all who have
contributed. Payment comes from payroll taxes.
Fiscal welfare operates through the tax system.
It uses tax incentives to encourage savings for
retirement, expand health insurance access,
and encourage home ownership.
What are the government-sponsored sources
of income support for the aging? Social Security
provides more than 40 percent of the income
of older people. Individuals who contribute to the
system by paying payroll taxes during their working
years automatically receive benefits when they
reach the age of eligibility. Supplemental Security
Income is a joint federal–state program for the
aged, blind, and disabled poor. Benefits are quite
low, below the poverty level in most states, and
many who are eligible fail to apply for such assistance
because of the social stigma attached to
means testing.
What government health care programs
serve the elderly? Medicare is a program of
national health insurance for people over age 65
who are eligible for Social Security. It covers
many of the costs of a hospital stay (Part A)
and physician office visits (Part B). Although
Medicare is an important program for the aged,
older people still pay a large and increasing
share of their income for health care. Medicaid
is a program of health insurance for the aged,
blind, and disabled poor. It pays for a range of
health care services as well as a large share of
the cost of nursing home care.
Which government programs protect the
disabled? Two programs provide income for
disabled people: Disability Insurance, which is
one of the benefits of Social Security, and SSI,
which provides a minimal income for those who
have not contributed to Social Security. Both
programs contain work disincentives, since beneficiaries
stand to lose health insurance coverage
if they return to work.
How is long-term care of the elderly financed
in the United States? Long-term
care refers to the range of supportive services
and living environments that help the elderly
continue to live independent lives for as long as
possible and that provide institutional care when
independent living is no longer feasible. In the
United States long-term-care benefits are provided
by a complex array of programs including
Medicare, Medicaid, and services under the
auspices of the Older Americans Act. Medicaid
is the main source of public funding for long-term care. To discourage institutional care,
during the past decade states have been allowed
to use a portion of their Medicaid dollars for
waiver programs to provide services in the home.
Among the services offered are homemaker services,
adult day care, meals-on-wheels, physical
therapy, and help with chores.
What social services does the Older Americans
Act provide? The Older Americans Act
also provides funds for a number of services including
congregate meals, day care, and meals-on-wheels. Many of these services overlap with
those provided by Medicaid waiver programs.
Although services through the OAA were originally
supposed to be available to all elderly regardless
of income, scarce resources have meant
that these services increasingly have been targeted
to the elderly poor and to minorities.
