Jason Maciejewski (00:00):
Welcome to Inside The Senior Alliance, a podcast exploring resources and issues in the field of aging. I’m Jason Maciejewski, CEO at The Senior Alliance, the Area Agency on Aging serving Western Wayne County and the Downriver area. And joining me today is Amber Christ, Managing Director of Healthcare Advocacy at Justice in Aging. Amber, thank you for joining me today.
Amber Christ (00:20):
Thanks for having me.
Jason Maciejewski (00:21):
So Amber, for those who might not be familiar with Justice in Aging, could you share about the work that you do, what you engage in, and really how the organization got started?
Amber Christ (00:30):
We are a national nonprofit, and our mission is that we believe everyone, as they age, should be able to access quality healthcare and long-term care, safe housing, and have enough income to meet their basic needs no matter how much income you have. And we utilize the law to protect and improve systems and program. We are an organization of attorneys and policy advocates. I am the managing director of our health advocacy here at Justice in Aging, but we also focus on economic security and other issues that deeply impact the lives of older adults. We got it started in the 1970s. We’ve been doing this for 54 years, and we train hundreds of thousands of advocates each year. We advise policymakers at the state and federal level, and we do that to improve the laws and the programs that older adults rely on. And then when we’re not successful in working with the federal government or state governments, we use impact litigation to protect the rights of older adults.
Amber Christ (01:28):
And we’ve been using that model for our entire history. And in that, we’ve improved programs, created new policy, and we’ve returned billions of dollars in benefits to older adults.
Jason Maciejewski (01:39):
So that certainly is a long history of advocating for older adults, low income, older adults. What are some of the key milestones or victories that have shaped Justice in Aging over the last really 50 years?
Amber Christ (01:51):
Yeah, there’s been a lot since we’ve been doing this for a while. Like I said, we opened our doors in 1973, and at the time we had offices in Sacramento, California, and Washington, DC. And in fact, our name was the National Senior Citizens Law Center at the time. And we decided to rename ourselves in, I think it was 2014 that we became Justice in Aging. And that was really because we wanted to better align our organizational name with what we were doing. We weren’t really a center anymore, and the word senior citizens was outdated, not to mention the acronym NSCLC is like a real tongue twister. So the mission of Justice in Aging has really fundamentally been the case since the beginning. And for every single major policy that has impacted older adults, we’ve played a role in that. The milestones have been the SSI program came into being right as we were coming into existence, and we became the primary experts on the Supplemental Security Income or SSI program.
Amber Christ (02:49):
When there were threats to social security, we have been part of litigation and ways to expand those benefits. We were part of informing the nursing facility reform law. When Medicare Part D came on board, we were very engaged there and ended up having to sue when those benefits weren’t reaching older adults as they should have been. I will say over time, you know, we started small and now we have over 40 staff members. And there’s been key areas too, like moments in time that have really been areas where we’ve been engaged in or times where older adults particularly needed support. And one of those most recently was the pandemic where we saw older adults so disproportionately harmed. And that really helped us pivot from some of the work we were doing to really think about how we can move people out of nursing facilities and institutional settings and really focus on expanding our at-home network or home and community-based services so people can age and live in their communities.
Amber Christ (03:46):
So it’s been a long history and I could talk forever about Justice in Aging’s impact, but it’s been really exciting to be part of this organization because we do so much really great work on behalf of older adults.
Jason Maciejewski (03:57):
You’ve certainly been engaged with many different policy initiatives over time. I know that we really prioritize advocacy for older adults and caregivers. As an Area Agency on Aging, we’re charged to do that under the Older Americans Act. And we really work in partnership with US Aging and our state association, the Area Agency on Aging Association of Michigan, to really educate elected officials on aging issues, on a vast range of advocacy priorities that we deal with. But what, at Justice in Aging, what are your current priorities?
