Harris’s Medicare At Home plan would expand economic security by creating a new universal benefit, in the grand tradition of President Franklin Roosevelt and his visionary Secretary of Labor, Frances Perkins.
In 1934, President Roosevelt considered adopting a comprehensive cradle-to-grave program of economic security. Ultimately, he decided to start more slowly and incrementally with what became the Social Security Act of 1935, which, among many other achievements, created Social Security and unemployment insurance. He recognized that Social Security was too important to risk failure by beginning too ambitiously.
A decade later, in 1944, having just been elected for the fourth time, FDR built on this legacy by calling for an economic bill of rights in his State of the Union address. This so-called Second Bill of Rights would give every American the right to comprehensive economic security, including a first–rate education; guaranteed employment at a living wage – “enough to provide adequate food and clothing and recreation”; a decent home; “adequate medical care and the opportunity to achieve and enjoy good health”; as well as “adequate protection from the economic fears of old age, sickness, accident, and unemployment.”
He understood, as Vice President Harris does, that people want the right, the ability, and the assistance necessary to age in place, with dignity and independence. In a capitalist system like ours, where working families are dependent on wages, economic security requires insurance against the loss of those wages, which Social Security and Unemployment Insurance provide. That is necessary, but it is not sufficient. Economic security and a decent and dignified life also require getting the care you need, including home care.
Medicare provides health care to Americans over age 65 and people with disabilities, but it has a huge gap: Long-term care. Most people think that Medicare covers long-term care, only to face a devastating shock when they (or a loved one) are in need of care.
Long-term care costs around $100,000 per year, so almost no one can afford it. Currently, the only program that covers long-term care is Medicaid. But unlike Medicare, which is universal, Medicaid is means-tested. As a result, seniors and people with disabilities are forced to “spend down” all of their assets, including property, before they can qualify for long-term care through Medicaid.
Sometimes, people must even divorce their loving spouses in order to qualify for long-term care coverage. And even then, after breaking up families and depleting their nest eggs, they may wind up in a dehumanizing corporate nursing home that exists to exploit patients for profit, because that’s still all they can afford.
In one heartbreaking instance, physicist Leon Lederman was forced to sell his Nobel Prize medal for $765,000 to pay for his care — and he still ultimately wound up in a nursing home.
Medicaid was not enacted as a long-term care program, but that is what it has become by default. And because it was not structured to be a long-term care program, it forces middle class seniors to bankrupt themselves so that they can receive care. It forces seniors and people with disabilities into nursing homes when they are healthy enough to remain at home.
This is a system that is fundamentally broken in this country. But Kamala Harris’s new plan for a universal Medicare At Home benefit would finally begin to change all that.
Those who have responsibilities for aging parents are also often caring for young children. Many other Americans are caring for a spouse while also dealing with their own health challenges. Kamala Harris’s Medicare At Home plan would benefit the entire family. It would empower seniors and people with disabilities who are healthy enough to age in place but can’t afford the care they need to remain at home.
Before the creation of Social Security, it was routine for parents to live with their adult children. Those who did not have children, or whose children were unable or unwilling to care for them, were forced into poorhouses.
FDR and Frances Perkins saved millions of seniors from the poorhouse. Now, Kamala Harris has a plan to save them from another form of institutionalized care, the nursing home.
Her plan is completely affordable because the Biden-Harris administration finally stopped letting Big Pharma rip Americans off. Kamala Harris would pay for this new Medicare At Home benefit, along with adding vision and hearing coverage to Medicare, with the savings from Medicare negotiating lower prescription drug prices. Big Pharma will continue to profit, just not at unconscionably exorbitant rates.
Seniors get to pay lower prescription drug prices, and also receive new hearing, vision, and home care benefits. And the so-called sandwich generation will have more time and resources. Moreover, states will benefit because the proposal will reduce their hard-pressed budgets, which are heavily burdened today by the long-term care costs funded by Medicaid. Harris’s proposal is a win-win for everyone (except for Big Pharma CEOs).
Kamala Harris’s Medicare at Home plan is a big step toward fulfilling Medicare’s promise of a simple, universal benefit. When she signs it into law, it will bring us far closer to the grand vision of full economic security first imagined by President Roosevelt and Secretary Perkins.
