Medicare Change Would Expand Coverage for 14 Million People

A new Medicare proposal from Vice President Kamala Harris could expand coverage for millions of people.
This week, Harris proposed expanding Medicare to provide home care for families that cannot afford long-term care. The benefits would be available for those who are unable to perform daily activities like bathing and eating or if they have a cognitive impairment.
Roughly 14.7 million Medicare beneficiaries would be eligible for the home care benefit under Medicare, according to an estimate from health policy organization KFF.
“The changes aim to change Medicare’s approach to long-term care, affecting both family finances and the federal budget in a positive way,” Michael Ryan, a finance expert and the founder of michaelryanmoney.com, told Newsweek. “In my experience with retirees, home health care costs often force families into difficult financial decisions or drain their savings early.”
The proposal is estimated to cost around $40 billion yearly, but Ryan said there could be savings in the long term.
“Many of my clients who ended up in expensive institutional care could have remained at home with proper support, often at a lower cost,” Ryan said. “By investing in preventive home care, we could reduce expensive hospital stays and avoid premature nursing home admissions.”
If passed, this would mark the first major expansion of Medicare since the Medicare Modernization Act of 2003, when prescription drug benefits were added.
In addition to the new home care benefits, Harris’ proposal calls to expand Medicare for vision and hearing benefits. That means seniors could now use their Medicare to secure new eyeglasses or hearing aids.
According to KFF, just under half (44 percent) of Medicare beneficiaries reported difficulty hearing in 2019, and one-third had problems with their eyesight.
There would also no longer be “estate recovery,” which happens when Medicare takes money from the sale of decedents’ homes to recoup home care costs.
“What Vice President Harris is voicing support for is something many states have been trying to tackle in recent years and finding mixed success,” Alex Beene, a financial literacy instructor for the University of Tennessee at Martin, told Newsweek.
“We have millions of seniors who need home health services, but currently, Medicare is quite limited in its coverage of those services…Extending coverage to more options and longer time periods during the week is desperately needed for families struggling to take care of their own lives in addition to the seniors in their families.”
Under the proposal, the Medicare expansion would be funded by additional drug negotiations outlined in the Inflation Reduction Act. The IRA lowered prices on many prescription drugs but also caused several insurers to hike their premiums on seniors.
Former President Donald Trump, the Republican presidential nominee, also voiced his support for home care for seniors but has not proposed any policy changes like Harris.
Trump’s ideas have generally centered around the workforce shortages in the home care space and offering tax credits to unpaid family caregivers.
In today’s current Medicare coverage, home care has been relatively unaddressed.
The government-run health care only covers “skilled services” part-time, typically for nursing or physical therapy for those deemed homebound. That means those who require long-term home care are excluded from Medicare’s coverage if they don’t need specific “skilled services.”
Staffing shortages also impact seniors who need home care. KFF estimates that 700,000 Americans are currently on waiting lists due to excessive demand.
To enact Harris’s proposal, Congress would likely need to issue new laws. While there’s been bipartisan support for reducing the waitlist for Medicaid home care, nothing has been approved by law so far.
Ryan said Harris’s proposal would also provide relief to Gen X, who is often deemed the “sandwich generation,” as they face caregiving responsibilities for their aging parents while still financially taking care of their Gen Z adult children.
“Many are struggling to juggle caregiving responsibilities while staying employed,” Ryan said. “Protecting their ability to work is vital for long-term financial security and retirement planning.”
While it could make a major difference for seniors, Ryan said, based on similar past proposals, there’s likely to be resistance.
“With the growing aging population, the urgency is undeniable,” Ryan said. “Without proper cost control and bipartisan support, this initiative could stumble. Still, the potential benefits to the economy and healthcare system could be game-changing.”