Vice President Kamala Harris on Tuesday announced a new proposal that would require Medicare to cover costs associated with home long-term care, potentially allowing seniors and people with disabilities to receive care at home instead of in skilled nursing facilities. It was announced that there is a sex.
The proposal could have broad appeal among middle-income Americans who don't qualify for Medicaid. But if passed, it would likely have only a gradual impact on skilled nursing care, experts told Skilled Nursing News.
“Even with this benefit, it is unlikely that many older people (in skilled facilities) will be able to live sustainably in their own homes. There will certainly be a need for nursing homes. , the impact of this will be even more modest,” said Fred Bentley, managing director of ATI Advisory's post-acute, long-term care and senior living practice. “Even with this type of benefit, there are still going to be many older adults who have such great ADL needs that they just aren’t enough.”
Of course, Ms. Harris' home care proposal would require Congressional approval, which is difficult to predict, but judging by the fate of the Biden administration's less strong proposals in this area, Ms. Harris' plan Bentley said it could be a hard sell.
However, if the new proposal were implemented, “beneficiaries could imagine living independently for a much longer period of time and not having to spend money to qualify for Medicaid,” Bentley said. he said.
Medicare typically does not cover long-term care services in your home. Instead, Medicaid serves as the main source of public assistance for this type of care, but families must demonstrate very low income to qualify. Additionally, coverage and eligibility requirements can vary widely from state to state. As a result, many middle-income households face overwhelming financial burdens when caring for elderly relatives.
Analysts have suggested that Harris' proposal may resonate with voters, especially certain groups.
“It's tapping into the sentiment and desire of many people to have a more robust home health program and have it covered by Medicare,” Bentelly said. “It will resonate with the demographic that the Harris campaign is very interested in: women of the sandwich generation.”
As for the proposal, Bentley said there would be a cost-sharing component based on a sliding scale related to income, which would be a new area of Medicare coverage.
“Copays and coinsurance will vary based on income level,” she said, adding that many details still need to be worked out, but it could be beneficial for middle-income women. “But on the surface, many people in that demographic will feel some sense of relief.”
KFF analysis shows that nursing home stays are necessary but can be costly, second only to 24/7 home health care assistance and nearly twice as expensive as nursing home stays. .
However, the costs associated with 24/7 home care are staggering. KFF estimates that hiring a professional live-in home health aide for 24/7 care can cost more than $288,000 per year.
And Harris' proposal could cost about $40 billion a year, a CNBC News article noted, which would come from government savings earned through negotiations with drug companies to lower drug prices. .
Currently, more than 37 million people in the United States, or approximately 14% of the adult population, provide unpaid care to older adults, according to a report from the U.S. Bureau of Labor Statistics. The majority of these caregivers (approximately 59%) are women, who often have to balance caregiving responsibilities with work and other family obligations. Mr Harris highlighted the immense challenges faced by these carers, particularly those supporting both elderly parents and their children.
“It's almost impossible to do everything, especially if (caregivers) are working,” Harris said on ABC's “The View.” “We are finding that so many people are being forced to quit their jobs, which means losing their source of income, not to mention the emotional stress.”
Bentley said it's unclear whether the proposal would allow families to be compensated for the care of a loved one, similar to how some states allow Medicaid reimbursement for care.
Staffing issues can derail success
Long-term care advocacy groups applauded Harris' home care proposal, but noted that for any such proposal to be successful, staffing shortages facing all sectors of long-term care, including home health care, must be addressed. did.
“Adding home care to the Medicare program, a much-needed component of broader long-term care funding reform efforts, will help millions of seniors and their families improve their quality of life as they age in their homes. “It will provide access to services that promote safety,” said Katie Smith Sloan, president and CEO of Leading Age, a nonprofit organization that provides aging services. said in a statement: “At the same time, it is no exaggeration to say that we cannot provide care without staff. Continued focus and investment in our workforce, as set out in our proposals, remains essential.”
KFF experts say it's been decades since a major proposal of its kind was introduced to help middle-income families struggling with rising home health care costs.
Smith-Sloan also emphasized the need for new ideas to address the long-term care crisis.
“It's rare that a presidential platform includes such specific proposals,” she said. “Our nation's population is aging and the demand for long-term care and services is increasing.Nonprofit organizations that provide aging services believe that the current patchwork approach to providing and financing long-term care is We've been warning for years that we're broke. Too many people struggle to get the help they need as they age.”
And one of the goals of the new proposal is to provide savings to everyone, Harris said.
“We're not going to pay these high costs, so we're going to save Medicare money,” Harris said, calling the proposal a compassionate effort and a fiscally responsible measure. Ta.
Drawing from her own experience, Harris spoke about the challenges of caring for her mother, who was battling cancer until her death in 2009.
The significance of this plan is not only to reduce the burden on caregivers. According to AARP research, more than two-thirds of adults age 50 and older want to stay at home for as long as possible.
