May is Older Americans Month, and a new report shows the Volunteer State is among the bottom of states when it comes to caring for its most vulnerable adults.

America's Health Rankings 2023 Senior Report from UnitedHealthcare ranks Tennessee 42nd in health outcomes for those age 65 and older. Notable challenges include a high prevalence of frequent mental distress, drug deaths, smoking, lack of physical activity, and increased poverty.

Michele Johnson, executive director of the Tennessee Justice Center, said elected leaders are not focused on creating policies to serve all Tennesseans.

"We need to have elected officials to roll up their sleeves and address the health care infrastructure," Johnson asserted. "Expanding Medicaid is vitally important not just for people who are in the coverage gap, which it is important for them, but it's important for older Tennessee because we have health care deserts."

Tennessee is among 11 states to not expand Medicaid. Johnson noted some states are six times more likely to lose a hospital when they have not expanded Medicaid, and she believes expanding Medicaid would strengthen the state's health care infrastructure and economy.

Johnson is also concerned about the unwinding of the public health emergency, which is in the process of redetermining health care for older Tennesseans. She contended state leaders should make it simple and ensure it protects seniors.

"This should be a fair process that is simple and lacking in bureaucracy as possible," Johnson argued. "And unfortunately that right now we're really concerned like hundreds of thousands of people, including seniors, will go without health care, not because they're not eligible but because the process is just so daunting."

The report found about 10% of Tennessee adults age 65 and older are living in poverty.

Dr. Rhonda Randall, chief medical officer of Employer and Individual for UnitedHealthcare, said the comprehensive report found poverty increased overall by 10% between 2019 and 2021.

"We know that's really important because it has impacts on how much of their dollars are they spending on housing, food, medical care and more," Randall explained. "We want to make sure that not only are we seeing that number decrease, where seniors are living in poverty that the communities are aware of it."

Randall noted because of the pandemic, they saw more seniors receive access to home-delivered meals and seniors who were eligible for the Supplemental Nutritional Assistance Program signed up. She added as we age, nutrition is very important and a decrease in food insecurity by 6% was an improvement, as fewer worried about accessing nutritious food.

The Social Security Administration has reversed its controversial plan to eliminate phone services for benefit claims, a move that would have forced millions of seniors to apply online or in person, creating barriers for rural residents and those without reliable internet access.

The decision followed intense advocacy from organizations and beneficiaries such as Phyllis Wilson of Southaven, Mississippi, who faced the system's challenges firsthand. While navigating issues with her spousal benefits under the Windfall Elimination Provision (WEP), Wilson called the administration's 1-800 number and waited on hold for three hours without an answer, even documenting the ordeal with a screenshot. Her persistence paid off when she called the local office in Hernando, which was able to help.

"And I know there were other people who could not get through, whose offices had actually closed," she said, "but they answered right away and they talked to me about my spousal benefits and had told me that they could see that I was impacted by the WEP; there was nothing that I needed to do. "

Wilson's payment arrived within a week, prompting her to alert friends about the solution. The now-reversed policy would have affected Mississippi's 680,000 Social Security recipients. The administration itself estimates that this change could have overwhelmed offices with 4 million additional annual visits, or up to 85,000 more per week.

Kimberly Campbell, AARP Mississippi state director, praised the administration's about-face for recognizing the importance of phone access for vulnerable people.

"There is also the issue of travel," she said. "You have someplace where individuals may have to travel hours to get to in-person application and to prove their identities, and so removing the phone capabilities was critical to us."

As the administration implements phone-based fraud checks, projecting around 70,000 claims might be flagged annually for in-person verification, Campbell warned that access hurdles persist. Nearly 8 million seniors have travel-limiting disabilities, while 6 million don't drive at all, according to the Center on Budget and Policy Priorities.

The Social Security Administration is standing down on implementing a plan which would have dramatically affected how recipients can access critical benefits and receive information they need.

AARP Iowa has been pushing back on the plan, reminding lawmakers in Congress that thousands of Iowans rely on Social Security and need to be able to access their benefits and receive timely customer service.

Michael Wagler, AARP Iowa state director, said his organization is working to make sure older Iowans continue to get the information they need. He said while it is good news the agency has stopped the proposed changes, doing so adds to the uncertainty around restructuring plans including staff reductions, office closures and other changes.

"There was already a crisis of customer service happening related to long hold times, and low staffing, delayed call back systems, confused announcements offices closing different things that are happening at a pace we just can't prepare for," Wagler explained.

The proposed changes were scheduled to take effect in less than a week but the agency announced all claims will still be allowed to be processed over the phone, at least for now.

The latest data show more than 687,000 Iowans receive a total of $1.2 billion a year in Social Security benefits.

Beyond the logistic challenges, Wagler pointed out uncertainty and confusion also create opportunities for criminals.

"We are also concerned that the change to phone services and other changes that are also happening on a daily basis will lead to scammers using the confusion that the agency has created around this rollout to exploit and prey on Iowans," Wagler noted. "While this announcement's aim was the idea that it was to combat fraud, we are also concerned that this will have the opposite effect."

AARP said its members have sent more than 1 million emails and calls to Congress in recent weeks to push back on the proposed changes and their negative effects on customer service for the 69 million older Americans who rely on Social Security.

In less than a week, many Wisconsinites will be unable to apply for Social Security benefits over the phone, which could lead to potential disruptions and challenges for millions as the nationwide change takes effect.

Starting April 14, seniors applying for retirement benefits or making direct deposit changes must do so online or in-person at a Social Security Administration office as part of a new identity verification process. The change comes in haste from the White House amid massive federal budget cuts which have already trimmed staff and resources at the agency.

Jim Flaherty, communications director for AARP Wisconsin, said calls to AARP's national call center have more than doubled in the last two months.

"They're concerned, and they're confused," Flaherty observed. "It is up to our President and our Congress to work in a bipartisan manner; this is not a partisan issue. They need to work together to make sure that this program remains strong and solvent for current and future generations."

People can qualify for Social Security benefits through retirement, disability or as a family member of someone who is eligible. More than 1.3 million Wisconsinites receive Social Security benefits. For now, those applying for disability, SSI and Medicare can continue to do so by phone.

There is also confusion about Social Security Administration office closures, which the agency said have been falsely reported but cuts to resources and services disproportionately affect rural and tribal communities. About one in five Wisconsinites would have to drive at least 46 miles from their home to the nearest Social Security office, while nearly half would have to drive at least 23 miles, according to the Urban Institute.

Flaherty emphasized for some, it is more than an inconvenience.

"For a lot of folks, Social Security makes up the majority of their retirement income," Flaherty pointed out. "Cuts to the program and services could be devastating for them. These are folks who are struggling to just to pay their rent or mortgage and put food on the table."

While the Trump Administration has said it will protect Social Security and changes are meant to address fraud and increase efficiency, Flaherty added people are understandably anxious about what could happen next.

"This is a very tough and serious situation that we want folks to be aware of," Flaherty stressed. "This is the time to call your members of Congress and say, 'Hey, you've got to do something before this April 14th deadline to extend this,' because it would be devastating for so many folks."