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Some see election implications in the concerns of older Americans

By: Erik Gunn
Nurse or doctor helping woman walk with walker, elderly caregiver

Concerns about nursing home ownership and Vice President Kamala Harris' proposal to allow Medicare to cover home health care both reflect the political relevance of concerns that older Americans have, advocates say. (Getty Images)

Caregiving, especially for the elderly, is emerging as an important issue in the November election.

On the same day Democratic presidential candidate Kamala Harris rolled out a plan to extend Medicare coverage to include home care for the elderly, advocates held a press conference to discuss the results of a poll asking Wisconsin voters about their views on long-term care.

“I feel like the issue of long-term care in particular has been this kind of sleeping giant ready to be awoken,” said George Goehl, a community organizer with Addition Action, an advocacy group that focuses on small towns and rural communities around the country.

In Wisconsin, Addition Action has been working with community groups organizing to oppose the sale of county-owned nursing homes to private investors.

In Sauk County, a county home was recently sold to a corporation with several Milwaukee homes over the objections of local residents. In Lincoln County, the sale of a county home to a private investor was halted after community residents mustered widespread opposition.

The poll that Addition Action commissioned included a statewide sample of 400 people age 55 and older, as well as an oversample of 400 rural and small community residents.

Overall, 86% of those surveyed said long-term care costs, including nursing homes and assisted living, were unreasonable, including 57% who called those costs “very unreasonable.” Asked whether the government was doing enough to ensure access to quality, affordable long-term care, 68% said government should do more and 12% said it should do less, while 19% said the government was doing the right amount.

The survey participants gave a mixed assessment when considering private ownership and public ownership of nursing homes.

Public county-owned homes were trusted more by 16% while 35% trusted privately owned homes more. Both groups together, however, accounted for just over half of the survey group.

The remaining 49% were divided nearly equally between people who said they weren’t sure and people who said they trusted — or mistrusted — both kinds of owners equally.

But 64% of people in the survey opposed the sale of public, county-owned nursing homes to private companies, while 33% favored such sales — a margin of 2 to 1.

The survey results are largely bipartisan, according to the polling firm, Hart Research. Majorities of Republicans, independent voters and Democrats said they favored policies including high wages for long-term care workers, eviction protections for nursing home and assisted living residents, expanded access to Medicaid to enable more elderly to obtain long-term care and federal support for public nursing homes.

“Nursing homes are an important part of long-term care, but they are just one part of the care infrastructure we need,” said Judy Brey, who is part of a community campaign that opposed Sauk County’s sale of its public nursing home. Brey spoke on a Zoom call Tuesday to discuss the poll findings.

“This poll tells us that today, most seniors in rural communities like mine don’t believe there is enough affordable, quality long-term care, so the need for long-term care is only going to grow,” Brey said.

Also on the call was Dora Gorski, who has been part of a group in Lincoln County that successfully opposed the sale of a public home there a few years ago. “We know that more can be done to support seniors, especially since we’re growing in numbers in this community and throughout the United States,” Gorski said.

Majorities in the poll also told surveyors that they would view political candidates more favorably who have a plan “to protect public, county-owned nursing homes” from being sold to for-profit corporations.

According to Goehl, in three April 2024 county board elections board members in Sauk, Lincoln and Portage counties who had led efforts to sell county-owned homes to private firms were defeated by candidates opposed to such sales.

“This issue had stirred up a hornet’s nest,” Goehl said in an interview Tuesday.

The poll’s release came on the same day that Vice President Kamala Harris, campaigning for president, announced a proposal to allow the federal Medicare program to cover in-home health care.

Appearing on the television talk show The View, Harris said the expansion would be funded in part by savings that Medicare would receive as a result of negotiating prescription drug prices with pharmaceutical manufacturers.

Harris described the proposal as an effort to meet the needs of “the sandwich generation” — adults who bear the dual responsibilities of raising children and assisting aging parents who are no longer able to live on their own.

Currently, most people who cannot afford to pay for long-term care home services out of pocket can only get that covered through Medicaid — and then they have to divest themselves of most of their assets.

“They have to make themselves poor,” said Haeyoung Yoon, policy director at the National Domestic Workers Alliance (NDWA) a nonpartisan nonprofit for domestic workers including nannies, house cleaners, and home health workers that represents about 400,000 people across the country through local and state affiliate groups.

Home health workers are part of “the fastest- and largest growing occupation in our economy,” Yoon told the Wisconsin Examiner. “We’re going through the  graying of America — baby boomers are aging.”

Yoon said stronger public investment in care, including home health care, is needed so the work pays family-sustaining wages while being affordable to the general public. Currently the average annual wage in the field is less than $22,000 she said, and employees, if they have health care, are likely to be on Medicaid.

Yoon also is part of Care In Action — a separate organization that engages in political advocacy on behalf of the domestic workforce. Speaking in her role as a political advocate, she said the Harris proposal represented an important policy advance.

“It’s a historic and really big deal to say this is something that she wants to do when she’s elected,” Yoon said. 

