Harris Issues Historical Proposal for Medicare Home Care Coverage

The plan could offer relief for the "sandwich" generation — Americans struggling with the financial burden of caring for both kids and parents
Home care nurse visiting senior woman

On Tuesday, Oct. 8, Vice President Kamala Harris and her presidential campaign released a proposal for a plan called Medicare at Home, which would add home care coverage to Medicare.

The press release promises the coverage would be extended to "all of our nation’s seniors and those with disabilities on Medicare who need it." The plan would also add hearing and vision coverage for seniors to Medicare — coverages which are currently excluded from original Medicare Parts A and B.

Should the proposal come to fruition, it would offer home care coverage under Medicare for the first time in American history. There are currently more than 67 million people on Medicare, according to the campaign, with about 4 million new enrollees each year, many of whom could benefit from these additions.

How Medicare at Home could help seniors — and their families

According to the CDC, the average life expectancy in the U.S. is more than 77 years — but many of those who are lucky enough to live that long wind up needing some help with day-to-day activities.

Unfortunately, that help has long been unaffordable and inaccessible to many Americans. According to the 2023 Genworth Cost of Care Survey, the median monthly cost of a home health aide is $6,292, which comes out to $75,504 per year — slightly more than the median U.S. household income of $75,149, according to 2022 Census data (most recent available).

The high cost of professional assistance means much in-home care ends up falling to family members: The Harris campaign estimates that about 105 million Americans are caregiving for their loved ones.

The resulting pressure is particularly high for the "sandwich generation," those who find themselves caring for their aging parents and their children at the same time — often while also holding down a full-time job. According to the Pew Research Center, almost a quarter of U.S. adults, or 23%, are part of the sandwich generation.

Medicare at Home, which would offer custom-designed plans available on a sliding cost scale, could help reduce the cost of in-home care for seniors and their family members — both financially and emotionally.

Still, such a plan could increase the cost of Medicare at the national level, with the Brookings Institute estimating a $40 billion annual price tag on a "very-conservatively designed" program.

And, of course, the proposal’s fate rests in November’s election — and, should it come to pass, the Harris administration’s ability to get it off the ground.

Paying for senior care in 2024 — and beyond

While the nation waits to see whether Medicare at Home becomes a reality, there are millions of Americans who require care today — care that, as mentioned, can be extremely costly.

Unfortunately, there’s not (yet) a great system in place to make such care more accessible. Most private health insurance plans, like those available through an employer or Obamacare plans on the marketplace, don’t cover long-term care, either. (There are some exceptions, such as for patients who require skilled services or rehabilitative care.)

While the first line of defense might be a senior’s retirement savings, such high-cost care could quickly deplete even a plush nest egg. Along with saving up ahead of time, there are a few other options to consider.

  • While Medicare doesn’t, Medicaid often does pay for long-term care, either in your home or in a nursing home. Eligibility requirements vary by state, but coverage is often restricted only to those with lower income. Higher earners with significant health care costs should check to see if their state offers a "medically needy program."
  • If they’re written correctly, whole life insurance policies can help pay for long-term care — even care provided by a family member. This could be accomplished by opting in to a living benefit rider, which allows the policyholder to access some or all of their death benefit while they’re still living under certain circumstances (such as terminal or chronic illness). A policyholder could also surrender the life insurance policy for cash value, using that money to fund care, though doing so comes at the cost of forfeiting the death benefit.
  • Long-term care insurance is a financial product specifically built to cover the costs of long-term care, though these can be pricey to buy into for older or sicker people, and benefits may be limited. Even a long-term care insurance policy with $200,000 in level benefits could quickly run out given the high cost of long-term care, so be sure you understand exactly what kind of coverage you’re getting before you sign the paperwork.

Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.