Harris announces plan for Medicare to cover long-term care at home

The Democratic presidential nominee, Vice President Kamala Harris, recently introduced a pivotal policy proposal aimed at significantly improving long-term, at-home care services for Americans aged 65 and older through Medicare, the nation’s public health insurance program for seniors.

In a recent interview on the popular ABC daytime talk show, The View, Harris stressed that the implementation of this plan would represent a major expansion of Medicare, which currently only provides limited coverage for at-home care.

“Taking care of a parent goes far beyond just meeting their medical needs,” Harris remarked. “It involves preparing meals they enjoy and can eat, selecting clothing that feels comfortable against their skin, and finding ways to bring joy into their lives—whether that’s through a laugh or a smile.”

She added, “While the skills of older individuals may decline, their dignity and pride certainly do not.”

This announcement is in harmony with the Harris campaign’s emphasis on the “sandwich generation,” a demographic representing over 105 million Americans who are balancing the dual responsibilities of caring for both their parents and children.

At present, Medicare primarily covers at-home care in “post-acute” circumstances, such as during recovery from surgery. Conversely, Medicaid—designed for low-income and disabled individuals—serves as the largest provider of what the government categorizes as “long-term support services.” This program accounted for a staggering $207 billion in spending for such services in 2021, representing about 44% of total national spending in this area, according to the Congressional Budget Office (CBO).

To finance the proposed at-home care services, Harris suggested that the plan would utilize savings from expanded Medicare prescription drug negotiations and by placing limits on payments to pharmacy benefit managers, who act as intermediaries in the U.S. drug supply chain. This year, Medicare completed its initial negotiations with drug manufacturers, and the CBO anticipates that these negotiations could save the government an estimated $98.5 billion over the next decade. However, Harris did not provide specific figures regarding the projected costs of her proposed at-home care support program, although her campaign indicated that home care is approximately $3,000 less per month than nursing home care.

A key aspect of the proposal is its aim to address a challenge many in the sandwich generation can relate to—the Medicaid “spend down.” Families often face the difficult reality of having to deplete their loved ones’ assets on healthcare before Medicaid begins to assist with expenses.

It’s important to highlight that individuals receiving long-term support services are among the most expensive beneficiaries for the government. Though they represent only 6% of all Medicaid enrollees, they account for a significant 34% of total federal and state Medicaid expenditures, as noted by an analysis from the Kaiser Family Foundation.