Benefit Bulletin: December 2021

Availability of Caregiving Help Falls, Costs of In-Home Care Climbs

By Rick Delaney, TSCL Chairman

The coronavirus has caused many families to rethink plans for long term care as the pandemic spread through nursing homes, killing more than 135,860 patients and 2,040 staff.  The pandemic caused some families to move their family members home, and others to postpone plans to move relatives into nursing homes in the first place.  This trend set off a widespread push for more Medicare funding for in-home care for older and disabled Americans, including better wages to attract and retain nursing staff.

Over the past year, one of the fastest growing costs during the COVID pandemic has been the cost of providing long term care in the home.  According to the Bureau of Labor Statistics data through July, the “care of invalids and elderly at home” category rose by 9.6%.  We ranked that expenditure category as the 9th fastest growing cost faced by older Americans from July 2020 to July 2021.  The cost of providing care in the home, which includes help with feeding patients, bathing, dressing, physical therapy and other services, has been driven, in large part, by an ongoing shortage of qualified caregiving aides and nurses.

Last spring, President Biden said he wanted $400 billion for home care, but Congressional budget negotiators have so far been unwilling to devote that much.  The House Energy and Commerce panel proposed $190 billion.  A Senate bill would provide about $250 billion.

But to fund this expansion in home-care coverage, supporters are counting on savings from allowing Medicare to negotiate drug costs, which would cut federal spending by nearly $500 billion according to an estimate from The Congressional Budget Office (CBO).  A number of both Democrats and Republicans in the House have resisted supporting a key budget provision that would allow Medicare to negotiate drug costs— even though 88% of participants in TSCL’s 2021 Senior Survey support allowing Medicare to do so.

Those in Congress who want Medicare to negotiate prices say they will try to push legislation through different committees.  If they are successful, that could lower drug prices for consumers and may lead to new coverage for sorely long over-due in- home care and services for some of our nation’s most vulnerable older and disabled Americans.  How are the costs of providing in home care affecting you or someone you know?  Send an email to your Member of Congress here.


Sources:  “A Once-In-A-Decade Chance To Overhaul Health Care Gets Personal For Democrats and Advocates,” Washington Post, September 19, 2021.  “Pharmaceutical Industry Backs Democratic Holdouts On Drug Pricing Plan,” Isaiah Poritz,, September 24, 2021.