Harris proposes Medicare at-home long-term care benefit in bid for caregiving voters

Vice President Kamala Harris announced a campaign promise on Tuesday to expand Medicare to cover the cost of long-term care at home, a major addition to the entitlement program for seniors and their families aimed at swaying voters in the 2024 elections .

If Harris’s proposed legislation were enacted, it would give the option of staying home instead of entering a nursing facility to millions of seniors and people with disabilities. It could also mean new economic opportunities for more than 40% of people, or more than 105 million, providing unpaid care to relatives who need assistance with activities of daily living.

The expanded program, though, would be a major new cost for the federal government. Democrats have enacted a long-term care entitlement only to see it become unworkable and eventually repealed .

“It is a personal experience for me as well as something I care deeply about,” Harris said in an appearance on The View, sharing her experience of caring for her mother before she died from cancer.

Harris used her appearance on The View, the top-rated daytime talk show, on Tuesday to announce her proposal in an appeal to the roughly one-quarter of people who both raise children and care for an aging parent, what Harris called the “sandwich generation.”

“There are so many people in our country who are right in the middle. They take care of their kids and they’re caring for their aging parents, and it's just almost impossible to do it all,” Harris said.

Medicare covers at-home skilled nursing care and only covers home health aides and other types of assistance under specific circumstances.

Medicaid, the largest payer of long-term care services, covers millions of low-income people or those with little savings. In practice, this means that families cannot qualify for coverage until they “spend down” their savings.

The at-home health benefits under Medicaid are also state-specific, meaning that eligibility, benefits, management, and reimbursement for long-term care services can vary depending on location.

A similar program to what Harris is introducing was originally baked into Obamacare in 2010, called the Community Living Assistance Services and Supports Plan, or CLASS Plan, a voluntary insurance program administered by the Department of Health and Human Services.

The program, however, needed to be self-sustaining through premium payments, which analysts quickly calculated would be too expensive for most buyers, making the program fiscally unsound. The Obama administration abandoned the program when it was repealed in the 2012 fiscal cliff bill.

The policy proposal is the latest of Harris’s campaign promises targeted at caregiving voters. The vice president also announced a plan in August to expand the pandemic-era child tax credit and establish a $6,000 tax credit for parents of newborns.

The campaign did not provide reporters with estimates for the cost of the program prior to its announcement, but the center-left Brookings Institution published a paper this week projecting that such a program could cost as much as $40 billion per year.

Harris said on The View that the long-term health program will be funded by expanding the ability of Medicare to negotiate prescription drug companies directly with pharmaceutical companies.

“What I was intending to do was allow Medicare to continue to negotiate drug prices, which means we are going to save Medicare money because we’re not going to pay these high prices,” Harris said.

In August, Harris proposed expanding the Medicare drug price negotiation program and expediting the speed at which the Center for Medicare and Medicaid Services can select drugs and set the maximum "fair" price. Implementing this would take an act of Congress to change the Inflation Reduction Act, the 2022 legislation passed by Democrats and signed by President Joe Biden.

The Congressional Budget Office projected that the current drug price negotiation policy is slated to save Medicare approximately $100 billion by 2031.

The Harris campaign did not respond to the Washington Examiner’s inquiry about the cost or exact design of the program.

Michael Cannon, director of health policy studies at the libertarian Cato Institute, criticized using the revamped Medicare system to fund the at-home health benefit.

“Once again, the Democrats acknowledge that federal healthcare entitlements are so wildly inefficient, running them efficiently would squeeze out so much savings that one could fund an entirely new entitlement,” Cannon wrote on X.

Harris and former President Donald Trump vying for the votes of seniors.

In response to Harris's announcement, the Trump campaign issued a statement outlining how the former president this summer outlined a plan to revitalize senior care, including implementing a home care benefit and rolling back changes to nursing home staff requirements implemented by the Biden administration.

“President Trump will prioritize home care benefits by shifting resources back to at-home senior care, overturning disincentives that lead to care worker shortages, and supporting unpaid family caregivers through tax credits and reduced red tape,” Trump campaign officials said.

Trump has also promised to eliminate all taxes on seniors’ Social Security benefits.

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Harris tried to humanize the complicated policy issue during her TV announcement, saying that home healthcare is “really about giving folks dignity."

“Taking care of a parent, you know, means trying to cook what they want to eat, what they can eat. It means picking out clothes that are soft enough that it doesn’t irritate their skin,” Harris said. “It means trying to think of something funny to make them laugh or smile.”