Harris campaign leans into long-term care at home

• And some of the cost would be covered through expanded Medicare drug price negotiations — another policy that polls well with swing voters.

Yes, but: That cost could be a staggering $40 billion a year, according to a Brookings Institution outline for adding long-term care coverage to Medicare.

• It would be hard for a new administration to sell such a plan if Republicans control even one chamber of Congress.

Between the lines: Harris' plan broadened the health policy conversation beyond reproductive rights and medical costs.

• It's aimed at "sandwich generation" Americans in their prime working years who are facing increasing family and financial pressures.
• People who need long-term care may have "declining skills to some extent, but their dignity, their pride, has not declined," Harris said, in outlining the plan on "The View." "Plus, for their family to send them to a residential care facility, to hire somebody, is so expensive."

The big picture: America faces a looming senior care crisis, with nearly 70% of older adults projected to need long-term care services that are hard to come by, let alone pay for.

• Seniors tend to prefer receiving these services at home, and studies show at-home care is more cost-effective than hospital stays.
• "This is huge, because at every kitchen table in America, people are talking about how they're going to afford the cost of care for their aging parents, their disabled loved ones and their kids," Ai-jen Poo, a national caregiving policy advocate, told Axios.
• Former President Trump's policy platform, released this summer, says he would "shift resources back to at-home senior care" and support family caregivers through tax credits.

State of play: Medicare currently doesn't cover long-term care — a fact that often catches older adults by surprise.

• Medicare's existing home health benefit covers specific services like physical therapy and medical supplies for a limited time following a hospital stay. It does not cover help with daily activities like bathing or cooking.
• That leaves Medicaid as the main payer of extended care for seniors and people with disabilities. Many people end up spending down their assets near the end of life to qualify for Medicaid coverage of long-term care. Others might pay upward of $100,000 out of pocket for home aides.

Harris's proposal would let Medicare cover in-home health care after a medical provider has determined an enrollee needs help performing daily tasks.

• Medicare would create a sliding scale for beneficiary cost-sharing for the long-term care services. The administration would partner with technology companies and other private-sector businesses to create the program, a fact sheet said.
• Harris also announced on Tuesday that she would work with Congress to add vision and hearing coverage to traditional Medicare and end Medicaid programs' ability to seize the homes of recently deceased enrollees.

Reality check: Adding a long-term home care benefit to Medicare would require legislation from Congress, said Larry Levitt, executive vice president of health care at KFF.

• The proposal would be fully paid for by expanding Medicare's ability to negotiate lower drug prices, increasing discounts drugmakers cover for certain pharmaceuticals and cracking down on Medicare fraud, the Harris campaign said in a news release.
• Adding a Medicare benefit could also save money in the Medicaid program, the Brookings paper notes.

Between the lines: President Joe Biden campaigned on expanding long-term home care services by strengthening the existing Medicaid benefits. Legislation to grow the benefit stalled in Congress, but the administration has finalized rules to expand access to Medicaid home care and increase pay for home health aides.

Zoom out: It's personal for Harris. She cared for her own mother, Shyamala Gopalan, when she was sick with cancer.