Amber Christ (04:28):
So I think I mentioned this before, but we have some areas of focus. So healthcare is a really expansive area of focus for us, and economic security. And when I talk about economic security, I’m talking about the income that people receive. So predominantly, older adults rely on social security, and we focus a lot on the supplemental security income program under the social security umbrella because that is a program that people who are the most marginalized or have the least amount of income rely on. We also have a focus on housing and some of the services that are funded and activities that are funded under the Older Americans Act. When I think about our priorities, they really fall into the substantive areas of our work and then the major programs under there. So we’re really focusing on improving and protecting Medicare, improving and protecting Medicaid, improving and protecting Social Security and Older American Act funded activities.
Amber Christ (05:24):
And I can get into more detail there. I know that we are probably going to talk about some of the current issues. So I do want to emphasize in our priorities, it’s both protect those programs, but also to improve them and expand on them. So we’re always kind of walking and chewing gum at the same time, making sure that people aren’t losing access to benefits and they’re able to access them, but we also want to be improving the programs and expanding access to more people.
Jason Maciejewski (05:50):
Right. Our approach is the same way in our advocacy, but regarding Medicare, Medicaid, Social Security, what are the challenges that you’re seeing right now and why is this particular moment so crucial for older adults?
Amber Christ (06:02):
Well, first off, you know, we have 10,000 people every day turning 65 in the United States. And by 2050, we’re going to see that 20% of the population’s going to be 65 and over. We also know that older adults are the fastest growing group experiencing homelessness. There’s an increasing need for long-term care and services in the home and the community, but we have a caregiver shortage. So in terms of the moment, it’s so, you know, we’re seeing this growing need. But right now, in our current environment, instead of meeting that growing need and the gap in services, we’re seeing threats to those programs and reductions in access to those programs through cuts to funding for the programs, to cuts to eligibility for those programs. And we’re seeing that in Medicare, we’re seeing that in Medicaid, and we’re seeing that in Social Security and the Older Americans Act.
Amber Christ (06:53):
And the impact is that older adults are going to lose services when they need them the most. And we see that as a significant harm to their health and their wellbeing. We are fearful that we’re going to see higher rates of institutionalization, higher rates of homelessness. And then we talked a little bit about, you know, a focus on caregivers, that these harms will also be felt by families and by unpaid caregivers who are going to have to help fill in those gaps. At this moment too, we’re also seeing immigrants targeted, both older immigrants in our communities and immigrant caregivers. Immigrants represent 30% of our long-term direct care workforce. And given the already shortage and the availability of caregivers, policies today on immigration are going to impact the availability of caregivers and just exacerbate that shortage that we already have today. So there’s going to be significant harm that the policies are actually having on individuals, their families, and communities.
Amber Christ (07:51):
And then also the harm that immigrant caregivers not being there to provide that care to older adults and people with disabilities, the ripple effect into communities is going to be significant. So this moment, there’s a lot happening. It feels like there’s a lot under threat. So it feels really essential for people to be engaged and to be advocating on behalf of older adults and people with disabilities.
Jason Maciejewski (08:12):
Yeah, we really are in a critical moment for many of these programs and services. And a major topic that we’ve been engaged with over the last year in advocacy is H.R. 1, which passed last year as well. And can you explain what H.R. 1 means for older adults and why Justice in Aging is paying such close attention to it?
Amber Christ (08:32):
So this is one of our top priorities and has been our top priority since really December of 2024 when we knew that there was possible cuts coming to Medicaid. And H.R. 1, or what was previously known as the One Big Beautiful Bill Act, was the vehicle for those cuts. And this, like you said, passed in July of 2025. And the reason we paid attention to it is because the law makes almost $1 trillion in cuts to Medicaid. And Medicaid is such an essential program for older adults. Medicare is not comprehensive, but it does not include many essential benefits that older adults need. Notably, it does not have extensive coverage of long-term care, either care in institutional settings like nursing facilities or care provided in the community and in the home. So people don’t have any option for long-term care coverage except for Medicaid. So Medicaid is our primary payer of long-term care.
