WASHINGTON—Vice President Kamala Harris announced a proposed Medicare at Home benefit designed to help families with caregiving needs and strengthen Medicare. Under the plan, Medicare would cover homecare for the nations’ seniors and those with disabilities who are enrolled in Medicare, as well as vision and hearing benefits aimed at helping seniors live independently for longer.
Based on study results, nearly a quarter of American adults are part of the “sandwich generation,” providing intergenerational care to both their children and a parent or a loved one with disabilities. This Medicare benefit intends to save families, caregivers and the federal government money by allowing seniors to stay in their homes.
The proposal seeks to bring savings to the Medicare Trust Fund and Medicaid by allowing more citizens the option to stay longer in their homes and community-based settings, which are less expensive than nursing facilities and can result in fewer hospitalizations. Harris’ efforts to strengthen Medicare’s long-term care system intend to improve labor-force participation by giving adult children reassurance in caring for their parents without having to give up jobs, increasing labor supply and boosting the economy. The new Medicare at Home proposal would create a benefit in a new category for Medicare without affecting existing premiums or drawing on Medicare Part A. Additionally, this new benefit aims to extend the life of the Medicare Trust Fund by expanding Medicare drug price negotiations, increasing the discounts drug manufacturers cover for certain brand-name drugs in Medicare and addressing Medicare fraud.
The Medicare at Home benefit plans to improve Medicare through the following means:
Providing Medicare at Home for the First Time
- At-home services: This service aims to allow Medicare enrollees to be evaluated by physicians and/or nurses to determine whether seniors are able to independently perform activities of daily living—such as bathing, eating and going to the bathroom—and/or face serious cognitive impairment. Aides will be designated by Medicare and can include any qualified home health aides, personal care attendants or direct care workers recognized by their state.
- Services tailored to fit needs: Medicare will design plans that provide coverage for those with long-term care needs and modest incomes, with a sliding scale for cost-sharing for seniors with higher incomes.
- Innovate and engage with the private sector: This initiative plans to draw upon the best practices across Medicare plans and the private sector to expand the homecare workforce, partner with technology companies in areas like remote patient monitoring and telehealth services, as well as other private sector partnerships.
- Prioritize care workers: This initiative is centered around providing care workers with access to better wages, improved quality of care for seniors and those with disabilities and treating seniors with dignity.
Strengthening Medicare by Including Hearing and Vision Coverage
Currently, Medicare does not cover hearing aids, eyeglasses and contacts or associated exams, although more than 90% of senior Medicare enrollees use eyeglasses and nearly half of enrollees struggle with hearing. By strengthening Medicare to include hearing and vision coverage for seniors, Harris and Walz’s proposal intends to provide coverage of hearing aids, hearing exams, eye exams and new glasses and lenses. These initiatives hope to assist Medicare enrollees see more clearly and get the eye care they need, as well as ease some of the struggles with moderate and severe hearing loss. Additionally, these initiatives will help more seniors live independently for longer and avoid falls, depression and other harms.
Stopping States from Seizing Seniors’ Homes, Restoring Funding to Medicaid for Long-Term Care Services
Many states currently have the right to seize family homes of recently deceased Medicaid beneficiaries. This practice, known as “Medicaid Estate Recovery,” means that those homes are not passed on to the seniors’ children. Harris and Walz said they aim to work with Congress to put a stop to this practice. Additionally, they will urge the Centers for Medicare and Medicaid Services to better clarify the conditions for hardship waivers to Medicaid Estate Recovery.
Offering New Benefits Paid for by Savings from Negotiating with Major Prescription Drug Companies
The majority of the plan’s cost are intended to be funded by expanding Medicare drug negotiations, increasing the discounts drug manufacturers cover for certain brand-name drugs in Medicare and enforcing pharmaceutical benefit managers to increase transparency, disclose cost information and regulate practices that raise prices. The remainder of the costs aim to be funded through implementing international tax reform.
