Special Message to the Congress Proposing Programs for Older Americans

To the Congress of the United States:

America is a young nation. But each year a larger proportion of our population joins the ranks of the senior citizens. Today, over nineteen million Americans are 65 or older-a number equal to the combined populations of twenty states. One out of every ten citizens is in this age group--more than twice as many as a half century ago.

These figures represent a national triumph. The American born in 1900 could expect to reach his forty-seventh birthday. The American born today has a life expectancy of seventy years. Tomorrow, the mirades of man's knowledge will stretch the life span even farther.

These figures also represent a national challenge. One of the tests of a great civilization is the compassion and respect shown to its elders. Too many of our senior citizens have been left behind by the progress they worked most of their lives to create. Too often the wisdom and experience of our senior citizens is lost or ignored. Many who are able and willing to work suffer the bitter rebuff of arbitrary and unjust job discrimination.

In this busy and productive nation, the elderly are too frequently destined to lead empty, neglected lives:

--5.3 million older Americans have yearly incomes below the poverty level.

--Only one out of five has a job, often at low wages.

--Over two million elderly citizens are on welfare.

--Nearly forty percent of our single older citizens have total assets of less than $1000

Countless numbers dwell in city and rural slums, lonely and forgotten, isolated from the invigorating spirit of the American community. They suffer a disproportionate burden of bad housing, poor health facilities, inferior recreation and rehabilitation services.

THE FEDERAL ROLE

The historic Social Security Act of 1935, sponsored by that great President Franklin D. Roosevelt, first proclaimed a federal role in the task of creating a life of dignity for the older American. By 1951, the number of our senior citizens who had earned and received social security benefits exceeded the number on public welfare. Today, more than 15 million Americans over 65 draw social security, while only 2 million remain on the welfare rolls.

We in the Executive Branch and you in the Congress have extended the federal role in other ways:

--The last eight housing acts contain special public housing provisions for the elderly and special assistance for them when they rent, buy or modernize their own homes.

--The Hill-Burton hospital to expand and improve nursing homes and other long-term care facilities.

--Public Welfare provides programs help restore older people to self-support and self-care.

--The Manpower Development and Training programs direct special efforts at the problems of the middle-aged and older Americans.

--The National Institutes of Health have established programs of research on aging.

In 1965, the Congress enacted and I signed into law two landmark measures for older Americans:

--Medicare, to ease the burden of hospital and doctor bills.

--The Older Americans Act, to develop community services to put more meaning into the lives of the senior citizens. When he signed the 1935 Social Security Act, President Franklin Roosevelt said, "This law . • • represents a cornerstone in a structure which is being built but is by no means complete." President Truman in 1950 and President Kennedy in 1961 proposed and the Congress passed legislation to improve the social security system.

The time has come to build on the solid foundations provided by the work of Congress and the Executive Branch over the last three decades. Last summer, I declared a Bill of Rights for Older Americans--to fix as our nation's goal an adequate income, a decent home, and a meaningful retirement for each senior citizen.

Now we must take steps to move closer toward that goal.

Let us raise Social Security benefits to a level which will better meet today's needs.

Let us improve and extend the health care available to the elderly.

Let us attack the roots of unjust job discrimination.

Let us renew and expand our programs to help bring fulfillment and meaning to retirement years.

TOWARD AN ADEQUATE INCOME

Social Security benefits today are grossly inadequate.

Almost two and one-half million individuals receive benefits based on the minimum of $44 a month. The average monthly benefit is only $84.

Although social security benefits keep five and one-half million aged persons above the poverty line, more than five million still live in poverty.

A great nation cannot tolerate these conditions. I propose Social Security legislation which will bring the greatest improvement in living standards for the elderly since the Act was passed in 1935.

I recommend effective July 1, 1967:

1. A 20% overall increase in social security payments.

2. An increase of 59% for the 2.5 million people now receiving minimum benefits-to $70 for an individual and $105 for a married couple.

3. An increase of at least 15% for the remaining 20.5 million beneficiaries.

4. An increase to $150 in the monthly minimum benefit for a retired couple with 25 years of coverage--to $100 a month for an individual.

5. An increase in the special benefits paid to more than 900,000 persons 72 or over, who have made little or no social security contribution--from $35 to $50 monthly for an individual; from $52.50 to $75 for a couple.