Amber Christ (09:31):
Medicaid is also the primary payer of other benefits that Medicare doesn’t cover, including dental, vision, and hearing. And then Medicaid can make Medicare affordable for lower income people because Medicaid pays for Medicare out-of-pocket costs. So things like copays and premiums and co-insurance and deductibles. So Medicaid is just this essential program for older adults. And then H.R. 1 comes in and it’s making cuts to that program and also making eligibility changes. And we’ve been so focused there because there was sort of a narrative during the negotiations around this law that it wasn’t going to impact older adults and people with disabilities. And that really cannot be any further from the truth. Like I said, the Medicaid program is the primary program paying for so many services that older adults and people with disabilities rely on. And so right now, since the law’s passed, we fought really hard not to have the law pass.
Amber Christ (10:28):
It passed anyway. And now we’re working, we’ve pivoted to how do we mitigate the harm to older adults as it gets implemented? And there’s a lot of ways we’re engaging in that. The two areas I really want to focus on is that with the cuts to federal funding to Medicaid, states are in a really tough spot. So Michigan’s going be in a really tough spot with its budget because the state is going to lose hundreds of millions of dollars in Medicaid funding. And not just Medicaid funding, H.R. 1 also cuts SNAP or food assistance funding. The state’s going to lose federal funding for both Medicaid and SNAP. And so they are going to have to make choices about how to fill that budget hole. And really states don’t have very many options. They can cut benefits, they can cut eligibility, or they can cut reimbursement rates for services, right?
Amber Christ (11:21):
All three of those are going to harm older adults and people with disabilities, especially because home and community-based services, those services that help people remain in their homes and communities, that is funded by Medicaid and they are optional for states to cover. They are not optional in people’s lives, but they are optional for states to cover. And when the state doesn’t have any areas to cut, they’re going to turn to optional first. So that really puts home and community-based services, dental, vision, and hearing in the crosshairs for cuts. And even if that’s a cut through eligibility or a cut through reducing provider rates, that’s going to harm access for older adults and people with disabilities. So absent a state raising revenue, we’re really afraid that we’re going to see massive cuts to these services that older adults rely on. And that means institutionalization. And again, that means more falling onto families to fill those gaps to the economic harm of those families as well.
Amber Christ (12:17):
So that’s one area. And then the second big area that H.R. 1 made significant changes to is it put work requirements in the Medicaid program for the first time. And I want to be clear, work requirements do not apply to older adults 65 and over or people who have Medicare. That said, there are a lot of indirect impacts of work requirements in the program, including having to prove eligibility and things like that. So there’s a lot going on with H.R. 1, and so that’s where we’re trying to educate people, make sure that people understand what’s coming, and trying to make sure that we can minimize the harm to older adults as the law gets implemented.
Jason Maciejewski (12:59):
Right. So we are already seeing our state legislature and the budget process this year grapple with these issues of Medicaid funding and the reductions from the federal government. And those are very directly impacting, you know, the work that we do on our long-term services and supports programs here, MI Choice. So these are very critical issues and there is absolute impact on the older adult community. One of the things that we’re doing is continued advocacy, and I think one of the biggest misconceptions people have about advocacy is that their voices really don’t matter. Advocacy isn’t just large protests or really big campaigns. It’s really small actions taken by individuals that in some, can have a really big impact on legislation or budgets. And certainly there are barriers that prevent older adults, particularly people with lower incomes or from underserved areas from participating in advocacy in a robust way.
Jason Maciejewski (13:54):
But what are some everyday actions that older adults or caregivers can take that actually have a real impact on policy decisions?
Amber Christ (14:03):
It’s so true. Small actions can have a really big impact. And I do think that the biggest enemy of progress is believing that your voice doesn’t matter. It really does. And to give an example that’s really current is that yesterday it was announced that the administration, federal administration was canceling mental health grants totaling in the billions of dollars for mental health and substance use treatment. So that was announced, I think it was, what is it? Today is Thursday. I think that organizations got letters on Tuesday night. The news broke on Wednesday morning. Last night, the administration had reversed course and took back those terminations of those grant dollars. And that was because of public outcry. That was people calling their lawmakers and then their lawmakers pressuring the administration to reverse course. And so really, the voices do matter. So it’s really important for folks to get to know your representatives in Congress and your state legislature to keep their office numbers and call regularly to let them know what’s important and thank them when there’s something helpful that’s happening and call them when there’s a bill being considered, whether you support it or oppose it.
