Vice President Kamala Harris is propose an expansion of Medicare to cover the costs of home help for many elderly people, a direct pitch to “sandwich generation“adults caring for aging parents in addition to their own children.
The plan, called “Medicare at Home,” focuses on Medicare coverage the costs of home care services and nurses to enable families to avoid nursing home costs. Harris links it to a plan she has already announced that would expand the child care tax credit up to $3,600 and $6,000 for parents of newborns.
Harris revealed the plan in an interview Tuesday on the talk show “The View,” where she spoke about his own experience taking care of his mother when she had cancer.
She emphasized that her plan would be an expansion of Medicare rather than Medicaid. This would allow it to coexist with private insurance. Medicaid also has some stricter eligibility rules.
According to census data, about a quarter of American adults are part of the sandwich generation of those caring for children and aging parents. A Harris campaign official says its internal data shows that this caregiver demographic has a significant number of undecided voters.
“In such a close election, proposals that speak to the financial security and health care needs of older Americans will resonate and can make a difference,” said Rich Fiesta, executive director of the Alliance for Retired Americans, who runs an anti-election PAC. -Trump ads.
A September AARP poll showed that 78% of women over 50 who care for older family members report having financial difficulties. Another AARP poll in Pennsylvania, a crucial battleground state, showed former President Donald Trump with an edge among voters 50 and older: 53% for Trump and 44% for Harris.
Except for the poorest seniors, for whom Medicaid can foot the bill, most seniors must rely on their own savings or family members for home care when they can no longer support themselves. all their daily needs but are not ready to move. a long-term care facility.
“We are now encountering more and more families who want Medicaid and who are not considered lowest income, but for whom providing and paying for long-term care makes them low income,” he said. said Kevin Prindiville, executive director of the Justice in Aging group.
Democrats have accused Trump of supporting Medicare cuts during his tenure in the White House, an accusation the Republican candidate has denied.
While he floated the idea in a March interview with CNBC, saying, “There’s a lot you can do in terms of cutting rights,” he later suggested those cuts would affect “rights theft and mismanagement.” “.
He has since said he would not “cut a dime” from Social Security or Medicare, and the Republican Party platform has similar language.
How much would “Medicare at Home” cost?
Adding Medicare coverage for home care could start at $40 billion a year, according to an estimate from a Brookings Institution study cited by the campaign.
However, the study authors caution that their figure is only a starting point for a “very conservatively designed universal program.” The final price could be considerably higher, depending on the generosity of Congress.
“That’s not to say that this is the program we should adopt, just that you could make it work for dollars that aren’t crazy,” said Jonathan Gruber, chair of the University’s economics department. Massachusetts Institute of Technology and co-author of the estimate. .
Gruber said the modeling also didn’t take into account the significant savings the benefits could generate in the form of ripple effects, like less money. spent on retirement homes or family members who could return to work full time.
“We think we’re going to potentially free up millions of informal workers in the health care sector to earn income in the labor market. And they’re going to pay taxes,” he said.
How would Harris pay for home health insurance?
Harris said its expansion would be financed primarily by the expansion of the Medicare Drug Price Negotiation Programcombined with a list of other reforms, like increasing the discounts drugmakers would have to offer on brand-name prescriptions.
This is not the first time Harris has committed to expanding the Policies of the Inflation Reduction Act targeting prescription drug prices. Medicare is currently on track to save just $31 billion each year through the bargaining program and other drug pricing provisions, which wouldn’t even be enough to cover the starting price of its proposal.
Harris called on Congress to expand the drug bargaining program, accelerating the pace of new price caps set by Medicare and subjecting more drugs to the limits. More aggressive negotiations on drug prices could save hundreds of billions over the next decade, according to a Stanford University white paper cited by the campaign, assuming it is able to survive an uphill battle on Capitol Hill.
Marc Cohen is co-director of a center focused on long-term services and support supported by LeadingAge, the association of nonprofit providers of services to older adults. LeadingAge has been calling for years to add home care to Medicare as a solution to the “dangerously broken” system.
“At some point we’re going to have to talk about a source, like Medicare itself, to pay for that. But I think it’s a very smart idea right now to move things forward. And then what you do , it’s developing a base of political support, even for the younger generation to say, ‘I want this to be available to my parents,'” said Cohen, a professor of gerontology at the University of Massachusetts Boston.
Who would be covered by Harris’ “Medicare at Home” proposal?
All Medicare enrollees deemed “unable to independently perform activities of daily living such as bathing, eating and using the toilet” would be eligible after being examined by doctors or nurses, according to the campaign proposal . People suffering from “severe cognitive impairments” would also be covered.
Not everyone would be covered by Medicare. Seniors with higher incomes are expected to pay more of the cost out of their own pockets.
The details of this coverage are an important factor that could also impact the cost of the plan, affecting the number of Americans who end up taking advantage of the benefit offered.
Only “Medicare designated” home health aides would be covered under the proposal, which would include “any qualified person home health aidespersonal care attendants or direct care workers recognized by their state.
The campaign did not address whether family members could be paid cash to care for an elderly relative, as a previous bill from House Democrats had proposed.
Prindiville said that’s among the things they’re hoping for in the details of the proposal, as lawmakers try to “strike the right balance” to make home care more affordable.
“When families want to provide this care, let’s pay for it so it makes economic sense,” Prindiville said.
