November 1, 2024
Too many Americans have experienced the stress and financial challenges resulting from inadequate health care insurance coverage. At Wellspring, we see this every day. Families and older adults who are struggling to manage care for themselves or their older loved ones are usually surprised to learn that Medicare does not cover most in-home care. Finding a way to pay for care – whether it’s in the home or in a health care facility – often leads to heartbreaking decisions about family or individual finances.
“The pain point for families – especially middle class and lower-income people – is excruciating,” says Sheila McMackin, MSW, LCSW, the founder of Wellspring. She says she was heartened when Vice President Kamala Harris released a fact sheet on Oct. 8 announcing a Medicare At Home benefit as part of her presidential election platform.
The fact sheet stated that under this plan, “Medicare will cover home care for the first time ever for all of our nation’s seniors and those with disabilities on Medicare who need it, in addition to vision and hearing benefits to help seniors live independently for longer.”
“All of us at Wellspring are glad that this topic is being discussed at this level,” says McMackin. “Yes, it’s a concept only at this point, but it’s a critical conversation.” The proposed coverage would help not just seniors and people living with disabilities, but millions of others who are part of the “sandwich generation,” caring for both their elders and their own children.
“Of course,” McMackin adds, “health problems and disabilities happen to everyone, regardless of how they vote. So it’s important to put forward ideas like this, even if it’s only inch by inch.”
The fact sheet also stated:
“Virtually all seniors and many people with disabilities are covered by Medicare—over 67 million people, with roughly 4 million Americans enrolling every year—and 105 million Americans are currently acting as caregivers for loved ones. Yet many Americans don’t realize that Medicare does not cover long-term services and assistance, like home health aides, except under very narrow circumstances. This situation is untenable for most, as the average cost of a full-time home care aide is almost double the income of the typical Medicare beneficiary, and the problem will only get worse as our population ages. As a result, American families face difficult, sometimes impossible choices.
“This new ‘Medicare at Home’ initiative builds on research published by Georgetown University and the Brookings Institution.”
“Whatever the outcome of the election,” says McMackin, “we believe this conversation needs to continue.”