Amber Christ (15:12):
And there are other ways too, in addition to calling your lawmakers, things like writing an op-ed or responding to an article in the media. It’s just really important that people share their story wherever they can, including sharing their story with organizations like The Senior Alliance and other advocacy organizations in the state and nationally that can elevate their voices as well. So totally agree with you that the small actions, people’s stories are critically important in shaping the laws and the policies that impact the lives of older adults.
Jason Maciejewski (15:43):
So when Justice in Aging is working to elevate the voices and lived experiences, those stories that you talked about of older adults and caregivers, when you’re in policy conversations at the state and federal level, I mean, what does that look like? Can you give us an example of how you bring those stories into your advocacy work?
Amber Christ (16:00):
You bet. The voices of older adults is essential in every aspect of the work that Justice in Aging does. So some examples include this summer when we were advocating against the passage of H.R. 1, we did a vigil at the Hill in Washington DC, and we asked for stories directly from older adults about what it would mean if they lost their Medicaid coverage and how it would impact their lives. We then read those stories over that 24-hour vigil and then elevated those stories and the recording of those stories to lawmakers and on social media. And again, while it was not enough to stop the cuts from being passed into law, it was so important for the voices of older adults to be on the record, and it did influence some of the provisions in the law. The law could have been worse than it what it was, and really those voices, those stories is what made it less bad even though it’s still really, really bad.
Amber Christ (16:54):
Another way that we incorporate stories is we work so often with direct service providers, people who are providing services to older adults and their older adult clients, like social workers and nursing homes, case coordinators and low-income housing, legal services organizations hearing about issues from their older adult clients. And we pull that, all of those stories into our advocacy. For example, if we’re commenting on a new regulation that’s impacting like the Medicare program, for example, we pull in examples of how that policy is working for older adults and why the proposal either would be a good thing or a bad thing. So the way that we’re using stories is just woven into every aspect of our advocacy. So I think it’s so important for older adults to be directly connected to people and organizations that can share their story either in the world or with organizations like us that are advocating so that we can elevate them with lawmakers.
Jason Maciejewski (17:53):
Very often I find that lawmakers identify with those stories on a personal level. You’ll be telling them about somebody on a Medicaid program and they’ll realize that, oh, they had a relative or a neighbor that was on that program or they’re making connections by hearing those accounts. So they’re really, really important. I also think that the advocacy on H.R. 1 maybe didn’t completely work because the bill got passed and signed into law. There are benefits to this advocacy down the road as we’re continuing to build the knowledge of elected officials and communicate with them. These things impact things that are going to come on in the future. So it’s really, really critical to be out there telling these stories. And for listeners to this podcast who really care deeply about Medicare, Medicaid, Social Security, what are some of the first steps for people to really get involved?
Jason Maciejewski (18:42):
What if somebody’s never advocated before, what’s the first thing that you maybe recommend they do?
Amber Christ (18:48):
I think it’s getting connected to organizations like The Senior Alliance or other organizations that you trust. That could be a state-based organization or a national organization. But getting information from trusted sources is so critical because there’s so much happening that organizations will be able to tell you what’s happening and then be able to give you ways to engage. So that might be at the national level, like us, Justice in Aging, you could sign up for a newsletter. There’s organizations like AARP, and you mentioned Jason US Aging previously. And then there are specific organizations that focus on the very programs we’ve been talking about. So Justice in Aging focuses broadly on older adults, so all the programs, but there are also organizations that focus on specific programs. So Medicare, there’s the Medicare Rights Center and the Center for Medicare Advocacy. There are organizations just for long-term care like Consumer Voice and for caregivers, like the National Alliance for Caregiving.
