Clinton proposal could be boon to home care

An HHBR Staff Report

President Clinton proposed a four-part long term care plan today that would bring significant financial help to Americans who care for elderly relatives in their homes.

The core of the plan is a $1,000 yearly tax break for either patients or their caregivers. The tax credits are expected to reach about 2 million Americans and cost $5.5 billion over five years.

In his initiative, which is expected to cost $6.2 billion over the next five years, the president is also proposing a new National Family Caregivers Support Program that would provide a range of critical services for caregivers such as respite care, home care services, and information and referral.

According to a report by the Associated Press, Clinton will ask Congress for $625 million in grants over the next five years to state and local agencies on aging, which were created by the Older Americans Act of 1965, to set up the support program.

The third component of the four-part plan calls for a national campaign to educate Medicare beneficiaries about the programs’ limited coverage and how best to evaluate long term care options. According to the AP report, the campaign, at a cost of $10 million, would make sure all 39 million Medicare beneficiaries realize they are not covered for most long term care; know what to look for in supplementary private insurance; and are aware they might be eligible for long term care welfare benefits under Medicaid.

In the fourth part of the plan, Clinton proposed that the federal government begin offering affordable long term care insurance to its employees, acting as a model employer, in hopes that other employers would follow suit.

According to the White House, the aging of Americans will only increase the need for quality long term care options. The number of Americans age 65 or older will double by 2030 (from 34.3 million to 69.4 million), so that one in five Americans will be elderly. The number of people 85 or older, nearly half of whom need assistance with everyday activities, will grow even faster (from 4.0 million to 8.4 million).

Sen. Harry Ried (D-NV), who serves on the Senate Special Committee on Aging, joined the president at the White House earlier today to announce the plan. Reid, according to a States News Service (Washington) report, said this is the first of many steps that need to be taken to ensure quality healthcare for seniors.

"I think this is really keeping with what I believe is needed," Reid said. "We need to pass this legislation."

Some home care representatives were not overwhelmed by the measure, however. "This is really just a Band-Aid on a very serious problem and more of a distraction than anything else," said American Federation of Home Health Agencies (AFHHA; Silver Spring, MD) Executive Director Ann Howard. "It’s not a bad idea as a complement to the Medicare home health benefit, but a $1,000 annual credit is a poor substitute for the revocation of the Medicare home health benefit for long term, medically complex patients.

"Once again, the patients we are talking about are those who are considered too sick’," said Howard, "and this will only translate into two or three weeks of care before these patients have to be shipped off to a nursing home or another institutional setting."

Whatever the merits of the tax break may be, the immediate response on Capitol Hill suggested Clinton’s initiative won’t meet any resistance in Congress. "These items were contained in the Republican Contract with America, and we passed them as a $6.5 billion healthcare initiative in December 1995," House Ways and Means Health Subcommittee Chairman Bill Thomas (R-CA) said this morning. "Since President Clinton vetoed these Republican provisions in 1995, I’m delighted he has changed his tune and is supporting them today. Every year millions of Americans go without adequate long term care because they are forced to go without many services. This GOP initiative the president has adopted can make a difference."

Assistance for long term care patients and their caregivers will be the largest new domestic initiative in the budget Clinton is preparing to send to Congress in a month, The Washington Post reported.