How Cory Booker would address long-term care
Sen. Cory Booker (D-N.J) is addressing access to long-term health care and the workers who provide such services in his latest policy proposal — an issue of growing concern with the 65-and-older population projected to nearly double, to 88 million, by 2050.
What would the plan do?
Medicaid currently makes people spend down their assets and have low income before they can qualify for long-term services and supports for the elderly or disabled, though eligibility rules vary by state. Booker would increase Medicaid asset limits for long-term services to $200,000 and income limits to 300 percent of the federal poverty line (almost $50,000 for a family of two) to expand access to these services.
Booker would also expand the Earned Income Tax Credit to help cover family caregivers' expenses. He would also pay long-term care workers at least $15 an hour and extend them full workplace benefits. He additionally would back legislation that would give the disabled the right to access long-term services in their homes.
How would it work?
Booker proposes having the federal government pick up the entire cost of covering more people under the expanded limits — a move his campaign maintains would allow states to expand eligibility without straining their budgets. Individuals who exceed the asset or income limits would also be able to buy in to the program, with cost-sharing determined on a sliding scale.
What are the weaknesses in the proposal?
There's no firm price tag. The plan relies on making the tax code more progressive to cover a significant expansion of government health spending, including overhauling the capital gains, estate and income taxes. The huge expense is why Congress to date hasn't been able to come up with a better system for long-term care despite the demand and aging population. The plan would also issue directives to the Department of Health and Human Services — including supporting long-term care workers who want to join a union — that could be overturned by future administrations.
How much would it cost?
The full price tag is unknown and would depend on many variables, including how much states rely on Medicaid managed care. Booker contends the plan would generate some savings by, for example, moving some people out of more expensive institutional care settings and into home- and community-based care.
What have other Democrats proposed?
Sen. Bernie Sanders' (I-Vt.) latest version of "Medicare for All" legislation would expand coverage of long-term services and supports wherever possible, in home- and community-based settings. While Booker says he supports Medicare for All "as the ultimate goal," he bills his plan as a way to bring long-term care within reach for every American.
