Harris, 59, announced her plan during her media blitz on Tuesday, saying: “It’s just about helping an aging parent or person — you know — prepare a meal, put their sweater on” while relieving Americans of the cost of transferring loved ones to a residential care facility.
The “Medicare at Home” initiative would pay for health aides to assist seniors who “are unable to independently perform activities of daily living like bathing, eating, and going to the bathroom and/or face serious cognitive impairment,” according to a Harris campaign press release.
While the Harris team cites a Brookings Institution white paper that estimates the program cost at $40 billion, the proposal’s details are scant about how it “will be fully paid for” by negotiating lower prescription drug prices, cracking down on pharmaceutical benefit managers, “addressing Medicare fraud” and implementing “international tax reform.”
The Democratic presidential nominee is also promising the benefit will extend to “all of our nation’s seniors and those with disabilities on Medicare,” which currently serves at least 67 million Americans.
But Mark Warshawsky, a senior fellow at the American Enterprise Institute (AEI) focused on long-term care issues, told the Post the plan “will be very expensive for the taxpayer” and a “much larger” price tag than the Democratic campaign is estimating to expand in-home care, which currently costs $130 billion nationwide.
“My view [of the plan] is largely negative because these costs are currently covered by a range of both private and public spending already,” Warshawsky said. “And then for those that can’t, Medicaid covers these expenses.”
“There are a lot of loopholes that enable people who have significant assets to become eligible for coverage through Medicaid — the value of their home is often excluded, their 401k assets depending on the state are often excluded,” he went on. “Medicaid pretty much covers almost half of long term care costs in the country already.”
“If anything, we need to be reining in some of these Medicaid costs on long-term care because we have a gigantic deficit and we have a gigantic government debt,” Warshawsky added.
“It is difficult to overstate the irresponsibility, corruption, and insanity of this proposal,” wrote libertarian Cato Institute health policy studies director Michael Cannon in a Tuesday blog post.
“With one hand [Harris] proposes to increase Medicare long-term-care spending by $40 billion,” Cannon explained: “With the other hand, she proposes to cut $40 billion of Medicare drug spending—all without denying benefits to anyone.”
The Cato scholar went further and accused Harris of engaging in “a corrupt attempt to buy the votes of Medicare enrollees and their middle-aged children in an election year.”
Warshawsky also said the expanded benefit would rely “largely” on immigrants as in-home health aides — likely forcing the government “to increase immigration to accommodate that expansion in that demand.”
“That $40 billion estimate — that’s very disingenuous because that $40 billion estimate comes from Brookings and they have a very limited program, a very tightly defined program in terms of who’s eligible,” Warshawsky concluded. “It definitely will increase.”
Warshawsky also said the expanded benefit would rely “largely” on immigrants as in-home health aides — likely forcing the government “to increase immigration to accommodate that expansion in that demand.”
The AEI fellow also said it was “very misleading” for the campaign to claim the government would “save money by providing home care as opposed to nursing home care.”
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Even when considering “a sliding scale” suggested by the Harris campaign to provide more coverage “for those of modest incomes” and “cost-sharing for seniors with higher incomes,” an AARP report found family members of seniors with health needs were providing an additional $600 billion in unpaid care as of 2021.
That’s before considering the mounting costs of hearing aids, as well as eye and ear exams.