During an appearance on ABC’s “The View” Tuesday, Vice President Kamala Harris announced a new Medicare home-based care proposal.
The proposal focuses on helping the “sandwich generation,” or adults who are caring for their aging parents while also raising children.
“There are so many people in our country who are right in the middle,” Harris said during her appearance on the show. “They’re taking care of their kids and they’re taking care of their aging parents, and it’s just almost impossible to do it all, especially if they work. We’re finding that so many are then having to leave their job, which means losing a source of income, not to mention the emotional stress.”
About 53 million adults in the U.S. care for a spouse, elderly parent or relative, or a child with special needs. This is an increase from 43.5 million in 2015, according data from a 2023 Guardian Life report.
Broadly, Harris is proposing to allow Medicare to cover home care, which is a proposal that has been raised by industry stakeholders regularly in the past. Currently, Medicare covers home health care – generally delivered after an acute event – but not home care, which is generally a non-medical service.
“They want to stay in their home,” Harris. “They don’t want to go somewhere else. Plus, for the family to send them to a residential care facility, to hire somebody, that is so expensive.”
Katie Smith Sloan, president and CEO of LeadingAge, pointed out that the demand for senior care continues to grow.
“Our country’s population is aging – and the demand for long-term care and services is growing,” she said in a statement. “Nonprofit providers of aging services have long warned that our current patchwork approach to long-term care delivery and financing is broken. Too many people struggle to access the help that’s needed as we age. Today’s announcement is truly exciting, and unique. Rarely do we see a proposal with this level of specificity included in a Presidential platform. Adding home care to the Medicare program, a much-needed component of a broader long-term care financing reform effort, will offer millions of older adults and families access to services that promote quality of life and safety as people age at home. At the same time, we cannot overstate that without staff, there is no care. Continued attention and investment in the workforce, as noted in the proposal, remains essential.”
Currently, Medicaid is available for low-income seniors that need access to home- and community-based care services (HCBS).
However, long waiting lists have been a persistent issue that limits access to these care services. More recently, MACPAC examined the use of presumptive eligibility and expedited eligibility as a way to speed up the process.
Then again, a small portion of seniors in the U.S. are covered by Medicaid.
Harris explained the reason behind the focus on Medicare for these latest efforts.
“This is about Medicare, because otherwise people have to spend down everything they’ve got to be eligible for the care they need as a Medicaid recipient,” she said.
She also noted that her proposal was about helping individuals get ahead, and not just get by.
Joanne Cunningham, the CEO of the Partnership for Quality Home Healthcare, called the development “important and welcome” news.
“It shows a tremendous understanding of what … the sandwich generation’s needs are, and the needs that many older people have in order to live independently in their homes,” she told Home Health Care News. “I would also want to remind the Biden, Harris administration that the existing Medicare home health program is under assault currently, and has been since 2020, with billions of dollars in cuts that have diminished access to care, so I think that investment and a stabilization of the existing Medicare home health benefit is something that is also needed. With this news, I would just offer that recommendation and reminder.”
The National Alliance for Care at Home also applauded Harris for pushing care at home into the spotlight.
“By raising the topic of expanding care at home in such a visible way, in high profile way, this is another acknowledgment that American families really are hoping for stronger access to care at home, that people want to age in place with dignity and independence,” Dr. Steve Landers, CEO of the National Alliance for Care at Home, told HHCN.
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