6. Special benefits for an additional 200,000 persons 72 or over, who have never received benefits before. During the first year, additional payments would total $4.1 billion--almost five times greater than the major increase enacted in 1950, almost six times greater than the increase of 1961. These proposals will take 1.4 million Americans out of poverty this year-a major step toward our goal that every elderly citizen have an adequate income and a meaningful retirement.

The time has also come to make other improvements in the Act.

The present Social Security system leaves 70,000 severely disabled widows under age 62 without protection.

The limits on the income that retired workers can earn and still receive benefits are so low that they discourage those who are able and willing to work from seeking jobs.

Some farm workers qualify for only minimum social security benefits. Others fail to qualify at all. As a result, many farm workers must go on the welfare rolls in their old age.

Federal employees in the civil service and foreign service retirement systems are now excluded from social security coverage. Those having less than five years service receive no benefits if they die, become disabled, or leave Federal employment. Those who leave after longer service lose survivor and disability protection.

I propose legislation to eliminate these inequities and close these loopholes. I recommend that:

--Social security benefits be extended to severely disabled widows under 62.

--The earnings exemption be increased by 12%, from $125 to $140 a month,

from $1500 to $1680 a year.

--The amount above $1680 a year up to which a beneficiary can retain $1 in payments for each $2 in earnings be increased from $2700 to $2880.

--One-half million additional farm workers be given Social Security coverage.

--Federal service be applied as social security credit for those employees who are not eligible for civil service benefits when they retire, become disabled, or die.

Social Security financing must continue on an actuarially sound basis. This will require future adjustments both in the amount of annual earnings credited toward benefits and in the contribution rate of employers and employees.

I recommend:

--a three-step increase in the amount of annual earnings credited toward benefits

--to $7800 in 1968; to $9000 in 1971; and to $10,800 in 1974.

--that the scheduled rate increase to 4.4% in 1969 be revised to 4.5%; and that the increase to 4.85% in 1973 be revised to 5%.

PUBLIC ASSISTANCE

Despite these improvements in social security, many elderly Americans will continue to depend on public assistance payments for the essentials of life. Yet these welfare programs are far behind the times. While many states have recently improved their eligibility standards for medical assistance, their regular welfare standards are woefully inadequate.

In nine states, the average amounts paid for old-age assistance are as low as $50 a month, or less.

Twenty-seven states do not even meet their own minimum standards for welfare ments.

The Federal Old-Age Assistance Act lows the states to provide special incentives to encourage older persons on welfare to! seek employment. But almost half the states have not taken advantage of this.

To make vitally needed changes in public assistance laws, I recommend legislation to provide that:

--state welfare agencies be required to raise cash payments to welfare recipients to the level the state itself sets as the minimum for subsistence;

--state agencies be required to bring these minimum standards up-to-date annually;

--each state maintain its welfare subsistence standards at not less than two- thirds the level set for medical

assistance;

--state welfare programs be required to establish a work-incentive provision for old-age assistance recipients.

TAX REFORM FOR SENIOR CITIZENS

Our Federal income tax laws today unfairly discriminate against older taxpayers with low incomes who continue to work after 65. The system of deductions, credits, and exemptions is so complex that many senior citizens are unable to understand them and thus do not receive the full benefits to which they are entitled.

I recommend that:

--the tax structure for senior citizens be completely overhauled, simplified and made fairer.

--existing tax discrimination against the older Americans who are willing and able to work be eliminated. Under this proposal, taxes will be reduced for almost 3 million older Americans--two out of every three who now pay taxes. Nearly 500,000 of these Americans will no longer have to pay taxes. There will be some increases for those in the upper tax brackets-those best able to afford them.

THE SUCCESS--AND THE FUTURE"--OF MEDICARE

During the long wait for Medicare, many older Americans needlessly suffered and died because they could not afford proper health care. Nearly half had no health insurance protection. For most, coverage was grossly inadequate. As a result, men and women spent their later years overburdened by health care costs. Many were forced to turn to public assistance. Others had to impose financial hardship on their relatives. Still others went without necessary medical care.

Since Medicare went into effect just over six months ago:

--more than two and one-half million older Americans have received hospital care.

--hospitals have received nearly $1 billion in payments.

--more than three and one-half million Americans have been treated by doctors under the voluntary coverage of Medicare.

--130,000 people have received home health services, and Medicare paid the bills.

--6,700 hospitals, with more than 98 per cent of the general hospital beds in the nation, have become partners in Medicare.

High standards set by Medicare will raise the level of health care for all citizens--not just the aged. Compliance with Tide VI of the Civil Rights Act has hastened the end of racial discrimination in hospitals and has brought good medical care to many who were previously denied it.

