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Trump's long-term care cabinet

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When members of the Senate Finance Committee voted Thursday, entirely along party lines, to back Seema Verma, they set her up to be the obvious fall gal for problems with the U.S. long-term care finance system.

Verma is on track to be the administrator of the Centers for Medicare & Medicaid Services for President Donald Trump. As head of CMS, she will, in effect, be the chief operating officer for the Medicaid nursing home benefits, and of Medicare home health care programs. When poor elderly people lack the ability to find and pay for much-needed long-term care services, and the quality of the services provided is poor, Verma will likely be the one called to Capitol Hill to testify.

But there are other top officials in Trump’s administration who ought to recognize that they share about as much responsibility for this issue as Verma.

Related: HUD post would make Ben Carson a nursing home loan chief

The Senate voted to confirm Dr. Ben Carson, a brain surgery professor and former presidential candidate, as secretary of the U.S. Department of Housing and Urban Development.

Elaine Chao was confirmed as Transportation secretary Jan. 31; Steven Mnuchin, as Treasury secretary Feb. 2; Tom Price, an orthopedic surgeon, as Health and Human Services secretary Feb. 8; and David Shulkin, a psychiatrist, as Veterans Affairs secretary Feb. 13.

R. Alexander Acosta, who helped the U.S. Department of Justice set up its health care fraud-fighting team in Miami, could be the next Labor secretary.

They all need to recognize that the silver tsunami is their tsunami.

HUD has an obvious role in paying for the construction of housing for older people, efforts to renovate existing buildings to meet the needs of older people, and changing laws, regulations and traditions in an effort to come up with new ways to meet older people’s housing and care needs.

The U.S. Department of Transportation has to find ways to keep loss of the ability to drive a car from pushing otherwise active, able-bodied older people into long-term care facilities.

The Treasury secretary is the chief financial officer for the major federal programs responsible for meeting older people’s needs, including the Medicare hospitalization trust fund. And, Mnuchin has been active in movie financing. That means he knows how to accumulate the cash to pay for huge projects quickly.

Veterans Affairs already provides long-term care services, including community-based services, for veterans of all ages.

The Labor Department could play a role in helping insurers, employers and benefits administrators put together new types of sustainable programs that workers can use to insure against post-retirement health problems, including the post-retirement need for long-term care.

In addition to overseeing CMS, the U.S. Department of Health and Human Services will oversee the efforts of the National Institutes of Health to fight Alzheimer’s disease, Parkinson’s disease, severe arthritis and other conditions that lead to heavy use of long-term care.

Trump is the son of a man who got rich by building housing for veterans returning from World War II. Now it’s time for the president to lead a national effort to figure out how the country will meet the long-term care needs of those veterans’ children.

Allison Bell is a senior editor at 


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