Vice President Kamala Harris is proposing a major expansion of Medicare designed to help families care for aging or disabled relatives at home.
The Democratic presidential nominee laid out her plan during an appearance on ABC News' "The View" on Tuesday, pitching the policy to the "sandwich generation" of families who are raising children and caring for aging or ailing parents at the same time. The Harris campaign offered a preview of the announcement to select news outlets Monday.
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"There are so many people in our country who are right in the middle," Harris said. "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."
According to a brief summary the campaign distributed Tuesday, Medicare would cover home health aide visits and other services to enable older people to stay in their homes rather than move into skilled nursing facilities.
Medicare coverage of home health is limited and the program does not pay for long-term nursing home stays. Medicaid only covers these services for people with very low incomes and meager assets.
"This is about Medicare, because otherwise people have to spend down everything they've got to only be able to eligible for the care they need as a Medicaid recipient, which means they have to spend down everything," Harris said. "They're going broke in order to qualify for Medicaid," she said.
"We're talking about these kinds of things where it's just about helping an aging parent or person prepare a meal, you know, put their sweater on," Harris said. "It's about dignity for that individual. It's about independence for that individual." As she has in the past, Harris highlighted her experiences looking after her mother, Shyamala Gopalan, who died from cancer in 2009.
Unpaid family caregivers are a growing part of the population and the healthcare landscape, and women — whom the Harris campaign sees as potential supporters in her race against former President Donald Trump, the Republican nominee — carry a disproportionate share of the burden.
"They want to stay in their home. They don't want to go somewhere else. Plus, for the family to send them to a residential care facility to hire somebody is so expensive," Harris said. Allowing older people to stay at home as they age instead of moving to nursing homes could save families about $3,000 a month, according to her campaign.
Harris seeks to solve the fiscal challenges of adding a new Medicare benefit by tapping the budget savings emerging from her separate proposal to expand Medicare drug price negotiations to include more prescription medicines and by tightening regulations on pharmacy benefit managers.
Partnership for Quality Home Healthcare CEO Joanne Cunningham hailed the proposal as ;"very, very good news" but said crucial details need to be fleshed out.
"There's a lot of important policy questions that would dictate the parameters, the structure, who's eligible, what the cost is," said Cunningham, whose organization represents long-term care providers such as Humana division CenterWell Home Health, Bayada Home Health Care and the LHC Group.
"It sounds like it's anchored to activities of daily living. So toileting, transferring, eating — those kind of things. Those are often kind of the triggers to determine someone's eligibility for other kinds of long-term care," Cunningham said.
One critical challenge that would have to be resolved is the home health workforce shortage, Cunningham said. "We know there's a sizable population of Medicare beneficiaries right now that can't receive care because agencies do not have the workforce, and they can't support that workforce because of a declining reimbursement model," she said.