Medicare is an unqualified success. Nevertheless, there are improvements which can be made and shortcomings which need prompt attention.

The L5 million seriously disabled Americans under 65 who receive Social Security and Railroad Retirement benefits should be included under Medicare. The typical member of this group is over 50. He finds himself in much the same plight as the elderly. He is dependent on social security benefits to support himself and his family. He is plagued by high medical expenses and poor insurance protection.

I recommend that Medicare be extended to the 1.5 million disabled Americans under 65 now covered by the Social Security and Railroad Retirement Systems.

Certain types of podiatry services are important to the health of the elderly. Yet, these services are excluded under present law. I recommend that toot treatment, other than routine care, be covered under Medicare whether performed by podiatrists or physicians.

Finally, Medicare does not cover prescription drugs for a patient outside the hospital. We recognize that many practical difficulties remain unresolved concerning the cost and quality of such drugs. This matter deserves our prompt attention. I am directing the Secretary of Health, Education, and Welfare to undertake immediately a comprehensive study of the problems of including the cost of prescription drugs under Medicare.

NURSING AND HEALTH CARE

Medicare and the Medical Assistance program have removed major financial barriers to health services. Federally assisted programs are developing health facilities, manpower, and services--many targeted to the needs of older Americans.

We have made progress, but serious prod lems remain. Although the number of agencies that provide health services to individuals in their own homes has grown to more than 1,400 throughout the country, their services are often limited in scope and quality. Many communities still have no such services available.

The great majority of nursing homes are ill-equipped to provide services required for Medicare and Medical Assistance patients. Of the 20,000 nursing homes in the country, only 3,000 have qualified for Medicare. Of the 850,000 beds in nursing homes, less than half--415,000--meet Hill-Burton standards for long-term care. Many do not even meet minimum fire and safety standards.

Expenditures for nursing home care have increased by 400 per cent in the past decade. They now exceed $1.2 billion annually. Federal, state and local governments pay more than a third of these costs--and the government share is rising rapidly.

We have learned that there is no single answer to the problem of providing the highest quality health care to the elderly. Just as their needs vary, so much the approach.

Some senior citizens can be treated in their homes, where they can be close to their families and friends. Others may need once-aweek care at a nearby out-patient clinic. When serious illness strikes, extended hospitalization may be required. When chronic disease is involved, care in a nursing home may be needed. And when post-operative care for short durations is necessary, specialized facilities may be essential.

Thus, we must pursue a wide range of community programs and services to meet the needs of the elderly--to allow them freedom to choose the right services at the right time and in the fight place.

To move toward our health goal for the elderly, I propose to:

--Extend the Partnership for Health legislation to improve state and health planning for the elderly;

--Launch special pilot projects to bring comprehensive medical and rehabilitation services to the aged;

--Begin an extensive research effort develop the best means of organizing, delivering, and financing health services needed by the aged;

--Expand visiting nurses and other home health services. I am requesting funds for more health facilities and better health care institutions for the aged, including:

--The full authorization of $28 million for construction under the Hill-Burton program to provide new beds and to modernize existing facilities;

--Mortgage guarantees and loans to construct nursing homes for the aged;

--Infirmaries and nursing units in senior citizens' housing projects;

--Intensive research to find new approaches in design and operation of hospitals, nursing homes, extended care facilities and other health institutions.

JOB OPPORTUNITIES FOR THE OLDER AMERICAN

In our nation, there are thousands of retired teachers, lawyers, businessmen, social workers and recreation specialists, physicians, nurses, and others, who possess skills which the country badly needs.

Hundreds of thousands not yet old, not yet voluntarily retired, find themselves jobless because of arbitrary age discrimination. Despite our present low rate of unemployment, there has been a persistent average of 850,000 people age 45 and over who are unemployed.

Today, more than three-quarters of a billion dollars in unemployment insurance is paid each year to workers who are 45 or over. They comprise a7 per cent of all the unemployed--and 40 per cent of the longterm unemployed. In 1965, the Secretary of Labor reported to the Congress and the President that approximately half of all private job openings were barred to applicants over 55; a quarter were closed to applicants over 45.

In economic terms, this is a serious--and senseless--loss to a nation on the move. But the greater loss is the cruel sacrifice in happiness and well-being which joblessness imposes on these citizens and their families.

