by Roz Brown for Public News Service
New Mexico is one of 17 states where adults aged 65 and older outnumber children under 18. In less than a decade, it will be true for the rest of the country and the number of potential caregivers is shrinking.
The U.S. lacks a long-term care system for seniors, while housing and nutrition systems have been made worse by the Republicans’ “One Big Beautiful Bill Act,” slashes nearly $1 trillion from Medicaid over the next decade.
Alison Barkoff, associate professor and director of the Hirsh Health Law and Policy Program at George Washington University, says more than 11,000 Americans are turning 65 every day and they are living longer, many to 80 years and beyond.
“We know that the vast majority of people are going to need long-term care in their lifetime, more than 70%. And the older people are, the more likely they are to have more significant long-term support needs,” Barkoff explained.
Low wages and high job burnout are exacerbating the shortage of senior caregivers, along with the loss of immigrant workers, who have historically filled a major portion of direct care and nursing home positions. By 2034, the U.S. Census Bureau projects adults aged 65 and over will outnumber children under 18 for the first time in U.S. history.
A 2023 analysis by AARP showed Minnesota, Washington and Utah are among the top states addressing the needs of aging seniors. New Mexico ranked 20th.
Barkoff pointed out Medicare, the federal health insurance program for people aged 65 and older, does not cover long-term care and the private insurance market is small because of high costs. At the same time, the majority of older adults cannot pay costs out of pocket.
“That leaves Medicaid as the primary funder of long-term care but it's a poverty program that has strict income and asset limits and for many older adults to be able to access Medicaid, they would have to spend down to become eligible,” Barkoff added.
A spend-down requires individuals to use their excess income or assets on medical bills and approved costs until their remaining resources drop below state eligibility limits.
Barkoff stressed older adults are the fastest-growing group experiencing homelessness and hunger has risen sharply over the past two decades, particularly among those with disabilities and residents of rural communities.