Long-term care reform needs more than a proposed $400 billion to boost home- and community-based services, financial experts and industry observers are warning. The question is whether President Joe Biden will take a broader approach to healthcare, and senior care in particular, as he prepares for his first speech before a joint session of Congress.

“There is no doubt that Medicaid long-term services and supports (LTSS) need updating and more funding. And the president deserves credit for highlighting that need,” finance expert and Forbes columnist Howard Gleckman explained in a column last week. “But expanding Medicaid home-based services would fix only part of the nation’s long-term care problem. It would do nothing for those older adults and younger people with disabilities who need institutional care.”. 

Gleckman argued that Biden should also consider a public long-term care insurance program or consider making long-term care a Medicare benefit. 

A group of federal lawmakers, led by Sen. Bernie Sanders (I-VT), is also pushing President Joe Biden to include an expansion of Medicare benefits in his roughly $2 trillion infrastructure proposal.

“If [Biden] refocuses his efforts, he can both help more families and neutralize those corporate critics, which boosts the chances that a long-term care expansion will pass Congress,” Sanders wrote. 

Early indications, however, are that the American Families Plan Biden unveils Wednesday will not offer much in the way of a substantial healthcare agenda.