While President Donald Trump would seek to cap the overall federal contribution to Medicaid and increase state flexibility, former Vice President Joe Biden would look to expand the program to provide more funding to long-term care services, reveals a new analysis on the presidential candidates’ proposals for seniors.

Forbes columnist and leading observer Howard Gleckman on Monday detailed some of their specific proposals for seniors in regards to long-term care and Medicare. 

Long-term care

When it comes to long-term care, Biden plans to spend $450 billion over 10 years in order to reduce states’ waiting lists for Medicaid home- and community-based services (HCBS), explained Gleckman. 

“Biden would give those who stay home to care for loved ones credit towards their own Social Security benefits. He’d also raise wages and benefits for direct care workers such as home care aides,” he wrote. 

Biden and running mate Sen. Kamala Harris (D-CA) echoed plans to increase access to HCBS in a policy proposal for long-term care facilities and nursing homes, if elected. His proposal also calls for increased survey frequency aimed at helping consumer decision-making, reinstating the ban on forced arbitration agreements, ensuring adequate staffing and training and requiring audits of nursing home cost reports and ownership data. 

Gleckman noted that while Trump has “largely been silent on the issue of long-term care,” his administration is in favor of capping federal Medicaid funds “in exchange for increasing state flexibility.” 

“Such a step would likely reduce resources available for Medicaid supports and services for older adults and young people with disabilities,” Gleckman explained. 

The Trump administration withdrew proposed guidance on Medicaid block grants and per capita cap programs last November.

Medicare

Biden’s plans for Medicare include reducing costs for specialty drugs and imposing a tax penalty on manufacturers who raise drug prices more than the rate of inflation. 

“While Trump has been largely silent about Medicare in his campaign, his most recent budget provides some important clues about his second-term agenda. In that budget, he proposed reducing projected Medicare payments to teaching hospitals and hospitals with large numbers of low-income patients. He also proposed reducing future payments for outpatient services that take place in a hospital,” Gleckman explained.