I’ve written before about my frustration with the focus of many demographic reports on the 65+ population as a whole rather than dividing the cohort between those ages 65-84 and 85+. This distinction is for two main reasons: the differing rates of care needs and the opposite demographic trends of the two groups. Disability (for Many) Begins at 85 The younger cohort, despite some aches and pains of aging, is by and large able to take care of themselves. It’s after age 85 that the likelihood of needing assistance due to cognitive or physical disability really soars. The Administration for Community Living of the U.S. Department of Health and Human Services (recently slated for elimination in a restructuring by t…

The drug coverage provided by Medicare Part D is a key part of a retiree’s health insurance, and there are many options to choose from for those who have standalone Part D plans. Since these plans can change from year to year – sometimes dramatically – switching plans may offer big savings. Plan features that may vary include premiums, deductibles, copays, pharmacy networks, and even which medications are covered. As a result, a plan that worked well for you in 2025 may not be the best choice in 2026. During Medicare’s fall open enrollment period (October 15 through December 7 every year), enrollees can review their coverage and, if needed, switch plans. How Does Drug Coverage Fit Into Medicare? Navigating…

With Americans having fewer children and the baby boomer cohort rapidly retiring, it has been immigrants who have been shoring up the U.S. workforce. According to the Migration Policy Institute, U.S. Census data show that – from 2000-2022 – the number of U.S.-born residents of prime working age (25-54) grew by just 2.9 million, while the number of prime-working-age immigrants (both documented and undocumented) rose by 7.7 million. During this same period, the 65+ population increased by 18 million. The Elder Care Workforce Immigrants have become especially important in elder care. According to KFF, immigrants make up 28 percent of the overall direct long-term care workforce (see Figure 1).  Other studies report broadly similar estimates. As this chart shows, a majority of thes…

We have a housing crisis in the United States that has as much to do with the types of housing available as the quantity. Builders construct luxury McMansions because they are more profitable than middle-income housing. Seniors can’t move out of their single-family homes because there are few alternatives nearby. Both factors limit the supply and thus increase the cost of housing for young families. I recently had a discussion with Catherine Buell, the former director of Amazon’s Housing Equity Fund, about alternative types of housing that can enhance the lives of baby boomers and younger people as well. She started by discussing the contrasting housing markets faced by prospective home buyers of different ages. “Many boomers own their houses outright, and quite frankly,…

My fascinating conversation with Ben Veghte, executive director of the Washington Cares Fund, covered both his state’s innovative model for public financing of long-term care and the Dutch approach to senior care. The Washington Cares Fund The Washington Cares Fund is a unique long-term care financing model that – starting in July 2026 – will provide state residents with up to $36,500 for long-term care costs, financed by a 0.58-percent payroll tax.  To qualify, residents must have contributed for 10 years, with some exceptions. I asked Veghte what to me was the obvious question – or perhaps flaw – in the plan: $36,500 is not very much given the high cost of care. He responded that the Washington plan is a stepping stone in two ways,…

There’s growing discussion of “social” housing as part of the solution to the ongoing housing crisis. While it can have various meanings, social housing is essentially public or subsidized housing that often comes with services. It is the mainstay of housing in Vienna, which is often rated the most livable city in the world. Unlike much of the subsidized housing in the United States, social housing is high quality and often includes residents with varying incomes. In a recent podcast, I had the opportunity to discuss a unique form of social housing with Derenda Schubert, the director of Bridge Meadows in Oregon. The three Bridge Meadows communities provide housing to both seniors and foster families. The existing communities have 36 to 40 housing units.  The seniors live in…

The Trump Administration’s flouting of the U.S. Constitution brings to mind Benjamin Franklin’s often quoted statement that “[o]ur new Constitution is now established, and has an appearance that promises permanency; but in this world nothing can be said to be certain, except death and taxes.” Taxes also may not be as certain as Franklin had thought, with the recently passed budget resolution allowing for $5.3 trillion in tax cuts over the coming decade. But that aside, almost as certain as death and taxes is the likelihood that sometime during our lives we will be either caregivers or care recipients – or both. The problem is that it’s difficult to predict when and for how long we will be receiving or…

The Social Security program was designed to support lower-income retirees more by replacing a larger share of their past earnings than higher earners receive. But the subsidies that encourage workers to save for retirement tilt in the opposite direction. For this reason, White workers – who tend to earn more than Blacks and Hispanics – receive a disproportionate share of the employer matches and federal tax breaks embedded in 401(k)-style savings plans, according to a study of workers with these plans. White workers start out saving more. They contribute 4.2 percent of their earnings, on average, and their employer matches add another 2.1 percent for a total saving rate of roughly 6 percent, the researchers at MIT, Harvard, Yale, and t…

In a recent podcast, I had the opportunity to speak with Marylou Sudders, the Secretary of Health and Human Services for Massachusetts throughout the COVID-19 pandemic. But COVID was only part of what she faced during her eight-year term. Sudders pointed out that Massachusetts has an older population than most states and by 2050 almost a third of people will be 65+. As a result, she and Governor Charlie Baker created a Council to Address Aging in Massachusetts to get the entire cabinet to think about how to become an age-friendly state. The Commission’s approach was to urge every community to plan locally on how to help their residents age in place. Lack of Continuum of Housing Options One of the state’s…