How a Harris Medicare Plan can make it easier to care for seniors at home

Long-term care for the elderly is a pressing issue facing millions of people in the United States. emotional, physical and financial costs can be extremely difficult for older people who need care and for those who provide it, whether they are professional caregivers or family members. Earlier this month, Vice President Kamala Harris announced an upcoming expansion of government health care benefits that would directly address these issues if she is elected president.

“I took care of my mother when she was sick. She was diagnosed with cancer. And so it’s a personal experience for me and something that I’m very excited about,” Harris said during a recent talk show interview. View. “There are so many people in our country who are right in the middle. They take care of their children, take care of their elderly parents, and it’s almost impossible to do that, especially if they’re working.”

Harris’ new offering, called Medicare home planemphasizes the support of these members in the so-called sandwich generation— people who take care of both young and elderly family members. If passed, home aides who provide daily tasks such as bathing, cooking and using the bathroom would for the first time be covered by Medicare, the federal health insurance program for adults 65 and older. the elderly and some people with disabilities. The proposal also identifies ways to increase wages for healthcare professionals, expand access to remote technology and telemedicine services, and cover hearing and vision needs, including hearing aids and glasses. Based on the eligibility criteria for such proposals, Harris’s plan could potentially help more than that 14.7 million of the 67 million people enrolled in Medicare, as well as countless caregivers, but that depends on the outcome of the upcoming US presidential election and important negotiations between the branches of the federal government.

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“I think anyone who has been through an aging parent situation has a deep understanding of how important it is and how many people fall through the cracks,” says Sara Szanton, a nurse practitioner and dean of the Johns Hopkins School of Nursing who specializes in on in aging. “What Vice President Harris has brought to the fore is a tremendous need that many of us have experienced or are experiencing.”

Research shows that the need for long-term care services and programs will only become more demanding. Demographic studies have shown this population growth is slowing down and family size is getting smaller— people have fewer cousins who are close in age, and more older relatives. This means that people will need to care for elderly loved ones with less family support.

“The world in general is aging, but we’re at a real tipping point,” says Szanton. The US has “10,000 people turning 65 every day right now, that’s 300,000 new people a month, which means a lot more people getting Medicare every month.”

Currently, Medicare pays for home care and rehabilitation services for a limited time after a hospital stay (for treatment related to problems such as a broken hip, cancer treatment, or heart surgery). People with very low incomes can apply for continued home care through the federal Medicaid insurance programs. Some state Medicaid programs offer independent carewhich allows people to hire informal carers, such as friends or family members, who may have to take time off work to care for their loved ones.

But many people start paying out of pocket; one 2024 survey shows that the average cost of home health care for 40 hours per week in the US is $5,892 per month. Some domestic helpers and services require payment for a set minimum number of hours per day, Santon explains. So if someone only needs an hour of help to cook, clean or carry the mail, they may have to pay more for a longer four-hour shift. Sometimes seniors and their families “essentially become impoverished and then end up on Medicaid,” Szanton says.

“There’s nothing for you unless you spend all your savings, stop working and somehow qualify for Medicaid,” says Kerry Graham, a gerontologist and health care analyst at Georgetown University’s Center for Health Insurance Reform. Graham also notes that most family care is left to women; almost any day 24 percent of women aged 55 and older in the USA they provide unpaid family assistance.

“A lot of caregivers are older people themselves,” says Graham. “It takes a lot of loss to be able to take care of your own health.” According to the Center for Disease Control and Prevention poll conducted from 2015 to 2017, 41 percent of caregivers reported having two or more chronic conditions. More than half also said that the deterioration of their own health had affected their ability to provide care.

Covering the cost of home care with a Harris plan can help alleviate some of these burdens. Day-to-day services will not cater for those who need advanced medical care or skilled nursing, but will help seniors who can live independently with some support. “If we can’t support people aging at home, both Medicaid and Medicare costs will go up,” Szanton says.

Szanton points out how much the government spends on just injuries of elderly people from fallsfor example. AND A CDC study published in July found that nonfatal falls among people age 65 and older accounted for $80 billion in health care costs in 2020, with Medicare paying the majority of those costs. “Daily activities like getting dressed, bathing, or going to the bathroom are the most common causes of falls,” says Szanton. “Being able to have more direct workers or aides through Medicare can help prevent some of those falls and some of those costs.”

Harris’ plan isn’t exactly cheap, though. Similar offers cost approx 40 billion dollars a yearbefore any potential savings from lower Medicare costs for hospitalization or institutional care. Harris’ team hopes that the savings from Inflationary Reduction Act Medicare Drug Price Negotiations will help fund the plan. Price negotiations for an initial list of drugs are expected to take effect in 2026, although Harris has pushed for that coverage to be expanded. The Centers for Medicare and Medicaid Services predicts that negotiations on selected medicines would save 6 billion dollars in 2023and Congressional Budget Office estimates $98.5 billion in Medicare savings from price negotiations until 2031.

Under Harris’ proposal, coverage and cost-sharing decisions would be determined on a sliding scale based on income. Graham says more information is needed about exactly what that will look like and who will be eligible for certain services. “When does it start?” she asks. “What is co-payment? Will there be a waiting period? Do you need to check it?” The plan states that assistants will help those with cognitive problems.service gap it desperately needs to be addressed, she says. “We’re seeing a significant increase in people with dementia and cognitive impairment,” says Graham, who herself cares for her father, who has dementia. “What’s proposed in Medicaid often focuses on physical impairments, but it’s very, very important that this proposal addresses cognitive impairments.”

And Szanton says health care providers cover only one section of the broad spectrum of long-term care needs. The program, which she jointly developed, is called CAPABLE (Community Aging in Place—Advancing Better Living for Elders), a nurse, occupational therapist, and handyman spend four to five months with older adults to help with health needs, as well as home modifications and repairs, such as lowering closets, removing hazards trip over or install handrails in the bathroom. The program, which operates in 25 states, has not only helped keep seniors in their communities, but also reduced hospitalizations, nursing home admissions, and total Medicaid and Medicare costs.

“We definitely need what Vice President Harris has proposed,” Szanton says. “I think there are other things that can help as well, where people can become more independent at the same time.”

Harris’ plan has not been fully detailed or finalized and will likely undergo many changes through the legislative process, Graham said. “Whatever is in the proposal right now is going to have to be negotiated, but I think we really need to focus on the fact that this is a bipartisan issue,” Graham says. “Harris is a Democrat, but the people who realize they don’t get any help from Medicare are Republicans and Democrats and many different people. So I think it’s an issue for everybody, and I hope we can continue to (continue) and really work together.”