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Vice President Kamala Harris has announced a policy proposal to have Medicare cover the cost of home care workers as part of her broader economic policy.
The vice president and Democratic nominee for president made the announcement on The View, to applause.
“It's about independence for that individual,” she said. “People are declining in skills to some extent, but their dignity, their pride has not declined. They want to stay in their home.”
Harris discussed how she cared for her mother, Shyamala Gopalan Harris, when she was dying of cancer. In particular, she mentioned the small details that are so important when a patient is fragile, such as “trying to cook what they want to eat, what they can eat,” and “picking out clothes for them that are soft enough that it doesn't irritate their skin.”
The View is the most-watched daytime talk show in the United States. The announcement comes as Harris is doing a series of targeted media hits, including going on Alex Cooper’s Call Her Daddy podcast to talk about abortion rights.
Women disproportionately provide care to parents, spouses, in-laws, friends and neighbors, according to the Family Caregiver Alliance.
Harris spoke about the “sandwich generation” of adults caring for both children and their aging parents. She also said that she planned on using money saved from Medicare being allowed to negotiate drug prices to pay for the home care program.
The proposal marks a difference in existing policy that it would use Medicare — historically an entitlement meant for elderly Americans — to pay for home care rather than Medicaid.
“Obviously, there’s always a lot of political fodder around protecting Social Security and Medicare, but actually talking about adding the thing that most people want, which is home care... is truly historic,” Nicole Jorwic, who leads advocacy and campaigns for Caring Across Generations, told The Independent.
Currently, Medicaid handles elderly care, “so to shift home care services into Medicare, which... is something that most people assume that it does cover — until they are hit a crisis and realize it doesn't — is truly major,” Jorwic added.
As of right now, the federal law requires Medicaid to cover the cost of nursing home care but not the cost of home care, which disability rights advocates say creates an bias towards sending people toward congregate care settings rather than allowing them to remain in their communities.
States are allowed to create waitlists for Medicaid waivers to access home care. In 2023, roughly 692,000 people were on those waitlists, according to research from the Kaiser Family Foundation.
“Because Medicaid has those limitations that states can cap the amount of folks that they're serving, which can lead to the waiting list, that's another reason why it's really strategic and historic that Vice President Harris is looking at Medicare because Medicare is a federal program,” Jorwic said. “So military families or other people who have to move across state lines wouldn't have to worry that their access to care would change based on where they're living.”
One of the few states without a waitlist is Minnesota, where Harris’s running mate Tim Walz is governor.
A survey sponsored by the AARP and conducted by the University of Michigan’s Institute for Health Care and Policy Innovation found that 88 percent of adults between the ages of 50 and 80 felt that it was important to remain in their homes as long as possible.
Since becoming the Democratic nominee for president, critics have faulted Harris for not releasing specific policy proposals. But in 2019, Harris was the first Democratic presidential candidate in the presidential primary to release a disability policy platform. She included home and community-based services in her Medicare for All proposal and called on an end to paying people with disabilities below the minim.
But both plans failed to pass Congress during the first year of Joe Biden’s presidency. The Senate Parliamentarian said that raising the minimum wage could not be included in the American Rescue Plan; and Senator Joe Manchin later killed a proposal to increase spending for home and community-based services in Medicaid.
Harris’s current policy doesn’t list a specific minimum wage number but does call for ending sub-minimum wage labor, a proposal which has passed in Republican states like Tennessee and South Carolina, and Democratic states like Colorado and California.
Similarly, Harris’s home care plan does not have an official price tag — unlike Biden’s initial $450 billion proposal — and she abandoned her support for Medicare for All as she pivoted to the center.
Former president Donald Trump accused Harris of ripping off his policy after the announcement. He specifically cited the current Republican platform, which states: “Republicans will shift resources back to at-home senior care, overturn disincentives that lead to care worker shortages, and support unpaid family caregivers through tax credits and reduced red tape.”
But Jorwic scoffed at the idea that Trump had proposed anything that would preserve home care.
“That is literally laughable to think that Donald Trump can say that he has any idea to expand access to home care when anything that he did as president was to eliminate it,” she said. “His proposals to cut the Affordable Care Act while cutting Medicaid would have removed a trillion dollars from the home- and community-based service system.”
