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home care
Here's Why Harris and Democrats Are the Best Choice for Seniors
This election will determine whether current and future seniors—and their families—can count on the government to keep the promises of Social Security and Medicare and to improve eldercare.
Nov 03, 2024
For seniors and their families, the choice in this election couldn’t be clearer. Before Donald Trump took office, our organization did not endorse candidates for president of the United States. But Trump was such a four-alarm fire for us and our members (older Americans across the country), that we felt a duty to endorse Joe Biden in 2020, breaking with nearly 40 years of precedent. This cycle, we have endorsed Kamala Harris as the candidate who will genuinely protect seniors’ interests, including the two programs in our organization’s name, Social Security and Medicare. We have also endorsed scores of candidates for House and Senate as “champions” for older Americans.
From a policy standpoint, this is a no-brainer. Kamala Harris, like Joe Biden, has pledged to protect Social Security and Medicare from Republican proposals to cut both programs—by raising the retirement age, means testing, and reducing COLAs. But she also has endorsed the idea that the wealthy should begin contributing their fair share in payroll taxes, which would go a long way toward safeguarding the financial health of both Social Security and Medicare. With additional revenue flowing in—plus billions of dollars in savings on prescription drugs from the Inflation Reduction Act—we could not only strengthen, but expand, seniors’ earned benefits.
In October, the vice president laid out a plan to expand Medicare to cover long-term, in-home care for seniors (and people with disabilities). That is a historic proposal. Under the current system, seniors must impoverish themselves in order to qualify for long-term care under Medicaid—and may well end up in nursing homes. Otherwise, the main alternative is for families to provide home care, often at a high financial and personal cost.
Kamala Harris also wants to expand traditional Medicare to include hearing and vision coverage. We have been fighting for the enhancement of benefits for decades, because seniors’ health and safety depends on proper hearing and vision care. These coverages were part of President Biden’s original Build Back Better plan, a noble effort that can be revived with a new Democratic president and Congress.
On the other hand, it’s almost laughable that anyone would think Donald Trump is the better choice for seniors and their families. Trump is unserious about policy, except insofar as it helps him score political points. He knows that Social Security and Medicare are tremendously popular, so he claims he will protect them, while embracing proposals that could devastate both programs.
Many of Trump’s public statements over the years do not inspire confidence. He once called Social Security a “Ponzi scheme,” comparing America’s most successful social insurance program with a petty criminal enterprise. This year, he said he’d be “open” to cutting “entitlements,” a comment his campaign tried to walk back in the face of understandable backlash.
Each year that Donald Trump was president, he submitted White House budgets that would have cut Social Security and Medicare by billions of dollars. He recklessly suspended the FICA payroll tax during the pandemic and said that he hoped it would be “eliminated” entirely, never mind that this is Social Security’s main funding source. Now, he proposes to repeal taxes on Social Security benefits that were put in place during the 1983 reforms (signed into law by President Reagan) to help fund the program.
The Center for a Responsible Federal Budget, hardly a liberal group, estimates that Trump’s plans would cost Social Security up to $2.75 trillion over ten years—and would accelerate the projected depletion of the program’s trust fund reserves by three years. That’s just six years from now!
In the end, though, this election comes down to values. Kamala Harris and her running mate Tim Walz came from the middle class and understand the struggles of working Americans. Harris was raised by a single mother in a modest Oakland neighborhood and cared for her aging mom when she was dying of cancer. Tim Walz lost his father at age 19, and credits Social Security survivor benefits with keeping his family from falling into poverty. These candidates’ lived experiences inform their policies affecting seniors and families.
The Harris/Walz ticket reflects the preferences of most Americans across when it comes to seniors’ earned benefits. Public opinion surveys consistently show that bipartisan majorities of Americans oppose cuts to Social Security and Medicare, and agree that the wealthy should begin contributing their fair share. On the other side, the now-infamous blueprint for a second Trump term, Project 2025, calls for radical changes to Medicare that would end the program as we know it. Meanwhile, the Heritage Foundation, which authored Project 2025, has advocated raising the Social Security eligibility age and other cuts to the program.
Donald Trump has (unconvincingly) attempted to distance himself from Project 2025, but he is a member of an elite financial class that focuses on lining the pockets of the already wealthy and powerful. It’s no coincidence, perhaps, that the GOP has recruited millionaire candidates for Senate in key battleground states who, unlike their Democratic rivals, do not represent the interests of working people. Many of these candidates have supported raising the retirement age and privatizing Social Security, while championing more tax cuts for the rich. Their hostility to the interests of seniors is apparent. The GOP Senate contender in Wisconsin even suggested that nursing home residents aren’t truly capable of voting.
This election will determine whether current and future seniors—and their families—can count on the government to keep the promises of Social Security and Medicare and to improve eldercare. Growing old in America is increasingly costly. Without these bedrock programs, not only seniors, but their family members in the “sandwich generation” will find it even harder to navigate the cycles of life. In this clarifying light, the choices for President and Congress shouldn’t even be close.Keep ReadingShow Less
Kamala Harris Has a Plan for Home Care—and FDR Would Love It!
Franklin Delano Roosevelt and Labor Secretary 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.
