The U.S. Department of Housing and Urban Development (HUD) has never been a high-profile agency, but it now has a high-profile Secretary in renowned neurosurgeon and one-time presidential candidate Ben Carson. Some see Carson's lack of experience in housing policy as a shortcoming. But with no policy legacy to defend (and no political axes to grind), Carson is ideally positioned to champion the kind of creative, nonpartisan, pragmatic solutions that low and moderate income Americans desperately need.
In particular, Dr. Carson has a unique opportunity to change the landscape of urban and rural housing for the elderly. He can do this by demonstrating how housing and medical care clinics can be fused into a single solution to ensure that residents also have access to needed care. And to assist frail seniors, Dr. Carson should implement programs that provide "Care assistance workers" to allow them to maximize their independence.
The housing crisis facing American seniors is horrific. By 2024, the rapidly aging Baby Boomers will add roughly 9 million senior households with income under $30,000 to the demographic mix. Retirees are outliving their single-family homes and desperate to find affordable alternatives that for the most part don't exist - an area of housing policy that the Trump Administration could champion to help middle class retirees.
A good place to start would be reviving HUD's Section 202 program, which was gutted by Congress in 2011. This public-private partnership used capital grants and rental assistance to boost private construction of affordable housing for seniors. At its peak, the program created 20,000 units per year, and more than 250,000 of these units continue to house older adults.
Shutting down Section 202 widened a growing gap in affordable housing options for seniors. As of 2011, 3.9 million low-income older adults were eligible for housing assistance, but only 1.4 million actually received it.
A creative revival of Section 202 would allow the Trump Administration to address three interconnected challenges, and demonstrate how changing the urban and rural housing landscape can also boost economic development by creating new jobs in the building and construction trades and necessitating a whole new army of care workers to help these elderly and disabled Americans remain independent.
First, a revitalized Section 202 would meet the affordable housing needs for millions of American seniors. Roughly 30 percent of older renters and 23 percent of those with mortgages spend more than half their income on housing, putting immense pressure on household finances, raising the specter of homelessness and jeopardizing access to necessities like medical care and food.
Section 202 would meet this demand by encouraging private construction of affordable homes designed around the unique needs of older adults. Such homes can be difficult to find - 40 percent of housing in the U.S. lacks basic accessibility features like no-step entry and single-floor design. A Section 202 community also combats social isolation, decreasing the risk of memory loss, stroke, and heart disease.
Second, a revived Section 202 program would enable older adults to receive care at home: the cheaper and preferred option to meet care needs. Nearly 70 percent of adults over 65 will require assistance to care for themselves at some point, and professional in-home care is half as expensive as a room in a nursing home. Given that 90 percent of seniors say they want to live at home for as long as possible, Section 202 housing could grant this wish for hundreds of thousands of older Americans, who would otherwise be forced to choose between no care or more expensive, publicly provided care.
Third, by increasing access to care at home, a new Section 202 program would help reduce overall healthcare costs. As America ages, Social Security and Medicare expenditures are projected to grow from 8 percent to 12 percent of GDP by 2050. The affordable housing/care at home combination can help reduce the pinch of these increases.
Currently, just 13 percent of care at home is financed by government, compared to 60 percent of nursing home care. Care at home would also help to reduce costly hospitalizations resulting from inconsistent levels of care and medical emergencies. In 2008 alone, it's estimated the U.S. saved as much as $25 billion in hospital costs due to the growth of care at home.
A revived Section 202 program is exactly the kind of non-partisan, forward-looking, common sense solution that older adults need and Americans of all parties want to see out of Washington.
Jeffrey R. Lewis is the president of Legacy Health Endowment in Turlock.