Senate Democrats propose adding long-term care benefit to Medicare

STAT News – Wednesday, May 20, 2026
By John Wilkerson

A group of Senate Democrats is proposing that Medicare cover in-home care, which would create the first new benefit in the program since the Part D retail drug benefit more than 20 years ago.

The long-term care proposal is the final piece of a three-part health care plan that senators, led by Ron Wyden (D-Ore.), are using to outline their vision and draw contrasts with Republicans ahead of the midterm elections. Earlier this year, they proposed a plan to lower drug costs and a framework for private health insurance overhaul.

The plan is not detailed, and does not offer cost estimates or address the question of funding. In addition to creating a home care benefit, it calls for spending more to shore up long-term care in Medicaid and creating stricter nursing home staffing standards. It also includes a workforce component aimed at training more long-term care employees and providing them better pay and benefits.

There are about 80 meetings scheduled with industry and patient groups to start developing details, Democratic staff said.

The nascent proposal is partisan. Democrats believe that improving long-term care is politically popular and that their position on the role of government in health care is so different from Republicans’ that there is no way to improve the system through compromise.

After Republicans cut more than $1 trillion from government health care spending over a decade, mostly from Medicaid, Democrats believe they need to rebuild the system.

“They’re going to have to work together to construct it themselves,” a Senate Finance Committee Democratic aide said of Democrats. “And then be ready to pass it when they have a trifecta.”

Despite the open-ended nature of the project, private long-term care insurance is not included. There’s a bipartisan private long-term care bill in the House by Reps. Tom Suozzi (D-N.Y.) and Aaron Bean (R-Fla.), but staff said Senate Democrats aren’t interested in that approach.

“We have seen how the private long-term care insurance market has worked over years, and we don’t think it meets the needs of Americans currently,” a staffer said. “So we are thinking about providing access in a different way through the programs that people know and rely on: Medicare and Medicaid.”

Staff also implied that Democrats will target private equity firms that have been accused of harming patient care in the pursuit of profits. Senators are “looking at the kind of profit hiding and related parties and shell games in nursing homes, and ensuring that taxpayer dollars are really spent on direct care,” an aide said.

Improving long-term care probably would be expensive, and Democrats have tried in vain to do it in the past.

Democratic presidential candidate Kamala Harris had a plan to add a home care benefit to Medicare. The Affordable Care Act included a measure, called the Community Living Assistance Services and Support Act, that was a voluntary, self-funded long-term care insurance program. However, the Obama administration killed that program after determining it was not financially viable.

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