Why Elder Care Is the Missing Piece in US Trade Policy

In a recent editorial in the Wall Street Journal, Jamieson Greer, the U.S. trade representative, made a compelling case for American trade independence. His critique of the World Trade Organization’s dysfunction is valid, and his vision for “diversifying and securing supply chains” is strategically sound.

But there’s a critical piece missing from the conversation: America’s 77 million seniors.

The Hidden Cost of Trade Policy

As the federal administration pursues reciprocal trade agreements and tariff-based negotiations, one sector remains uniquely vulnerable: elder care.

Consider the facts:

• Ninety percent of durable medical equipment (DME) components are imported, primarily from China
• Medicare pays fixed reimbursement rates that cannot absorb tariff-driven cost increases
• Forty-two percent of DME suppliers have closed since 2013 due to reimbursement pressures
• Seniors live on fixed incomes — Social Security adjustments lag behind the cost inflation of elder care

Trade Policy Drives Elder Care Affordability

Greer is right that America must chart its own course. But that course must account for our most vulnerable population.
The American Association for Elder Care’s (AAEC’s) Elder Care Cost Index shows that elder care costs have risen 104% over the past 20 years—outpacing Social Security adjustments by nearly 40 percentage points. Trade policy is now a primary driver of this gap.

The administration’s supply chain security goals are correct. But security without affordability is incomplete. What good is a secure supply chain if seniors can’t afford the products it delivers?

A Solution: Age-Friendly Certification as Quality Assurance

AAEC has proposed a framework that supports both the White House’s trade objectives and elder care affordability: Age-Friendly Certification (AFC), a standards-based system that certifies products for senior usability and safety. AFC-certified products—whether domestic or imported—meet rigorous age-friendly criteria: easy-to-read instructions, easy-to-open packaging, easy-to-use interfaces and safety features designed for aging users.

It’s a policy opportunity because AFC-certified products demonstrate quality standards that protect American seniors. They should be considered for tariff relief.

This approach:

• Supports supply chain security by certifying quality regardless of origin
• Protects American seniors by ensuring products meet age-friendly standards
• Creates market incentives for manufacturers to invest in quality to qualify for relief
• Aligns with administration goals using standards, not blanket exemptions

The Bottom Line

Greer writes that the U.S. is “driving reform on trade globally.” We agree. But reform must include the 77 million Americans who depend on affordable elder care.

Trade policy decisions made in Washington directly affect the grandmother in Ohio who needs a new wheelchair, the veteran in Arizona who relies on oxygen equipment and the caregiver in Michigan who struggles to afford supplies.

Elder care is the missing piece. It’s time to add it to the conversation.