Reply to Harris Proposes that Medicar cover Long-Term Care at Home

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[quote=Anonymous][quote=Anonymous]Considering full time care is 250K/ year we'd need taxes from 10 average Americans working to support 1 person with live in care. [/quote]

There would definitely be a cap on the amount of reimbursement. (population budgeting... not sure what they mean by that, but for sure it means a limit on hours of care)  And the way it is being envisioned, there would be an asset/means component. People with more income and assets would have a large co-pay...

https://www.brookings.edu/articles/a-home-care-benefit-for-medicare

[quote]Eligibility for the program would be restricted to people who independent clinical reviewers determined were [b]unable to perform two activities of daily living[/b] (e.g., bathing, toileting, or eating). That’s the standard that many State Medicaid programs already use, and it could be assessed annually during the initial implementation period to further develop and monitor the uniformity of functional assessments over time.

Second, the program would include [b]cost-sharing[/b] that varied according to people’s means. Medicare beneficiaries with high income and assets would receive [b]modest assistance[/b] from the program to defray a portion of the costs of home care; those with fewer assets and less income would pay much less.

Third, beneficiary contributions to the costs of their care would depend on both their current income and their accumulated assets, but through [b]cost-sharing rather than a strict cutoff[/b]. For example, at the cost listed above, we could allow all qualifying Medicare beneficiaries to fully retain income up to 150% of the poverty line ($22,600 in 2024) and assets up to $30,000; beyond that limit, individuals would still qualify but would pay cost-sharing out of their resources to defray taxpayer costs.

Fourth, only care provided by formal caregivers associated with home care agencies would be covered. Hours of support would be based on need, but provider agencies would be subject to a [b]population-based hours of service budget[/b]. The combination of resource-based copayments with [b]population-level budgeting[/b] will ensure that the costs of this program will not explode.

Finally, Federal Medicaid savings from shifting home care benefits from Medicaid to Medicare would be used to defray the costs of the program.
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