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Can Harris's Proposed At-Home Medicare End the Dreaded Spend Down of Senior Assets?

The Guardian
October 2024

A new proposal for “at home Medicare” by the Democratic presidential candidate, Kamala Harris, could help ease the burden of the cost of elder care for many families, experts say.

However, Republicans have already criticized the proposal as too expensive, a reminder of the political difficulties of enacting healthcare expansions in the US.

Paying for a home health aide out of pocket is far out of reach for most families. The median cost of a home health aide, someone who helps elderly people and disabled with basic tasks such as cooking and bathing, is $33 an hour or $6,292 a month, according to the financial company Genworth. The average retirement income of an American is $4,191. Nearly 6 million Americans older than 65 live on less than $1,170 a month.

Often, Medicaid steps into the void. The public health insurance program for low-income Americans covers more than half (61%) of all long-term support services nationally, according to the Kaiser Family Foundation (KFF). However, because the program has strict income limits, seniors in some states are forced to “spend down” their money to destitution levels to qualify.

“Either you’re going to go into a nursing facility or you’re going to forgo care, or alternatively people are providing that care without pay,” said Christ. “That’s why our system is driving people into institutions, and worse health outcomes and impoverishing entire generations of people.”

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