Medicare/Medicaid already pays for people to live in assisted care facilities. It seems the point here is that it doesn't pay for people to get assisted care in their own homes.
Presumably, some people would prefer to stay in their own homes instead of being forced to move to a facility. So the question is why not change Medicare/Medicaid to allow for that?
ATM, the only rational reason would seem to be cost. But, having done the accounting/taxes for assisted care facilities, it's not clear to me that providing that care in someone's home is more expensive.
I've checked an ademic paper (
http://www.ahcancal.org/ncal/resources/Documents/MedicaidAssistedLivingReport.pdf ) and states' rates, as one might expect, are all over the place. Some exceed the $75, and by a good margin. I would think these variations are to be expected, and at least partially attributable to the various the cost-of-living found in different locales.
Seems to me existing Medicare/Medicaid money can be used for this purpose (paying for in-home care instead of forcing people to relocate to a care facility).
I'm starting to get the impression that a chunk of this bill is designed to force standardization of medicaid among the states. That begs the question "why".
Fern