Kamala Harris makes bold Medicare expansion proposal: Home Long-term Care Coverage

via Jonathan Cohn at Huffington Post:

Democratic presidential nominee Kamala Harris on Tuesday proposed a major new initiative: expanding Medicare to cover the cost of long-term care at home.

Such a plan could mean the option of staying at home, rather than in a nursing facility, for the millions of seniors and people with disabilities who need help with the daily tasks of life.

It could also mean physical and financial relief ― and new opportunities for school or work outside the home ― for the millions of working-age Americans who today provide so much of that care on their own without much in the way of outside assistance.

If the proposed legislation is enacted, such a program would represent a substantial boost in federal support for caregiving and, by any measure, one of the largest one-time increases in American history.

Harris made her announcement during an appearance on “The View,” the nation’s top-rated daytime talk show, and presented the initiative as a way to help the “sandwich generation” ― that is, the working adults who have aging parents while still caring for children. Roughly a quarter of the American population falls into that category, according to Pew Research.

This would be absolutely huge, and is one of two major expansions of Medicare coverage which I've been hoping for for a long time (the other one is adding dental/vision/hearing coverage to traditional Medicare, which is one of Bernie Sanders' biggest fave-raves). My stepfather, who lived to be just shy of 100 years old and who was legally blind, required home healthcare workers to assist him for the last few years of his life, and it was quite expensive as you could imagine.

Harris pledged to finance the home care initiative fully, in part by tapping the savings from yet another reform she has proposed: expanding the federal government’s power to negotiate drug prices directly with manufacturers. The federal government acquired that power just two years ago, thanks to Democratic legislation that Harris supported.

Cohn's story goes on to suggest that such a home healthcare expansion policy would likely cost around $40 billion/year, which isn't actually all that much from a federal budget perspective.

...“It’s just about helping an aging parent or person prepare a meal, put their sweater on ― and it’s about dignity for that individual, it’s about independence for that individual,” Harris said.

It's also worth noting that while this would be a game changer, a version of it was supposed to be part of President Biden's "Build Back Better" bill:

,,,in order to secure the necessary votes, Democratic leaders had to jettison the home care proposal in order to satisfy a handful of legislators who thought it and some related proposals required too much new federal spending.

...The previous proposal would have essentially taken the existing Medicaid program and made it bigger. Harris envisions Medicare taking on home care for its beneficiaries, which to many analysts and advocates for the elderly seems like an improvement, in part because Medicare is not limited to those in the most dire economic circumstances.

In any event, such a program is highly unusual in that it would be wildly popular while costing relatively little (again, "little" is carrying a lot of weight here, but it is the federal U.S. budget we're talking about):

...One week ago, the left-leaning public opinion firm Data for Progress released a poll on a hypothetical proposal “to expand Medicare to include coverage for long-term in-home care.”

The support was overwhelming, at 88% overall, and the numbers didn’t even vary much among self-identified Democrats, Republicans and independents.

Yup. MAGA Republicans have elderly parents, too (and many of them are elderly parents).