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ASHA Legislative / Regulatory Policy Agenda

ASHA works to address the following policy priority issues. (For more detailed information about these issues, ASHA Members can go to the Members Area section of the website)

Federal Taxation

  • Tax Cuts and Jobs Act (TCJA): Landmark tax reform legislation enacted in December 2017 included numerous important provisions for the seniors housing industry. Given the size and scope of the law, it is expected the bill’s language will have to be clarified in several areas. Of particular interest to seniors housing is the treatment of pass through business 20% deduction, the individual and corporate tax rate decreases, the preservation of business interest deductibility, depreciation schedules, retaining like kind exchanges, carried interest treatment, Opportunity Zones and FIRPTA, among others.
  • Medical Expense Deduction: The reform bill preserves and enhances the medical expense deduction by extending the 7.5% of adjusted gross income (AGI) threshold for all taxpayers, but only through 2018.

Long Term Care Financing & Retirement Incentives

  • More than 52% of adults turning age 65 in 2015-2019 will need substantial levels of long-term care services and supports (LTCSS). Making matters worse, it will become increasingly difficult for many people to afford the care they will need. Research by the Insured Retirement Institute (IRI) suggests trouble for retiring Boomers. According to the study, 24% of Baby Boomers have no retirement saving – the lowest number since the study started in 2011. Only 55% of Baby Boomers have some retirement saving and, of those, 42% have less than $100,000. Thus, approximately half of retirees are, or will be, living off their Social Security benefits. Medicare in its current form does not pay for senior living and Medicaid is reserved for the low-income resident.

Health Care Delivery in AL and IL

  • Recent changes in federal rules regarding Medicare Advantage (MA), creates new flexibility for plans to include supportive services, such as those offered in senior living. This may offer some opportunities for those providers who can demonstrate better health metrics for resident in senior living. Entry into the MA market will require collaboration with other providers, additional investment in data collection and technology platforms, and for some providers, a willingness to assume a new risk (as well as potential benefits).

Senior Living Workforce Shortage

  • The senior living workforce shortage impacts day to day operations at our communities. Recruiting, retaining and training employees is both a challenge and an opportunity. Creative and strategic efforts to address these issues are occurring in most companies. Public policy issues also impact the workforce such as federal and state regulations relative to minimum wage, overtime, union organization and others. NOTE: According to data from the Paraprofessional Healthcare Institute, Inc. (PHI), 28% of home health care aides are immigrants.

Limit Federal Regulation of Seniors Housing

  • Every state provides comprehensive oversight of seniors housing. State and local government understand the unique circumstances in their communities and can best ensure compliance with the rules they establish. ASHA has historically opposed duplicative federal senior living regulation since it would increase costs, discourage investment, and impede innovations in caring for the frail elderly.

Full Funding for Alzheimer’s Research

  • It is critically important that Alzheimer’s Research under the National Alzheimer’s Plan is fully funded. Alzheimer’s is the most expensive disease in America. In 2018, caring for people with Alzheimer’s and other dementias will cost the United States and estimated $277 billion.

Ensure Access to Capital that is Needed to Meeting the Demand for Seniors

  • The existing housing finance system provides critical liquidity to the multifamily sector, including seniors housing. ASHA supports responsible changes, but reform must maintain reliable access to credit for seniors housing in all market conditions.