THE ARISING · Markets & Strategy
Wyden Seeks Input on Medicare or Medicaid Universal Home Care Benefit
A senior Senate Democrat is asking for public feedback on options to expand home care coverage for older Americans and people with disabilities. Sen. Ron Wyden has put that question to the public, and the answer could reshape a market that now sits largely outside Medicare.
Wyden is the ranking Democrat on the Senate Finance Committee. According to Newsweek, he released a request for information seeking feedback on how to overhaul long-term care. It is not a bill. It lays out options rather than one finished proposal.
Two routes stand out. One would create a new Medicare home care benefit. The other would use Medicaid to build a universal home care benefit. The document also covers nursing-home quality and the long-term care workforce.
The gap he is targeting is well defined. Medicare covers certain skilled nursing, therapy and home health aide services for eligible people. Aide coverage is available only when the person also receives qualifying skilled services. Medicare does not pay for custodial care when that is the only care needed. It also does not pay for 24hour home care or home meal delivery.
Medicaid fills much of that space. According to KFF, as cited by Newsweek, it is the country's main payer for long-term services and supports and accounts for more than half of U.S. long-term care spending. Families who need ongoing help but do not qualify for Medicaid often face large bills.
The costs are sizable. CareScout's 2025 Cost of Care Survey puts the national median for a non-medical caregiver at $35 an hour. At 44 hours a week, that is $80,080 a year. Assisted living has a median of $74,400 a year, and adult day health care $24,700.
For the market, the strategic question is substitution. A public home care guarantee could take over spending that families now cover from savings or private policies. It could also change demand for the products built around that spending. The source does not say how any benefit would be designed, so these effects are interpretation, not findings.
Kevin Thompson of 9i Capital Group, quoted by Newsweek, said many private insurers have exited the market or sharply cut coverage because the financial risks became too great. He said cost is the biggest obstacle to a universal program.
Michael Ryan, a finance expert, framed the open questions as who pays for universal care and where the caregivers will come from. He also said families should not expect relief soon, because this is a request for input, not legislation.
The request builds on a May initiative Wyden launched with 16 other Senate Democrats. That effort listed three priorities: affordable home care, better nursinghome care and a stronger long-term care workforce. In the May statement, the senators called for a home care guarantee for people with Medicare.
For now, nothing changes for Medicare recipients. Wyden said he wants responses from across the country. Watch for the feedback his committee receives, and whether any of the options turns into a bill with a funding plan attached.
Major Hospitals Open Longevity Clinics, and STAT Asks Whether They Work PPIC Projects California's 65-Plus Labor Force Will Reach 1.8 Million by 2040 FDA Approves Viatris' Ryzumvi Eye Drops for Presbyopia in Adults Wyden Seeks Input on Medicare or Medicaid Universal Home Care Benefit Atrogi's Oral Muscle Drug Linked to 13% Power Gain in Small Study Over 90% of US Nursing Homes Staff Below Acuity-Based Expected Level, LTCCC Says