Long-term care is too expensive for most people
Long-term care is too expensive for most people
With just a month to go until the presidential election, Vice President Kamala Harris proposed a new plan on Tuesday: to expand Medicare — the federal insurance program for older adults — so that it covers long-term care for people in their own home.
This would be a big change. Right now, Medicare does not offer coverage for long-term care, and many families are left trying to piece together care for elderly relatives on their own.
Most of us will probably need some kind of long-term care, eventually.
“And if we don’t need it ourselves, our family members will need it, or we’ll actually help to care for our loved ones,” said David Grabowski, a professor of health care policy at Harvard Medical School.
Many people get that care from family, he noted. “It’s spouses, it’s adult children that are delivering that care. And by the way, that’s typically women.”
Paid care — whether at a nursing home or in your own home — is hugely expensive, per Tricia Neuman, senior vice president at the health policy nonprofit KFF and executive director of its Program on Medicare Policy.
“Paying for care at home can be in the order of tens of thousands of dollars, which so many families don’t have available to them,” she said — especially middle-income families.
Wealthy people can afford it. Meanwhile, those who are low-income can get help from Medicaid.
As for those in between? “Long-term care is expensive enough that a lot of people just aren’t able to save for it on their own,” explained R. Tamara Konetzka, a professor of public health sciences at the University of Chicago.
Only about 10% of people buy long-term care insurance, because that’s expensive too and the benefits are often limited.
“And so a lot of people start out paying private pay, kind of muddling along and providing informal care to their parents, for example, and then eventually they run out of assets and qualify for Medicaid,” Konetzka said.
Medicaid is the biggest payer for long-term care insurance in the country, said Mark Warshawsky, a senior fellow at the American Enterprise Institute. “Almost half of long-term care is paid for by Medicaid.”
But in order to qualify, Harvard’s David Grabowski said that people generally have to spend most of their money first. And if they own a house, states can come after it once they die to recoup some of those costs.
“It’s not a nice process, and it’s part of the reason that our current system is really broken,” Grabowski said.
Harris’ plan to have Medicare cover long-term, in-home care would have to pass Congress. She’s proposed paying for it with money Medicare will save now that it’s allowed to negotiate drug prices.
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