Biden orders study of changes to high court
The president wants a bipartisan commission to look into issues of adding seats to the Supreme Court and limiting justices’ terms.
President Joe Biden is proposing a major expansion of the govern- ment’s role in long-term care, but questions are being raised over his using the low-income Medicaid program and piggybacking the whole idea on an infrastructure bill.
The White House infrastructure package includes $400 billion to accelerate a shift from institutional care to home and community services through the feder- al-state Medicaid program. The size of the financial com- mitment — about 17% of the $2.3 trillion infrastructure proposal — leaves no doubt that Biden intends to put his mark on long-term care.
Biden is acting as the nation emerges from a pandemic that has taken a cruel toll on older people. Long- term care was always going to be a growing issue in an aging society like the United
States. The pandemic has made it even more consequential.
“The most important thing that Biden did is to say that ‘Long-term care is a major priority in my administra- tion,’ ” said Howard Gleck- man, a retirement policy expert with the Urban Institute think tank.
The White House has not spelled out much. A summary of Biden’s plan says the money would go to expand home and community-based services so more people could get care. The proposal would reauthorize a program within Medicaid that helps people move out of nursing homes and back into their communities.
But Medicaid remains a safety net program and that means middle-class people can face arduous challenges to qualify even if they have staggering expenses for long- term care. Because Biden is funneling his funding boost through Medicaid, that leaves out the middle class.
Biden “is the working-class guy, the middle-class guy ... he knows if we only focus on Medicaid, his core con- stituency is not going to be helped, unless they wipe out their assets,” said William Arnone, CEO of the non- partisan National Academy of Social Insurance, which works on policy.
Some Republicans have questioned whether long- term care has any place in an infrastructure bill. Senate Minority Leader Mitch McConnell called the White House plan a “liberal wish list” mislabeled as infrastructure. In rebuttal, Biden said infrastructure should include expanded services — not just roads and bridges — as part of what Americans need to “build a little better life, to be able to breathe a little bit.”
Medicaid spends about $200 billion a year on all long- term care needs, according to the Kaiser Family Foun- dation.