A Q&A with Senate Committee on Aging Chair Bob Casey

As chair of the Senate Committee on Aging, Democratic U.S. Sen. Bob Casey Jr. is one of the Senate's preeminent voices on issues related to older adults. 

Casey spoke with City & State about a range of issues important to America’s seniors, from establishing minimum staffing requirements in long-term care facilities to protecting federal government programs like Medicare and Social Security. 

The following conversation has been edited and condensed for length and clarity. 

What are the biggest challenges facing older adults in Pennsylvania and the US in general?

Some are just fundamental in terms of making sure that we protect Medicare and Medicaid. Medicare is so vital for the lives of tens of millions of Americans – and yet, it's the official position of the Republican Party to turn Medicare into a voucher program. They've proposed it year after year. It's an obnoxious idea and we have to stop it. They also want to decimate the Medicaid program, which is a nursing home program for Americans. An overwhelming number of Americans cannot have long-term care without Medicaid. So we have to stop them from ripping away funding for that – and they've tried that. They try that every year. 

In addition, I think the challenges that most seniors face are similar to those that other families face: the high cost of food, the high cost of living, rent rates, and housing costs. 

There are certainly issues that are unique to seniors, that we've got to make sure we're paying close attention to on the Aging Committee. We focus on a range of issues, including frauds and scams related to seniors, all of which are, unfortunately, changing every year. The artificial intelligence scam wasn't an issue five years ago; now it is. That's a short list.

How can the Long Term Care Workforce Support Act, which you introduced, address workforce shortages in long-term care?

I believe you've got to utilize the Medicaid program to advance the ball on long-term care in a couple of different ways. To give a senior the option to have skilled care in their home, as opposed to having only one option – skilled care in a nursing home – the only way we can accomplish that is by making sure the Medicaid program is fortified enough to be able to invest. The same is true in the context of the current dynamic with long-term care, which is skilled care in a nursing home. 

I think we have to implement the administration's proposed rule on staffing a minimum level so that your mother or father in a nursing home gets the requisite hours per day where the nurse's aide, the nurse, and the medical professionals treat them and engage with them, not ignoring them for a day and going back the next day. That minimum staffing level is critical. 

But we cannot ask these providers to increase the number of hours they dedicate to patient care if we're not fortifying them with resources. Part of that is investing, using Medicaid dollars to invest in the workforce. As a country, we've never really invested in the workforce to take care of seniors … We keep saying how much we value those Americans and yet our investments and our prioritization of their care has not been there. And if you're not investing in the workforce, can you really give a damn about the people that are benefiting from that workforce?

Can Social Security and Medicare be protected through legislation? Or is this an issue that comes down to which party controls Congress?

There are a number of ways that we can strengthen both programs through legislation. We need to make sure that Social Security keeps pace with the rising costs that seniors are facing. That’s why I introduced the Boosting Benefits and COLAs Act, which will change how Social Security cost-of-living adjustments are calculated to better account for the rising cost of goods and services that seniors rely on. It’s why I fought to pass the Inflation Reduction Act, which has already brought down some prescription drug costs for Medicare recipients and will bring down even more over the next few years. It’s also why I am always fighting to ensure that the agency that administers Social Security receives the full amount of funding it needs to ensure every American gets the benefits for which they qualify.

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