As most of you know I am not a political pundit. And, while I do not want to wade into the controversial waters that are surrounding this year’s tight Presidential race, I do feel compelled to comment on the caregiving policies that both candidates have put forward in this election

First, as both a gerontologist and a journalist, I am inspired that the caregiving policies from both candidates seem to at least be getting more attention from the media. This is a win for caregivers no matter who wins on November 4. To have the 53 million caregivers acknowledged and spotlighted in the media is something many of us who have worked in this caregiving space have been wanting for more than 20 years.

And while the Harris campaign recognized the challenges of the Sandwich Generation, which is about 24 million Americans, the need to address caregiver support across the five generations caring for a loved one over age 50 is the larger population with 70-year-olds caring for 90-year-old parents and 3 million children under age 18 caring for parents or grandparents with chronic illness or a disability as well as all ages in between. In my book, Me Time Monday – The Weekly Wellness Plan to Find Balance and Joy for a Busy Life, I called the entire population of caregivers, Gen C or Generation Caregiver and this group defies age or life stage norms.

And while both Kamala Harris and Donald Trump have announced caregiving policies and support, not surprisingly the two candidates have very different visions on how to achieve this goal.  Here is a rundown as taken from the campaign’s websites and press notes:

Kamala Harris

• Medicare at Home – expanding Medicare coverage to include home care costs as well as vision and dental coverage for seniors – all currently uncovered benefits under original Medicare. Currently dental, vision and some transportation costs are available if the senior chooses a Medicare Part C (known as MedicareAdvantage Plans) but there is no coverage for home care services.

The Department of Health and Human Services estimated that an average American turning 65 will incur $120,900 in future long-term services and support costs, with families paying for over one-third of that themselves.  

According to the nonpartisan health research group KFF, a round-the-clock professional live-in home health aide can cost more than $288,000 a year.

• Harris has also talked on the campaign trail about capping prices in prescription drugs and looking to eliminate medical debt.

Donald Trump

• Caregiver Tax Credit – while there are no details on the amount of tax credit for caregivers, this policy is in alignment with Trump’s other tax cuts that will help families address the ongoing inflation and economic woes – the Trump Tax Cut and Jobs Act of December, 2017 are set to expire in 2025 unless he is re-elected. With additional tax cuts for caregivers, the hope is this would pass Congress as many previous caregiver tax credit bills have never made it into law.

• Trump also announced he will overturn disincentives that lead to care-worker shortages which is a big problem that will only grow larger over the next few decades as caring for older parents outpaces caring for children for the first time in U.S. history. Overall demand for full-time workers in long-term services and support settings is projected to increase by 42% between 2021 and 2036, according to the federal Health Resources and Services Administration. Demand for direct care workers, who make up the bulk of the workforce, is expected to grow 41%. Yet staffing shortages and turnover rates at 67% or higher are stressing the overall system and leaving family caregivers with no alternatives or support.

• Other ways that help caregivers, although not a specific caregiving policy is Trump’s proposal to eliminate taxes on social security and on tips for workers which puts money back into families’ pockets to cover costs currently not included benefits under Medicare and out-of-pocket costs of home care or senior living – none of which is a covered Medicare benefit.

Other Government Programs to Help Caregivers

And while we wait to see which candidate emerges as the new President and then how they will draw in the details of the current caregiving policies, which are currently big transformations but with little information on how they will be implemented, we do have other current help for family caregivers when it comes the policymakers on Capitol Hill:

• National Caregiver Support Plan –  provides grants to states and territories to fund various supports that help family and informal caregivers age 18 years and older to care for older adults age 60 and above in their homes for as long as possible. The program’s eligibility is as follows:
  • Adult family members or other informal caregivers age 18 and older providing care to individuals 60 years of age and older
  • Adult family members or other informal caregivers age 18 and older providing care to individuals of any age with Alzheimer’s disease and related disorders
  • Older relatives (not parents) age 55 and older providing care to children under the age of 18; and
  • Older relatives, including parents, age 55 and older providing care to adults ages 18-59 with disabilities

• Veteran’s Administration (VA) Caregiver Support Program – The Department of Veteran Affairs (VA) Caregiver Support Program (CSP) offers clinical services to caregivers of eligible and covered Veterans enrolled in the VA health care system. Benefits include 30 hours of free respite services so caregivers can get a break and free access to expert-led legal and financial planning services.

• The Sen. Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, which includes a pilot program providing some veterans access to assisted living as an alternative to a nursing home.

• Support and resources can also be found at most state Offices on Aging as well as USAging and the Elder Care Locator where caregivers can find hundreds of Area Agencies on Aging in local counties and cities that fall under the Administration for Community Living (ACL) benefits for older adults and their family caregivers.

• RAISE Family Caregivers Act – The RAISE Family Caregivers Act, which became law on Jan. 22, 2018, directs the Secretary of Health and Human Services to develop a national family caregiving strategy. The strategy will identify actions that communities, providers, government, and others are taking and may take to recognize and support family caregivers, and will include:
  • Promoting greater adoption of person- and family-centered care in all healthcare and long-term service and support settings, with the person and the family caregiver at the center of care teams
  • Assessment and service planning (including care transitions and coordination) involving care recipients and family caregivers
  • Information, education, training supports, referral, and care coordination
  • Respite options
  • Financial security and workplace issues

The Strategy includes nearly 350 actions the federal government will take to support family caregivers in the coming year and more than 150 actions that can be adopted at other levels of government and across the private sector to begin to build a system that ensures family caregivers – who provide the overwhelming majority of long-term care in the United States– have the resources they need to maintain their own health, well-being, and financial security while providing crucial support for others.

• GUIDE Model at CMS – The Guiding an Improved Dementia Experience (GUIDE) Model administered by the Centers for Medicare and Medicaid Services (CMS) is a voluntary nationwide model test that aims to support people with dementia and their unpaid caregivers. The GUIDE Model focuses on comprehensive, coordinated dementia care and aims to improve quality of life for people with dementia, reduce strain on their unpaid caregivers, and enable people with dementia to remain in their homes and communities. The model began on July 1, 2024, and will run for eight years.

Vote!

Regardless of which candidate you believe has the best answer to support caregivers, the most important thing is to vote – have your voice heard is the American way to help usher in needed change.

©2024 Sherri Snelling