Opportunity must be opened to the many Americans over 45 who are qualified and willing to work. We must end arbitrary age limits on hiring. Though 23 states have already enacted laws to prohibit discriminatory practices, the problem is one of national concern and magnitude.

I recommend that:

--the Congress enact a law prohibiting arbitrary and unjust discrimination in

employment because of a person's age.

--the law cover workers 45 to 65 years old.

--the law provide for conciliation and, if necessary, enforcement through cease and desist orders, with court review.

--the law provide an exception for special situations where age is a reasonable occupational qualification, where an employee is discharged for good cause, or where the employee is separated under a regular retirement system.

--educational and research programs on age discrimination be strengthened. Employment opportunities for older workers cannot be increased solely by measures eliminating discrimination. Today's high standards of education, training, and mobility often favor the younger worker. Many older men and women are unemployed because they are not fitted for the jobs of modern technology; because they live where there are no longer any jobs, or because they are seeking the jobs of a bygone era.

We have already expanded training and education for all Americans. But older workers have not been able to take full advantage of these programs. In many state employment offices, there is need for additional counselors, trained to deal with the special problems of older workers.

I am directing the Secretary of Labor to establish a more comprehensive program of information, counseling and placement service for older workers through the Federal-State System of Employment Services.

ENRICHING THE LATER YEARS

Old age is too often a time of lonely sadness, when it should be a time for service and continued self-development. For many, later life can offer a second career. It can mean new opportunities for community service. It can be a time to develop new interests, acquire new knowledge, find new ways to use leisure hours.

Our goal is not merely to prolong our citizens' lives, but to enrich them.

Congress overwhelmingly endorsed this goal, when it passed the Older Americans Act. As a result, we have launched a new partnership at all levels of government, and among voluntary and private organizations.

We have established a new agency and a new impetus to promote this partnership.

Forty-one states, the District of Columbia and Puerto Rico--where more than 91% of our older persons live--are now engaged in providing special services for senior citizens. Two-hundred and seventy community programs have already been started. Several hundred more will begin in the next few months.

We are helping states and communities to:

--Establish central information and referral services so that our older citizens can learn about and receive all the benefits to which they are entitled;

--Begin or expand services in more than 65 more senior citizen centers;

--Increase volunteer-service opportunities for older people;

--Offer pre-retirement courses and information about retirement;

--Support services which help older people remain in their homes and neighborhoods.

To carry forward this partnership, I recommend that:

--the Older Americans Act be extended and its funding levels be increased.

--appropriations under the Neighborhood Facilities Program be increased to construct multipurpose centers to serve senior citizens with a wide range of educational, recreational and health services, and to provide information about housing and employment opportunities.

--A pilot program be started to provide nutritional meals in senior citizen centers. Decent housing plays an important role in promoting self-respect and dignity in the later years. In the past three years, the total Federal investment in special housing programs for the elderly has doubled--to over $2.5 billion.

Rental housing for the elderly is one of our most successful housing programs. We have made commitments for about 187,000 units to house more than 280,000 persons. Direct loan and grant programs assist many senior citizens to improve their homes in urban renewal areas, and in areas of concentrated code enforcement where blight is worst. The new rent supplement program, enacted in 1965, promises to help thousands of low income older citizens to have good housing at reasonable rents.

I recommend that these housing programs be continued and that the full amount authorized for the 1968 rent supplement program be provided. I am directing the Secretary of Housing and Urban Development to make certain that the Model Cities Program gives special attention to the needs of older people in poor housing and decaying neighborhoods.

The talents of elderly Americans must not lie fallow. For most Americans, the most enriching moments of life are those spent helping their fellowman. I have asked the Director of the Office of Economic Opportunity to initiate and expand programs to make a wider range of volunteer activities available to older citizens:

--to enlist them in searching out isolated and incapacitated older people.

--to build on the success of the Foster Grandparent and Medicare Alert programs by using public-spirited older Americans as tutors and classroom aides in Head Start and other programs.

--to organize older citizens as VISTA volunteers in a variety of community efforts.

OUR OBLIGATION

These are my major recommendations to the first session of the 90th Congress on behalf of older Americans. But this message does not end our quest, as a nation, for a better life for these citizens.

I believe that these new measures, together with programs already enacted, will bring us closer to fulfilling the goals set forth in our Bill of Rights for Older Americans.

We should look upon the growing number of older citizens not as a problem or a burden for our democracy, but as an opportunity to enrich their lives and, through them, the lives of all of us.

LYNDON B. JOHNSON

The White House

January 23, 1967