Amber Christ (19:43):
So I definitely recommend plugging into those types of organizations. In Michigan, you all have such wonderful resources. There’s you all at The Senior Alliance, there’s the Michigan Elder Justice Initiative, there’s organizations serving LGBTQ older adults, MYGEN. So I just think that getting connected to those groups is a very first step. And then I think volunteering for an organization providing services is another really key way to get involved. That could be a food bank, that could be providing counseling, and then there’s sort of grassroots advocacy, like going to the Capitol, making those calls, and phone banking, those kinds of things. And there are also coalitions like that in Michigan that it’s really important that people could get engaged in, like Care Can’t Wait Michigan that’s working on aging and disability care. Detroit Disability Power is another one that we work closely with. I think those are just some ways.
Amber Christ (20:35):
And I wanted to come back to the stories and how important it is. Organizations like ours, we’re doing advocacy at a systems level. We’re trying to protect and improve Medicare, Medicaid, Social Security, Older Americans Act. Another way that we use stories is through litigation that our plaintiffs are people who have had issues with those programs, and so we’re litigating. And one thing we’re litigating on right now is Social Security, and that’s because we heard directly from older adults and people with disabilities that they were having a hard time accessing their benefits because of office closures, because they can’t talk to someone at the Social Security office. We couldn’t have known that unless older adults were directly telling other organizations or us that they were experiencing these issues. And so that lawsuit that we have is a result of people sharing their stories. So just another way that people can get engaged.
Amber Christ (21:26):
It’s just like that sharing your story with trusted organizations.
Jason Maciejewski (21:30):
So when it comes to getting people involved, I know we have those opportunities that you gave examples of. We have the Michigan Senior Advocates Council that we have members on that go to Lansing every month and talk with legislators. And for anybody that’s interested in doing that through The Senior Alliance, you can go to our website and call our mainline phone number and express that interest as we certainly have those opportunities for people to get involved. We have our newsletter Colloquy as well, which you can sign up for on our website too. Amber, when you look ahead at the aging landscape and the work of advocacy, what is out there that’s giving you some hope?
Amber Christ (22:04):
You know, Jason, you kind of mentioned it earlier that when you’re going to talk to lawmakers, so often they can relate to something because they have an older adult in their life that is experiencing the issue that you’re explaining. And that actually gives me hope. A lot more people are experiencing aging, families are trying to support people aging, and so people are talking more openly about the issues they’re facing. And that brings attention in a way that previously has been really hard to break through. So to me, that’s a hopeful thing that more and more people are relating to the issues we’re talking about and therefore will want to see policies that are addressing those issues, right? And I think another area that’s given me hope is that kind of grassroots organizing. Older adults are really engaged right now and are speaking up, and that gives me such enormous hope that the policies and the programs that older adults need are going to be protected and expanded is because older adults themselves are engaging so heavily right now.
Amber Christ (23:07):
So I just want to express enormous gratitude to work on behalf of older adults and for older adults who are engaging in this advocacy.
Jason Maciejewski (23:14):
Amber, where can listeners turn to learn more about Justice in Aging?
Amber Christ (23:18):
So I just want to make clear that I said this earlier, but Justice in Aging doesn’t provide direct services to clients, but what we do is that systemic advocacy. So we’re working on the programs and so we’re working with organizations like The Senior Alliance and other organizations directly serving older adults. And so if you want information about what we’re working on, we do a ton of education about Medicare, Medicaid, Social Security. You can find that all on our website, justiceandaging.org. You can sign up for our mailing list. We have some options on how often you want to be emailed, and you can also find us on social media. So lots of ways to connect with us.
Jason Maciejewski (23:59):
All right, Amber, really thank you for taking the time to join us today and talk about all the important work that you’re doing with Justice in Aging.
Amber Christ (24:06):
Yeah, thanks so much for having me and for all the great work that you’re doing there at The Senior Alliance.
Jason Maciejewski (24:10):
If you have questions about services or programs The Senior Alliance offers, you can call us at 734-722-2830. You can also email us at info@thesenioralliance.org. Information about our agency or the programs and services we offer can be found on our website, thesenioralliance.org. And on Facebook, we can be located by searching for The Senior Alliance. I’m Jason Maciejewski. Thank you for listening to this episode of Inside The Senior Alliance.
Speaker 3 (24:38):
Inside The Senior Alliance is a production of The Senior Alliance and Blazing Kiss Media.
