Most Americans would rather age at home, says poll
| Washington
A majority of Americans agree that government should help people fulfill a widely held aspiration to age in their own homes, not institutional settings, a new poll finds.
There鈥檚 a surprising level of bipartisan agreement on some proposals that could help make that happen, according to the late March survey from The Associated Press-NORC Center for Public Affairs Research. Still, Republicans lag Democrats in support of some policies, including the most far-reaching idea: Only 42% of Republicans favor a government long-term care insurance program for all Americans, compared with 78% of Democrats. Overall, 60% of the public supports that approach.
Other government options to help people deal with the costs of long-term care get solid support across the political spectrum.
For example, 63% favor more funding to help low-income people age at home, a policy reflected in President Joe Biden鈥檚 stimulus plan and his COVID-19 relief law. That includes about half of Republicans and about three-quarters of Democrats. Overall, only 10% are opposed.
There鈥檚 also bipartisan alignment about proposals involving public-private partnerships.
The poll found broad backing for facilitating the purchase of long-term care coverage through a supplemental insurance plan like Medicare Advantage (supported by 70% of Americans, including 77% of Democrats and 65% of Republicans) and for tax breaks to help purchase long-term care insurance (supported by 61%, including 64% of Democrats and 58% of Republicans).
Behind it all is a deep desire among Americans to maintain their independence in an aging society.
Contrary to common belief, Medicare does not cover long-term care. Relatively few people plan ahead, and it remains prohibitively expensive for most middle-class people. Nationally, nursing home care averages more than $100,000 a year. Home and community-based services can cost tens of thousands of dollars. Private long-term care insurance has failed to catch on because premiums are high and preexisting conditions restrictions apply.
鈥淚鈥檇 like to age in place as long as I can,鈥� said Steven Martens, of Nashville, Tennessee, retired from a career in banking. 鈥淚t鈥檚 the privacy, the feeling of independence. That feeling that you are still taking care of yourself means something to me and others. We feel good about ourselves because we are still taking care of ourselves.鈥�
The poll found that 88% would prefer to get long-term care services as they age at home or with loved ones. Just 12% would want to receive care in a senior community or nursing home.
However, Americans鈥� concerns about nursing homes have eased somewhat since the ravages of the pandemic last year. The share saying they鈥檇 be very or extremely concerned about a loved one needing long-term care in a nursing home dropped from 60% in September to 44% in March. Nursing homes and senior communities are coming out of a year in lockdown because of a sustained campaign to vaccinate residents and staff, to break the cycle of infections and deaths.
Los Angeles-area resident Tevina Quintana says she鈥檚 now able to see her mother, who lives in a community for older adults. Both are vaccinated. During the COVID-19 surges last year, 鈥渋t seems like they were never not on lockdown,鈥� said Ms. Quintana, who works with special education children.
Although Ms. Quintana is in her 30s, she says long-term care should be part of the foundation of social supports. She favors a government program like Social Security to provide long-term care.
鈥淚 think it should be available for everybody,鈥� she said.
鈥淚f we have to get taxed a little bit more, we get taxed for lots of things anyway,鈥� added Ms. Quintana, who describes herself as a progressive Democrat. 鈥淲e might as well do something that benefits our elders.鈥�
But Nashville retiree Mr. Martens doesn鈥檛 think that鈥檚 the best way.
鈥淚鈥檓 concerned that fiscally, how do we pay for that?鈥� said Mr. Martens, who describes himself as a moderate Republican. 鈥淥ur Medicare and Social Security systems are challenged the way it is. If we increase the level of support for long-term care, how do we fund it?鈥�
It would be a challenge. Democrats, who control both chambers of Congress and the White House, are working slowly and deliberately, testing the feasibility of potential approaches.
In the House, Energy and Commerce Committee Chair Frank Pallone, D-N.J., has been working on a plan that would establish a new benefit under Medicare, paying a modest daily sum to help defray the cost of home-based or institutional care. And Rep. Thomas Suozzi, D-N.Y., has proposed a public-private partnership to provide long-term care insurance for services in the home.
A new Medicare benefit would have the advantage of leaving no one behind, since all Americans would be guaranteed a basic level of coverage. But public-private partnerships would also make long-term care insurance more widely available. It鈥檚 not necessarily an either-or choice. For example, many Medicare recipients buy private insurance to fill the gaps in their government benefits.
Retired dentist Fred Rich, of Syracuse, New York, said he tried to buy private long-term care insurance but wasn鈥檛 able to get it because his medical history includes cancer.
鈥淭here鈥檚 a great need,鈥� Mr. Rich said. 鈥淭he baby boomers are getting older. They鈥檝e had fewer children, and their children aren鈥檛 as affluent as they were. So I think it鈥檚 going to be a problem.鈥�
This story was reported by The Associated Press.聽
