Recently, the Kamala Harris-Tim Walz campaign released its official policy platform, and among the pledges is a vague statement about home care services for seniors: As President, [Kamala Harris] will fight to lower care costs for American families, including by expanding high-quality home care services for seniors.
Those 21 words leave Harris’ policy on the issue up to interpretation, to say the least. But while the statement is vague, it opens the door for critical reform and a chance to address the failings of the current system. The question now is: How should this policy be designed to fix America’s home care model and enable seniors to flourish when aging in place?
Reforming the long-term care insurance market
The biggest worry facing most families in need of home care is how they’ll pay for it. Unfortunately, the private insurance market has failed miserably at providing an adequate solution to this problem. Long term care (LTC) insurance coverage rates have been in a continual decline for over a decade due to unaffordable premiums, to the point where less than 4% of Americans aged above 65 have cover.
Other countries have introduced government-backed public reinsurance programs to absorb some of the financial risks faced by private insurers. This has, in turn, helped to make LTC insurance premiums more affordable and sustainable and is an idea the United States should certainly consider. Moreover, better regulation, such as making it harder for carriers to outright deny home care expense coverage in some LTC policies, will also improve consumer outcomes.
Home healthcare visas
Even the best funded system in the world will fail without adequate staffing levels. The reality is that we’ve been reliant for decades on immigrants making up a substantial chunk of the home care work workforce – with many companies reporting between 40% to 70% of their workforce being immigrants. As our population continues to age, we’ll need a continuous increase in home care workers.
We’ve become accustomed to high skilled visas to attract global talent, which has enabled our tech and other high value industries to remain world beaters. A similar approach applied to home care, or senior care in general, such as via a notional “home health care worker visa” would open up the market to a huge amount of qualified, talented and dedicated care professionals.
Keeping PACE with holistic care
For aging in place care to be effective, seniors need their emotional and spiritual health tended to, rather than just their physical health. National programs such as PACE provided a blueprint for how we can deliver this to all seniors aging in place.
For example, PACE provides its program participants with adult day care, rehabilitative care, and meals at a local PACE center. Studies have shown impressive outcomes, including improved health, reduced hospital visits and significant cost savings, such as in South Carolina where they save $9k per year per PACE participant compared to residents in alternative care settings.
Providing assistance to family caregivers
It’s also important that future policy under a possible Harris administration consider the immense strain placed on family caregivers. Currently, an estimated 53 million Americans provide unpaid care for their loved ones. While family caregiving is often seen as a labor of love, the toll on caregivers is enormous. Many lack access to adequate support services or financial relief, making an already difficult situation even more challenging.
Any home care policy reform should include support for family caregivers. This could come in the form of tax credits, expanded access to respite care, or greater availability of professional home care services from time-to-time to relieve some of the burden.
The scale of the senior care challenge facing the next administration, whoever that is, is enormous. However, smart policy aimed at addressing weaknesses and holes in insurance, the labor market and how home care is delivered will have a tangible positive impact on millions of lives.
Dharam Khalsa is co-founder of assisted living platform Mirador, which is on a mission to remove barriers and increase transparency for consumers within the assisted living industry.