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Harris rolls out broad Medicare plan to provide long-term care in the home

Medicare card money

The Democratic presidential nominee, Vice President Kamala Harris, on Tuesday announced a proposal on long-term care under Medicare focused on the “sandwich generation,” which refers to Americans who are caring for their children while also caring for aging parents. (Photo by Getty Images)

Vice President Kamala Harris unveiled a plan Tuesday that would strengthen Medicare coverage to include long-term care for seniors in their homes, tackling one of the biggest challenges in U.S. health care.

The Democratic presidential nominee revealed the proposal while on “The View” — one of several high-profile media appearances this week as she and the GOP presidential nominee, former President Donald Trump, sprint to the November finish line.

“There are so many people in our country who are right in the middle: They’re taking care of their kids and they’re taking care of their aging parents, and it’s just almost impossible to do it all, especially if they work,” Harris said during the live interview. “We’re finding that so many are then having to leave their job, which means losing a source of income, not to mention the emotional stress.”

Harris is focusing on the “sandwich generation,” which refers to Americans who are caring for their children while also caring for aging parents.

Under the plan, Medicare — the nation’s health insurance program for people 65 and older and some under 65 with certain disabilities or conditions — would cover an at-home health benefit for those enrolled in the program, as well as hearing and vision benefits, according to her campaign in a Tuesday fact sheet.

Medicare for the most part now does not cover long-term care services like home health aides.

The benefits would be funded by “expanding Medicare drug price negotiations, increasing the discounts drug manufacturers cover for certain brand-name drugs in Medicare, and addressing Medicare fraud,” per her campaign.

Harris also plans to “crack down on pharmaceutical benefit managers (PBMs) to increase transparency, disclose more information on costs, and regulate other practices that raise prices,” according to her campaign, which said she will also “implement international tax reform.”

The campaign did not cite a price tag but noted similar plans have been estimated to cost $40 billion annually, “before considering ​​savings from avoiding hospitalizations and more expensive institutional care, or the additional revenues that would generate from more unpaid family caregivers going back to work if they need to.”

The proposal comes along with the nominee’s sweeping economic plan, part of which involves cutting taxes for more than 100 million Americans, including $6,000 in tax relief for new parents in the first year of their child’s life.

Trump responds

In response to the proposal, the Trump campaign said the former president “will always fight for America’s senior citizens — who have been left behind by Kamala Harris,” per a Tuesday news release.

The campaign also cited Medicare Advantage policies extended by the Centers for Medicare and Medicaid Services in Trump’s first term.

The campaign reiterated the 2024 GOP platform’s chapter on protecting seniors, saying Trump will “prioritize home care benefits by shifting resources back to at-home senior care, overturning disincentives that lead to care worker shortages, and supporting unpaid family caregivers through tax credits and reduced red tape.”

Harris and Howard Stern

While appearing live on “The Howard Stern Show” on Tuesday shortly after “The View,” Harris dubbed Trump an “unserious man,” saying the consequences of him serving another term are “brutally serious.”

She also again criticized Trump for nominating three of the five members to the U.S. Supreme Court who voted to overturn Roe v. Wade in June 2022 — a reversal that ended nearly half a century of the constitutional right to abortion.

“And it’s not about abortion, you have basically now a system that says you as an individual do not have the right to make a decision about your own body. The government has the right to make that decision for you,” she said.

Harris, who said she would appoint a Republican to her Cabinet if elected, was asked whether she would choose former Wyoming Rep. Liz Cheney.

Cheney was the vice chair of the U.S. House Jan. 6 committee tasked with investigating the 2021 attack on the U.S. Capitol.

Harris did not disclose a preference, but said Cheney is “smart,” “remarkable” and a “dedicated public servant.”

Cheney is among some prominent Republicans to endorse Harris. She campaigned with the veep in Ripon, Wisconsin — the birthplace of the Republican Party — just last week.

Trump talks with Ben Shapiro

Meanwhile, Trump said Harris is “grossly incompetent” during an interview that aired Tuesday on “The Ben Shapiro Show.”

“Biden was incompetent, she is equally incompetent and in a certain way, she’s more incompetent,” Trump told Shapiro, a conservative political commentator and co-founder of The Daily Wire, referring to President Joe Biden.

Trump also criticized Harris’ Monday interview on CBS News’ “60 Minutes,” saying the veep “answers questions like a child.”

“She’s answering questions in the most basic way and getting killed over it,” Trump added.

Look ahead for Harris, Trump campaigns

Harris was also set to also appear on CBS’ “The Late Show with Stephen Colbert” on Tuesday night. She will also appear at a Univision town hall in Las Vegas, Nevada, that airs Thursday.

Trump was slated to participate in a roundtable with Latino leaders and a Univision town hall on Tuesday in Miami, but both events were postponed due to Hurricane Milton.

Trump is set to give remarks Wednesday in Scranton, Pennsylvania. Later that day, he will continue campaigning in the Keystone State with a rally in Reading.

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