Can Harris’ proposed ‘at-home Medicare’ put an end to the feared ‘spending reduction’ of senior assets?

A new “home Medicare” proposal from Democratic presidential candidate Kamala Harris could ease the burden of elder care costs for many families, experts say.

However, Republicans have already criticized the proposal as too expensive, a reminder of the political difficulties of pushing through health care expansions in the US.

For most families, paying out of pocket for a home health aide is well out of reach. The average cost of a home care aide, someone who helps the elderly and disabled with basic tasks such as cooking and bathing, is $33 per hour or $6,292 per month, according to the financial company. Genworth. The average retirement income of an American is $4,191. Nearly 6 million Americans over the age of 65 live less than 65 years $1,170 per month.

That means many families rely on Medicaid, the public health insurance for low-income people and families, which often requires a painful “spend” of a senior’s resources below the federal poverty level.

“There’s a misunderstanding about what Medicare will cover today,” said Amber Christ, health care director at Justice in Aging. “People don’t want to think about” the specifics of aging, she said, adding that elder care programs “are terribly complicated health care programs.”

Often, Medicaid steps into the void. The public health insurance program covers low-income Americans more than half (61%) of all long-term support services nationally, according to the Kaiser Family Foundation (KFF). However, because the program has strict income limits, seniors in some states are forced to “spend” their money up to the poverty level to qualify.

To use swing state eligibility criteria as an example, seniors and disabled people in Pennsylvania can qualify for Medicaid long-term care benefits if they are “medically needy.”

To be medically needy, a person must earn an income of no more than $425 per month for expenses beyond health care – including housing, food, utilities, transportation and clothing. An individual can have other assets of not more than $2,400.

“Either you go to a nursing facility, or you forego care, or else people provide that care without payment,” Christ said. “That’s why our system drives people into institutions, resulting in worse health outcomes and impoverishing entire generations of people.”

Even as spending has fallen, there are now about 700,000 people on waiting lists for home care, KFF reports.

Harris’ pitch is intended to be especially salient to a quarter of Americans — especially women – “sandwiched” between an aging parent, a child under 18, or an adult child they helped financially in the past year, according to the Pew Research Center.

Bertha Motta, 64, remembers when she was a member of the “sandwich generation” — caring for elderly parents and young children in a single New York City home in the late 1990s.

Without help, Motta worked less to provide care: entertaining, cooking and cleaning for the little ones and older loved ones. Her work as a home health aide at 1199 SEIU was limited.

“During those years I couldn’t go to work from Monday to Friday,” says Motta, originally from Peru. “I worked on weekends, so I stayed home and took care of my parents and my kids at the same time.”

Although Motta’s parents needed her care, they were relatively independent, she said. In her work as a healthcare professional, she has seen far greater humiliations. She remembers a disabled and immobilized woman she had to leave after just six hours of daily care.

“Six hours wasn’t enough for her, believe me,” Motta said.

Every day the woman lay in bed in diapers.

“Imagine how we find her because she needs to go to the toilet but she can’t move – she just had to stay there in her bed with the diapers,” Motta said.

Medicare covers many people with disabilities and almost all Americans over age 65. Harris’s campaign said the program would help Americans pay health care workers like Motta to assist with daily tasks such as cooking, eating and bathing who might otherwise live independently in their homes. Harris’ campaign has proposed a sliding scale for costs for families. Because Medicare has no income limits, it could ease the burden of spending.

“We’re talking about declining skills” of older people, Harris said, announcing her plan on ABC’s talk show The View — “but their dignity, their pride, has not diminished,” she added.

Her campaign has said seniors would be independently assessed for eligibility by doctors and that most program participants would only need about 20 hours of care per week.

A independent report According to KFF estimates, 14.7 million people would likely be eligible. The Brookings Institute has roughly estimated the costs $40 billion a yearwhich the Harris campaign said would be paid for through extensive drug price negotiations in Medicare. Republicans have criticized this as too expensive.

“It is difficult to overstate the irresponsibility, corruption and insanity of this proposal,” Michael F. Cannon, head of health care policy studies at the conservative Cato Institute, wrote in a blog post shortly after Harris announced the proposal. He criticized the proposal to increase the federal deficit.

A recent report of the nonpartisan Committee for a Responsible Federal Budget concluded that Harris’ campaign proposals would add $3.5 trillion to the federal deficit, while proposals from former President Trump would add $7.5 trillion. Trump has also floated the idea “elderly care at home”but has put forward fewer details.

Harris’ proposal would also eliminate a worst-case scenario for families: a government policy called “asset recovery.” In some situations, an older person may qualify for Medicaid benefits while excluding assets such as a primary residence, often the family home.

But after a death, the federal government can require states to review their assets and try to recover the costs of care from families. A bill for tens and even hundreds of thousands of dollars could do that arrive unexpectedly by post, and often shortly after the death of a loved one. Democratic Rep. Jan Schakowsky of Illinois has been campaigning against the practice for years.

“Let me say that, starting with the recovery of the Medicaid estates, the people I tell about it – including colleagues of mine, members of Congress – are shocked to discover that Medicaid is currently the only program that states are actually obliged to chase money. when someone dies,” Schakowsky said. One of Schakowsky’s constituents is now fighting an estate claim for approximately $77,000.

State governments “are going after the only real asset that many people have, which is their home,” Schakowsky said. “It’s just incredible.”

If passed, Harris’ pitch would mark the first major expansion of health benefits since Obama’s Affordable Care Act. Harris has also proposed expanding vision and hearing benefits through Medicare, a wildly popular proposal.

Motta is hopeful that clients, their loved ones and workers like herself could benefit from the “Medicare at home” proposal.

“I feel so happy because I thought this was happening to me,” she said. “It must be great, really great, not only for them,” say her clients, “but also for us, the home care workers.”