Oct 25, 2024
Kamala Harris has a plan to expand Medicare to include home care. If Harris is elected president and signs her plan into law, it will be life-changing for millions of seniors and people with disabilities. Importantly, it builds upon President Franklin Roosevelt’s vision for a New Deal for the American people.
Vice President Harris should get enormous praise for her groundbreaking proposal. Long-term care is a looming challenge that’s barely getting discussed. Harris recognizes this challenge and is offering an important solution: Medicare At Home.
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.
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Harris' Medicare at Home Plan: A Step Forward, But We Need a Care Revolution
The Democratic presidential candidate's new proposal highlights urgent needs, but true reform requires addressing systemic inequities and empowering diverse caregivers.
Oct 12, 2024
Vice President Kamala Harris' recently announced "Medicare at Home" plan represents a crucial acknowledgment of America's caregiving crisis. However, it's a band-aid on a gaping wound—a wound that exposes the deep-seated inequities and systemic failures in our approach to elder care and support for family caregivers. I believe with some thoughtful adjustments, the proposal can lead to a more equitable elder care system in America.
The numbers are staggering: 53 million Americans provide unpaid care for aging or disabled loved ones, sacrificing their own financial security and well-being. By 2030, all Baby Boomers will be over 65, comprising 21% of our population. This demographic shift demands not just incremental change, but a radical reimagining of how we value and support care work in our society.
Harris' plan, while well-intentioned, risks perpetuating a broken care system that exploits caregivers—predominantly women and people of color—while failing to meet the diverse needs of families. By focusing on paying for "designated" Medicare aides, the current proposal supports only the high-cost portion of the market: the traditional for-profit home care agencies.
The current system is a microcosm of larger societal inequities.
That leaves behind many other care options that are vital to addressing our urgent care crisis. It ignores the reality that 78% of adults requiring long-term care solely rely on family and friends for support. And of those who can afford to pay for help, nearly a third rely on the “gray market” of informal caregivers. These groups—family caregivers and informal non-professional caregivers – should also be covered if Medicare were to pay for home-based care. Otherwise, the Harris proposal is favoring a for-profit home care agency system, at the expense of more affordable options, that the majority of people rely on.
Beyond affordability, many people actually prefer to not deal with the for-profit care market. One NIH-funded study on home care needs revealed a stark truth: patients value vouchers to pay for family and informal caregivers 50% more than agency-provided aides. This preference isn't just about familiarity. It's about dignity, cultural competence, and the recognition that care is deeply personal.
The current system is a microcosm of larger societal inequities. Unpaid family caregivers—mostly women, and disproportionately women of color—lose an average of $304,000 in wages and benefits over their lifetime. This is a form of structural inequality that perpetuates gender and racial wealth gaps.
To truly revolutionize home care, we must embrace a progressive vision that centers on equity, worker empowerment, and community-based solutions. Here's what that could look like:
1. A Universal Caregiver Benefit: Instead of means-tested programs, we need a universal benefit that recognizes caregiving as valuable work, regardless of who performs it. This would include payment to family members, friends, and community members, not just professional Medicare-designated aides. Such an approach would bring this existing "gray market" of family and informal caregivers into a more regulated and supported economy.
2. Technology for Social Impact: To truly transform home care, we must embrace innovation and flexibility. We can leverage technology platforms to create a more dynamic, responsive caregiver workforce. This can create flexible, well-compensated opportunities that benefit both caregivers and lower the costs for care recipients.
3. Community Care Cooperatives: Encourage the formation of worker-owned care cooperatives, empowering caregivers and ensuring that the benefits of their labor stay within their communities.
4. Comprehensive Training and Support: Provide accessible, culturally competent training for all types of caregivers, recognizing the diverse needs of care recipients and the varied skills of potential caregivers.
5. Intersectional Policy Approach: Recognize that caregiving intersects with issues of gender equality, racial justice, immigrant rights, and economic justice. Our solutions must address all these facets.
Critics may argue that this approach could compromise care quality. However, with proper oversight and community-based accountability mechanisms, we can create a system that's more responsive, more equitable, and more aligned with the values of dignity and self-determination.
The economic impact of this revolution would be profound. By recognizing and compensating currently unpaid care work, we could stimulate local economies, reduce gender and racial wealth gaps, and create a more robust social safety net for all.
We can create a level playing field where all care providers—from traditional care agencies to tech platforms to family caregivers and informal caregivers—can thrive while prioritizing the needs of care recipients and care workers.
Harris' Medicare at Home plan opens the door to a necessary conversation. Now, we must push it wide open and envision a care system that truly serves all Americans. We can build a society that recognizes the value of care work in all its forms.
Harris' Medicare at Home plan opens the door to a necessary conversation. Now, we must push it wide open and envision a care system that truly serves all Americans.
As we debate this plan, let's not lose sight of the broader struggle for social and economic justice. Reimagining home care for the 21st century is part of a larger project of creating an economy that works for all, not just the privileged few.
It's time for a care revolution that puts people over profit, community over corporations, and equity at the center of our policies. Harris has taken the first step—now let's march forward towards a truly just and compassionate care system for all Americans.Keep ReadingShow Less
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