Older Americans today have less of a social circle than previous generations, leaving many to resort to private care or government-paid resources, according to the report, “An Invisible Tsunami: 'Aging Alone' and Its Effect on Older Americans, Families, and Taxpayers,” by Congressional Republicans on the Joint Economic Committee.

Problem is, private care — particularly long-term care — can be prohibitively expensive, and government-paid resources such as Medicaid and Medicare are on an unsustainable path as their funding continues to be based on outdated assumptions that informal care is still more widely available, the Republicans write.

They examined data from the University of Michigan's Health and Retirement Study, to determine the amount of “social capital” for adults who were between the ages of 61 and 63 in 1994, and the amount of such capital for adults between those ages in 2014.

Their analysis found that 69 percent of “retiring adults” in 2014 lived with a spouse or partner, compared to 75 percent of retiring adults in 1994. Retiring adults in 2014 were also less likely to live within 10 miles of an adult child than retiring adults in 1994 (55 percent versus 68 percent).

In fact, today's retiring adults were less likely than those in the 1990s to have any relative living nearby (22 percent versus 34 percent), or a good friend in the neighborhood (59 percent versus 69 percent). They were also less likely to attend religious services, according to the data. This matters, as faith communities historically have been a strong resource for social support, Harvard University's Robert Putnam testified during a May 2017 Joint Economic Committee hearing.

“The decline in the availability of support from family, friends, neighbors and congregants among retiring adults has implications for future retirees, caregivers, and taxpayers,” the Republicans write.

The cost of private care can create a huge burden on families, while projected Medicare and Medicaid spending inadequately accounts for declining social support, according to their report.

“The good news is that by anticipating these potential costs, we can prepare for and reduce them,” they write. “Policymakers, health care providers, and institutions of civil society should think creatively about how to mitigate the looming challenge — starting now.”

The Trump Administration has approved a pilot program in North Carolina for next fall, in which private health plans that administer Medicaid benefits will identify high-need Medicaid patients fund or sponsor programs to help them get housing, food, personal safety and employment, according to The Washington Post.

“It's not the same as Medicaid directly paying for these additional services — that's outside the program's scope,” the Post writes. “But the North Carolina experiment does represent a way for the state and federal health insurance program to encourage a more comprehensive approach to health care.”

Moreover, a number of states are now requiring Medicaid managed care plans to screen for and/or provide referrals for social needs, and the Louisiana Department of health is working with the state's housing authority to help reduce homelessness among people with disabilities.

“While states have different ideas and approaches to serving the needs of their beneficiaries, we can all agree that one of our prominent goals should be to help individuals live healthier more complete lives by addressing the whole human need,” Centers for Medicare and Medicaid Services Administrator Seema Verma writes in Health Affairs. “We should keep exploring ways to achieve this goal so that we can identify best practices and replicate them.”

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Older Americans lack 'social capital' necessary for retirement

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