Argentum’s Senior Vice President of Public Affairs, Maggie Elehwany gives Pam McDonald, Foresight Radio Producer, a rundown of the 117th Congress. She identifies what she believes President Biden’s priorities will be and also introduces Argentum Advocates, the Association’s new program to influence public policy for senior living. This interview was recorded prior to the inauguration and has been lightly edited. You can listen to the entire episode here.
There’s a sea of change going on in Washington, DC, and it’s really important to think about how that impacts Foresight’s audience because we think it will be profound. Senior living communities haven’t been under federal scrutiny because our payors generally aren’t federal payers, such as Medicare or Medicaid. But COVID changed the world, changed this country, and changed senior living.
We anticipate being in the federal spotlight now and for the foreseeable future. We can’t necessarily look at it as entirely negative. But it’s coming and we need to lead how the federal government views our industry. There are so many wonderful things going on within our communities that we need to drive the narrative. That’s really what Argentum wants to be doing.
The Power of the Senate
The Georgia special elections surprised a lot of people when Democrats actually picked up both Senate seats. This means there is now a tie in the Senate. A tie goes to whoever won the administration. So, with a Democrat in the White House, the person who serves as the vice president also has the honor of serving as President of the Senate. They break a tie vote. We anticipate seeing former Senator Kamala Harris, now the future vice president, sit as the presiding officer of the Senate and, in all likelihood, will break a lot of tie votes in the next few years.
The Senate is obviously a very old institution, a very deliberative body. Often due to their procedural rules, they wield lots of power with the party in control, but their power is limited. The party in power controls the agenda. They control each and every committee within the Senate, the legislation that goes before it, and what issues are taken up both within that committees and on the Senate floor. They really have the power of crafting an agenda, including big-ticket items.
The Power of the Filibuster
I said the power wasn’t without its limitations and that is done through the filibuster in the Senate. Any one Senator can stop legislation they don’t like and filibuster. It’s really an old arcane procedure of saying, “I’m going to talk about this issue until nobody can stand it anymore.” Then nobody can vote on it.
To overcome that filibuster, you need a supermajority of 60 votes to override it. This means both parties are going to need to work with the other side, get some bipartisan support to pass legislation, or overcome a filibuster. A lot of Biden’s big-ticket items — climate change, health reform, Medicare for All — may not have the votes to pass. They’re going to need to reach across the aisle.
Now, an exception to the 60-vote rule that can’t be blocked by a filibuster is certain budget bills known as reconciliation. So, you’ll see legislation packaged even when it does not relate purely to a budget issue. They’ll throw that onto a reconciliation bill, so it only needs a simple majority; those 51 votes to get it through. So, we can anticipate some of these big-ticket items being done through that reconciliation process in the Senate.
Priority Legislation for the New Administration
We think really early out of the shoot, debate will start, and a bill will go to the floor as early as March, for COVID relief. This is particularly important to us at Argentum, to our sister associations, to our state associations, and probably to a lot of your audience because of what we need in this particular package. Many of our folks are struggling because of the slow financial relief that has been received so far by assisted living.
What we want to see in this next COVID relief package, and where we realize we need to unite together is really twofold: first, to make sure our members have the federal resources they need to help overcome this terrible pandemic. Most of that is a desperate need for financial relief. We had to take on expenses we never dreamed would be as significant as they are — from PPE to purchasing all these COVID tests. Yes, we are receiving something from the federal government, but often, on a state or even on a local level, we’ve had to assume different kinds of costs, like point-of-care testing and other things.
Lower Occupancy Harming the Financial Picture
Additionally, we know that occupancy rates have been declining. In assisted living, the average age is 84, 85, and there’s just a natural attrition rate of about 50% in any given year. But in light of COVID, there’s been either a chilling factor or state-imposed restrictions on seniors moving into congregate communities. This has been absolutely devastating.
It takes 70 to 80% of occupancy rates just to break even in a lot of assisted living communities. Any decline and we’ve had a significant decline averaging about 30%, is absolutely devastating to many of our listeners out there. And that’s something we need to make sure gets clear to this new administration and to the new Congress.
Confusion Over Assisted Living and Other Congregate Senior Care
We have stayed under the radar of the federal government and we did it purposely. Because we aren’t tied to Medicare or Medicaid, we didn’t want to invite federal regulation. We have plenty of regulation and I’m sure your listeners can say they’re overregulated on the state level. Because of the fairly significant confusion by both Capitol Hill staff and the administration, they equated assisted living and other types of congregate senior care with nursing homes.
There was an assumption that when nursing homes received financial relief through federal programs that assisted living received comparable relief. That’s a large hurdle to overcome. We think we’ve broken through that barrier. But now, of course, we have a whole new administration to educate and we need to hit the ground running.
Making Advocacy Easy
That’s why we’re very excited about our new joint advocacy program, uniting all voices of senior living communities across the country to focus on federal advocacy and the need to make those connections. Not necessarily at a Washington, DC level, but really to make those federal connections through local offices of their members of Congress to let them know what they mean to their individual communities.
To get involved and get their voice heard in Washington, all your listeners need to do is poke a button on our website. When they join Argentum Advocates, they’ll get our briefing materials and notices of proposed federal regulations. We make it easy to lend their voice and help us in Washington, DC, and also formulate and strengthen our voices at a local level.
There is no more important voice for a member of Congress. They hear from a lot of advocates in Washington, DC, a lot of lobbyists. Those are all important, however, there is no more important voice than that person at home in their district who they’re going to see in their grocery store, or at their church or their synagogue. They want to understand your needs.