Retirees should be big beneficiaries of the midterms: 'Democrats will hold every gavel that matters for aging and public policy'

By Richard Eisenberg

Here's what might be coming for Social Security, Medicare and long-term care

Congress could now get quite a few things done to help older Americans.

Older Americans could have a more financially secure retirement as a result of the midterm elections, thanks to lower healthcare costs for retirees, expanded Medicare coverage, and more affordable long-term care.

Prospects have also improved for addressing the issue of Social Security's solvency and boosting Social Security benefits for family caregivers.

"Democrats will hold every gavel that matters for aging and public policy," Brian Lindberg, public policy adviser for the Gerontological Society of America, said at the group's conference last week. But, he acknowledged, "the president's veto ability is a big blocking factor."

It's possible that budget maneuvers could lead to major healthcare changes in the lame-duck congressional session. Voting rules for the budget process could allow the current Congress to reverse healthcare cuts and expand coverage, Sen. Elizabeth Warren, a Massachusetts Democrat, wrote in Time.

But the prospects of these and other changes aimed at making retirement more affordable look stronger once the new Congress convenes in January.

That's when three influential senators are expected to take charge of key committees affecting older Americans: Vermont independent Bernie Sanders (Health, Education, Labor and Pensions), Oregon Democrat Ron Wyden (Finance, with jurisdiction over Social Security and Medicare) and Warren (Banking, Housing, and Urban Affairs). Sanders is also expected to chair the Finance committee's Social Security subcommittee.

Here's a look at what might be coming:

Healthcare costs

"We're going to fight hard to make sure that we can ensure that every single American can afford to go see a doctor when they need one," Hakeem Jeffries, the presumptive incoming speaker of the House, said in his election-night victory speech.

Numerous speakers at the Gerontological Society of America conference said the midterms were, in many ways, a healthcare election. That's no surprise, since 60% of voters were worried about affording healthcare, according to a poll by KFF, a health policy research group.

Lowering the cost of health insurance could mean Americans would have more money to save for retirement, making retirement more financially secure.

Affordable Care Act coverage became more expensive at the end of 2025 for individuals with incomes over $62,600 ($84,600 for a household of two) when the Trump administration and the Republican-led Congress eliminated the program's premium tax credits for those enrollees.

Premiums for ACA Silver plans shot up 13% on average in 2026 and are expected to rise 26% in 2027, according to KFF. In contrast, group health insurance premiums were up 9% on average this year and are expected to increase by the same amount next year.

Medicaid work requirements in President Donald Trump's One Big Beautiful Bill Act - also known as H.R. 1 - will cause some lower-income Americans under 65 to lose health insurance starting Jan. 1, 2027.

"The people most impacted would be 50- to 64-year-olds, mostly women, who left the workforce for caregiving," said Alison Barkoff, a professor at George Washington University's Milken Institute School of Public Health and a former U.S. assistant secretary for aging.

As things now stand, H.R. 1 will mean more than $901 billion in Medicaid cuts over 10 years and 7.5 million people losing coverage by 2034. Those would be the biggest changes to Medicaid since the program began.

Experts at the conference said they thought the lame-duck Congress might try to use the Dec. 11 federal budget deadline to restore ACA credits and postpone the start of Medicaid work rules.

"Total repeal of the Medicaid work requirements is unlikely," said Quin Lyons, a policy associate at consulting firm Healthsperien. It would be too hard for Congress to find the billions of dollars needed to pay for that.

If these potential fixes fail in 2026, the experts said, the new Congress is likely to try again in 2027.

The experts at the Gerontological Society of America don't expect Medicare for All to become law under the Trump administration, despite the many Democrats in Congress who campaigned on their support for it.

But they believe Sanders will make a strong push to allow traditional Medicare to provide vision, hearing and dental coverage. That was one of the proposals that the House Democrats' Cost of Living Healthcare Working Group said it wanted considered in the first 100 hours of the new Congress.

Congress next year will also try to make Medicare telehealth coverage permanent, Lyons said. Currently, the benefit expires Dec. 31, 2027.

Social Security

Look for heightened efforts to address Social Security's solvency woes as a result of the election. That's because newly elected senators will still be in office in 2032, when the program's trust fund is expected to start running short of money to fully cover benefits.

In an AARP survey, 90% of voters age 50 and over called preventing Social Security benefit cuts very or extremely important.

"If I was president, I might say, 'I'm going to be the person who sits down with Democrats and Republicans and fixes the trust fund for the next 75 years,' which is pretty darn easy to do," Lindberg said.

To bolster Social Security's finances, Democrats are expected to try to raise or eliminate the Social Security income-tax cap, which currently stands at $184,500. Newly elected Sens. Abdul El-Sayed of Michigan, Sherrod Brown of Ohio and Troy Jackson of Maine all campaigned to raise or end the cap. Warren is also a strong proponent of repealing it.

Jim Palmieri, a senior policy adviser on Social Security and financial security at the AARP Public Policy Institute, said the new Congress might also look into creating a Social Security tax credit for family caregivers. Some people need to leave the workforce or cut their hours in order to provide care to a family member, and since Social Security determines benefits based on employment earnings, caregiving can reduce their eventual income.

Democrat Kirsten Gillibrand of New York, who is expected to chair the Senate Special Committee on Aging, has co-sponsored legislation for a Social Security caregiving credit, and "there is strong bipartisan support for caregiving policies," said Serena Caldera, Palmieri's colleague at the AARP Public Policy Institute.

But "starting a new Social Security caregiver credit would not be easy," Palmieri said. One way to do it would be to drop some caregiving years from Social Security benefit calculations. Another would be imputing a wage for time spent caregiving.

Long-term care

More than half of adults who reach age 65 will need significant long-term care at some point. But many Americans struggle to pay the steep cost of such care. At the Gerontological Society of America conference, Marc Cohen of the LeadingAge LTSS Center at the University of Massachusetts Boston called these people "the forgotten middle."

Medicare typically doesn't cover long-term care, while Medicaid does, but only for low-income Americans. Some upper-income Americans pay for care out of their savings or through long-term-care insurance policies.

Senate Democrats recently held 95 listening sessions on establishing universal long-term-care coverage. And Wyden spent the last nine months asking for suggestions on how to improve long-term-care quality and make home care more affordable.

"It's a really exciting request for information about home care," said Barkoff.

Wyden may not be able to turn long-term-care legislation into law under Trump, Lindberg said. "But who knows? A small piece may make it through in the next two years."

Lyons said that overall, the new Congress could get quite a few things done to assist older Americans. But people can also expect a lot of positioning by Democrats ahead of the 2028 presidential election, he added.

"That will likely be an even more exciting election than the one we just saw," he said.

-Richard Eisenberg

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11-10-26 1620ET