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HARRIS PROPOSES MEDICARE EXPANSION FOR HOME-BASED LONG-TERM CARE:
“IT’S ABOUT GIVING FOLKS’ DIGNITY”  
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Wendell Potter
October 8, 2024
HEALTH CARE un-covered
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_ Monday on The View, Vice President Kamala Harris’ announced a
proposal to expand Medicare to cover long-term care at home could be
the most meaningful shift in our system in decades. _

Long Term Care in the Comfort of Your Own Home,

 

Today on The View
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Vice President Kamala Harris’ announced a proposal to expand
Medicare to cover long-term care at home could be the most meaningful
shift in our system in decades.

The fact that long-term care isn't already a part of Medicare tells
you how backward our system has been for many years. Right now, if
you’re a senior or someone with a disability who needs help with
daily tasks like bathing or eating, you’re basically on your own.
Medicare doesn’t cover this care unless you need skilled nursing,
which means millions of Americans are forced to turn to Medicaid, a
program for low-income people, or pay out of pocket—often to the
tune of six figures annually. Medicaid’s long-term care benefits
vary wildly by state, with waiting lists and eligibility traps that
force families to "spend down" their life savings before they qualify.

_This isn’t just a health care crisis._ It’s a pocketbook crisis
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millions of families—many of whom are already stretched thin.
Harris’ proposal to expand Medicare to cover home care would lift an
enormous burden off the “sandwich generation,” the people
balancing caring for their aging parents while still raising their
children. These are everyday Americans, caught between skyrocketing
nursing home costs and limited caregiving options, often relying on
unpaid family members to fill the gaps.

I know what this is like firsthand. When my mother could no longer
live on her own after breaking her hip, she ultimately decided she
would have to move into a nursing home. It was not possible for her to
continue living in the home and neighborhood she loved. It was
heartbreaking for all of us.

A Win for Seniors, People with Disabilities and Caregivers

Long-term care is one of the great blind spots in our health care
system. Nearly 20%
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require assistance with daily activities, and that percentage is even
higher among older seniors and people with disabilities, according to
the National Library of Medicine. Without sufficient coverage for home
care, we’ve defaulted to an institutional approach—nursing
homes—which many people would rather avoid.

Harris’ proposal promises a new option: to stay at home and receive
care in a familiar environment. For many seniors and individuals with
disabilities, home-based care not only provides more dignity and
independence but also delivers better health outcomes.

Let’s also not forget the caregivers themselves
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family members sacrificing their own careers, savings and health to
care for their loved ones. This proposal could be a game-changer for
them too, giving them physical relief and financial security. As
Harris has noted
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“There are so many people in our country who are right in the
middle. They're taking care of their kids and they're taking care of
their aging parents, and it's just almost impossible to do it all,
especially if they work.”

A federal investment in home-based care would open new opportunities
for these caregivers to pursue work outside the home and regain some
control over their lives.

The Historical Context: What’s Different This Time

This isn’t the first time we’ve seen a proposal like this. You
might remember that President Joe Biden had a similar idea as part of
his Build Back Better plan, which included a substantial investment
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home care. Unfortunately, that plan was gutted in Congress, leaving
home care on the cutting room floor.

We have also seen many proposals to expand health coverage using
private programs which leads to ballooning costs. For example, adding
a private option for Medicare, known as Medicare Advantage (MA), now
costs taxpayers an extra $140 billion a year
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of corporate gaming.

But Harris is taking a different approach by tapping into Medicare, a
program that Americans like and already covers 65 million Americans.
Medicare, unlike Medicaid, doesn’t come with the same income
restrictions or state-by-state patchwork of benefits. By shifting
long-term care into Medicare, Harris is proposing a more universal
solution, one that could provide peace of mind to millions of
Americans regardless of their income level. By using Medicare,
specifically traditional Medicare where this program will hopefully be
housed, Harris is removing the possibility for Big Insurance to use
the program for profits. Harris is also capitalizing on the simplicity
of the Medicare program which operates using roughly half 
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the administrative costs of private insurance corporations.

Harris proposes to pay for this new benefit with money the federal
government will save when it begins negotiating directly with
pharmaceutical companies
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lower drug prices next year. It’s a step that should’ve been taken
years ago, and it represents a critical source of savings — savings
that can be redirected to fund much-needed home care services. It’s
a win-win for the American people: lower drug prices and better
long-term care.

Political Challenges? Yes, But That’s To Be Expected

Of course, the road to making this proposal a reality won’t be easy.
There will be opposition from some corners of the political spectrum,
not to mention from the nursing home industry and big insurers. These
industries have a financial interest in keeping things as they are,
and they’ve proven time and again that they’re willing to fight
tooth and nail to preserve their profits at the expense of
Americans’ well-being.

But the American people are behind this. According to Data For
Progress, an overwhelming majority — 88%
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of voters support expanding Medicare to include long-term home care.
It’s one of those rare health care proposals that appeals to
Democrats, Republicans and Independents. That’s because it speaks to
a fundamental human desire: to age with dignity, to receive care in a
setting that feels like home, and to avoid financial ruin in the
process.

Harris’ proposal is a step in that direction, and if enacted, it
could reshape the way we think about long-term care for generations to
come.

_[WENDELL POTTER
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health insurance executive who had a “crisis of conscience,”
becoming disgusted with America’s broken healthcare system after
years of helping the industry mislead Americans._

_Wendell walked away from his job at Cigna, one of the country's
largest health insurers, in 2008 and became a vocal critic of the
insurance industry and a leading advocate of reform._

_In June of 2009, Wendell shocked the nation in a very big way when he
went public with what he knew about the healthcare system. In a
riveting Congressional testimony, Wendell described how insurance
company executives, in their quest to meet Wall Street’s profit
expectations, routinely canceled the coverage of policyholders who got
sick._

_He went on to disclose a common but little-known practice that
industry executives called “purging” behind closed doors. Under
purging, insurance companies used big price increases to force small
businesses with sick workers to drop their policies._

_Potter also explained how insurance companies flouted regulations
designed to protect consumers and how they intentionally made it
nearly impossible for consumers to get the information they needed
about their policies in a language they could understand. Wendell’s
testimony became a key building block in the case for expanding
healthcare under the Affordable Care Act._

_Wendell went on to become a bestselling author. The New York Times
called his first book, Deadly Spin, “a tour de force.” Pulitzer
Prize-winning author and historian Doris Kearns Goodwin called his
most recent book, Nation on the Take, “a stirring guide for how we
can work together to reclaim our democracy and reunify our
country.”_

_Wendell Potter is determined to change the course of healthcare in
America. Through the Center for Health and Democracy
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the last decade to fix our broken healthcare system for Americans and
to shine a light on the underhanded practices of big corporations and
other moneyed interests that frustrate the efforts of the richest
country in the world from providing basic universal healthcare for all
its citizens.]_

* home health care
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* home health care workers
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* long term care
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* Medicare
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* Kamala Harris
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* 2024 Elections
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* Seniors
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* Senior Care
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* medical insurance
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* health insurance
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* Medicaid
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