Vice President Kamala Harris, the Democratic presidential nominee, has announced a major policy proposal to expand Medicare to include long-term, at-home care services.
The proposal marks a notable shift for the public health insurance program, traditionally limited to older Americans.
Harris announced the proposal on ABC’s “The View,” a popular daytime talk show, emphasizing the program’s potential impact on the “sandwich generation” — the more than 105 million Americans providing care for children and aging parents. The proposed program aims to relieve the burden on families relying on Medicaid, which covers the largest portion of the nation’s long-term care services.
“Taking care of a parent means picking out clothes that are soft enough, making meals that are easy for them to eat, and finding ways to bring a smile to their face,” Harris said, highlighting caregivers’ emotional and practical challenges. “We’re talking about declining skills, but their dignity, their pride, has not declined.”
If approved, the initiative would significantly broaden Medicare’s scope. Currently, Medicare only covers at-home care under limited circumstances, typically following a hospital stay. According to the Congressional Budget Office (CBO), Medicaid spent $207 billion on long-term care services in 2021, covering everything from nursing homes to home health aides, as Harris emphasized.
Harris explained that the expansion would be funded through enhanced Medicare prescription drug negotiations and payment limitations to pharmacy benefit managers. Medicare’s recent negotiation efforts with drug manufacturers are expected to save the government approximately $98.5 billion over the next decade. While the vice president did not specify the program’s total cost, her campaign noted that at-home care is generally about $3,000 cheaper monthly than nursing home care.
The proposal also addresses the Medicaid “spend down” requirement, which can force families to exhaust personal assets before qualifying for Medicaid assistance. This aspect of the plan resonates with many in the sandwich generation, who often find themselves in difficult financial positions while trying to care for loved ones.
Reflecting on her own experience caring for her late mother, Shyamala Gopalan Harris, who died in 2009, the vice president and Democratic presidential nominee spoke about the program’s importance for preserving independence and dignity.
“It’s about dignity for that individual. It’s about independence for that individual,” she said.