Understanding the Policy Realities of an Aging Nation
The Policy Realities of an Aging Nation
According to U.S. Census data, 17.3 percent of Americans—57.8 million people—were age 65 or older in 2022. With an estimated 10,000 individuals turning 65 each day, this population is projected to reach 88.8 million by 2060.
Since 2012, the number of older Americans has increased by 34 percent, compared to just a two percent increase among those under 65. By 2035, older adults are expected to outnumber children under 18 for the first time in U.S. history.
A significant majority—85 percent—of older adults prefer to age at home rather than in institutional settings. This approach is not only preferred but also more cost-effective for individuals, families and government systems.
About USAging
USAging represents and supports the national network of Area Agencies on Aging (AAAs) and advocates for Title VI Native American Aging Programs. These organizations help older adults and people with disabilities live with optimal health, independence and dignity in their homes and communities.
The 2026 Policy Priorities reflect the real-world experiences of USAging members and focus on actions needed from Congress and the Administration to support aging in place and strengthen caregiving systems.
Key Policy Priorities
Support Aging Well at Home Through the Older Americans Act (OAA)
The Older Americans Act (OAA) is the foundation of the nation’s non-Medicaid home and community-based services system. Each year, it supports more than 14 million older Americans through a nationwide network of providers.
- Information and referral services
- Home-delivered and congregate meals
- In-home care services
- Health and wellness programs
- Transportation
- Elder abuse prevention
- Adult day care services
Modernizing the OAA
Originally signed into law in 1965, the OAA requires reauthorization to reflect today’s aging population. USAging urges Congress to advance bipartisan legislation to modernize and strengthen the Act.
Funding Priorities
Increased funding is critical to meet growing demand and maintain effective services. OAA programs reduce costs for Medicare and Medicaid by helping older adults remain independent and healthy at home.
Support Family and Professional Caregivers
Family Caregivers in Crisis
In 2025, approximately 63 million Americans served as caregivers, providing an estimated $600 billion in unpaid care annually. Despite their essential role, many caregivers face financial strain, health risks and workforce challenges.
National Family Caregiver Support Program (NFCSP)
This program provides training, respite care and support services. However, it currently serves only a fraction of those in need, highlighting the need for expanded funding and policy support.
Strengthening the Workforce
The caregiving workforce faces shortages due to low wages, high demand and limited career advancement opportunities. Investment in workforce development, training and compensation is essential to meet future needs.
Protect Medicaid Home and Community-Based Services (HCBS)
Medicaid is the primary funder of long-term services and supports (LTSS), covering 61 percent of spending. HCBS options allow older adults to remain at home and are significantly more cost-effective than institutional care.
- Average HCBS cost: $38,275 per person
- Average institutional care cost: $53,666 per person
Despite these advantages, many states still prioritize institutional care, limiting access to preferred home-based services. Policy reforms must protect and expand HCBS availability.
Connect Health Care and Aging Services
Integrating health care with community-based services can improve outcomes and reduce costs. Area Agencies on Aging play a critical role in coordinating care, addressing social determinants of health and supporting older adults holistically.
Policymakers must ensure that community-based organizations are included in care models and fairly compensated for their services.
Conclusion
As the population of older Americans continues to grow, policies must evolve to support aging in place, strengthen caregiving systems and ensure sustainable funding for critical programs. Investing in these priorities will improve quality of life for millions while reducing long-term costs for families and government programs alike.
Source: USAging Policy Priorities 2026