| From Defense to Design

| Allison Cook

| Something is shifting in the aging field. After a year and a half of playing defense — fighting cuts, protecting programs, and holding the line — some advocates and researchers are beginning to lift their gaze. The crises brought on by the current administration aren’t over, but a growing number of people in the field are starting to ask a different question: when we emerge from this crisis, how can we build something better?

Three new initiatives have emerged that reflect this turn. Each takes a distinct approach — drawing on historical lessons, articulating a bold new agenda, identifying concrete improvements to the current system — but all three share a conviction that this is a pivotal moment, and that the field must be ready to shape what comes next.

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One initiative aiming to shape the direction of the field is a compendium of long-term services and supports (LTSS) financing solutions. Marc Cohen, Co-Director of the LeadingAge LTSS Center at UMass Boston, shared that he was inspired to work with others on this project by a quote from economist Milton Friedman: “The actions that are taken depend on the ideas that are lying around. [Our basic function is to] keep them alive and available.” The compendium’s mission embodies this sentiment. It is an interactive, searchable list of LTSS funding bills that did not pass, going back to the 1980s. Users can organize the bills by category, find the bill language, and compare on a range of parameters. When a policy window opens, federal and state policymakers can pull from what already exists — on tax reforms, new benefit structures, or program design — rather than starting from scratch. Cohen shared that he “sees our LTSS system as a three-legged stool that includes financing, caregiving, and the workforce.” The compendium will expand to the other two legs – with the caregiving section scheduled to go live within the next few weeks.  

Another initiative shaping the direction of the field is the Future of Aging Policy Project by Justice in Aging. Executive director Kevin Prindiville shared that the project “will cover three ‘R’s: what needs to be repealed, what needs to be rebuilt, and reimagining systems.” By compiling policies that have consensus in one place, the Future of Aging Policy Project aims to build a comprehensive and forward-looking aging policy agenda. While the two biggest issues are LTSS and Social Security, it will also cover a range of other topics such as economic security, housing, and immigration. Justice in Aging’s goal is to have the agenda ready before the policy window opens so it can shape what future Congresses and administrations prioritize.

A third initiative, the Aging and Disability Health Policy Lab, launched at the end of 2025 with the goal of making health care and home- and community-based services (HCBS) more accessible for both older adults and people with disabilities. Its focus is narrower but no less important: helping policymakers understand how to fix our current system. “In a space where the existing programs haven’t been maximized and, in many cases, have created an administrative infrastructure that is at best clunky – and in some cases is adversarial to the people that they serve,” shared Executive Director Tim Engelhardt, “we are aiming to improve the functioning of current programs and make them more accessible.” The Aging and Disability Health Policy Lab is providing a series of ready‑to‑use model policies that state and federal policymakers can use to improve how our HCBS system works. 

The crisis isn’t over. But these three initiatives are a sign that the field isn’t waiting for it to end before doing the hard work of envisioning what comes next. When the policy window opens, the ideas will be ready.

Allison Cook is founder of Better Aging and Policy Consulting.