A new study in Health Affairs paints a bleak picture for the future of middle-income seniors. Fifty-two percent of U.S. seniors who will be 75-years-old and older in the next 10 years will be unlikely to qualify for Medicaid long-term care but won’t have the financial means to cover the costs for assisting living rent and out-of-pocked medical costs. Researchers refer to this growing population as “the forgotten middle.”

The study, led by Caroline F. Pearson, senior vice president at NORC at the University of Chicago in Illinois, said that assisted living and independent living communities are out of financial reach for many middle-income seniors. The study authors projected that by 2029, 60 percent of the country’s 14.4 million seniors will have mobility limitations that may prevent them from living independently. In addition, 20 percent will have high health care and functional needs. Many will need the care offered in senior housing, but more than half of them will not have enough financial resources to pay for it.

A federal housing policy that raises eligibility limits for low-income tax credits and other programs to include more middle-income seniors would address this problem, the research team said. Housing communities that have the capacity could also establish their own Medicare Advantage plans that offer onsite medical services from employed physicians.

Researchers also suggested that lawmakers consider expanding supplementary benefits that cover nonmedical services under Medicare Advantage to fee-for-service Medicare. They also could consider a new benefit that pays for long-term care.

“Any policy solution should recognize the full range of services that seniors may need as they age,” said the study authors, noting that failure to provide in-home supportive services may lead to a premature loss of function and avoidable hospitalizations. However, remaining at home may not provide the best outcomes as social isolation and loneliness leads to real and costly declines in health status.