Recent policy proposals, including one from the Harris-Walz campaign, have called for expanding coverage of in-home assistance with basic tasks that often become more difficult as people age, such as eating, bathing and dressing independently, to all Medicare beneficiaries with established care needs. In addition to addressing care needs that are often unmet or handled by unpaid family members, this type of program could help households more efficiently manage risks at older ages, expand the productive capacity of the economy by providing more flexibility to would-be unpaid caregivers, and potentially reduce reliance on other public programs.
Authors
- Acknowledgements and disclosures
- The Brookings Institution is financed through the support of a diverse array of foundations, corporations, governments, individuals, as well as an endowment. A list of donors can be found in our annual reports published online here. The findings, interpretations, and conclusions in this report are solely those of its author(s) and are not influenced by any donation.
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- United States of America
Table of Contents
- The growing number of people with long-term chronic conditions need support 1
- More than a third of 65-year-olds are expected to need assistance with personal care needs for at least two yearseven those in excellent health at age 65 2
- Proposals to expand social insurance for long-term care 3
- What are the potential consequences of expanding coverage for in-home care 3
- Amount and type of care utilization 3
- Projected average long-term care costs for a 65-year-old are high and largely uninsured 3
- Medicaid 3
- Other public 3
- Out-of-pocket 3
- Unpaid care 3
- Private insurance 3
- Labor force participation and co-residence of unpaid caregivers 4
- Risk protection 4
- Impact on the private insurance market 4
- Health care utilization and spillovers to other government programs 5
- Supply of care workers 5
- Conclusion 5
- Acknowledgements and disclosures 6
- Footnotes 6
