A new answer to America’s growing elder-care challenges

Last week, the national debt reached $40 trillion for the first time. Worse, our population is aging, and the number of working adults contributing to the tax base is dwindling. This means that the demand for elder care is going to surge, and we cannot afford a government program to paper over the problem.

Elder care is often provided by family members who are juggling jobs, children and other responsibilities, but geography, work and other obligations can make that difficult or impossible. There are few affordable options on the market for elders who don’t have families to take care of them: Non-medical in-home care now costs about $80,000 annually on average for 44 hours of care a week. Nursing home care now exceeds $100,000 annually . Taxpayers often end up shouldering much of those costs, particularly for residential care .

A common response to America’s growing elder-care needs is one we’ve heard time and again across policy debates: Spend more money the country doesn’t have. Scholars at the Brookings Institution, for example, have proposed adding a home-care benefit to Medicare that would extend paid home-care coverage to an estimated 15 million beneficiaries. They estimate that such a benefit would increase taxpayer-funded Medicare spending by roughly $40 billion a year.

But pouring more federal money into a supply-constrained market won’t create the plentiful, affordable options families need.

Instead, policymakers should focus on expanding the supply and range of care available to families. That starts with recognizing a simple fact: Not every older American needs the same kind of help.

Some older Americans need skilled nursing or substantial hands-on assistance, while others need light help preparing meals, getting to appointments, shopping for groceries or keeping up with household tasks. Some may simply need a dependable person around to check in and provide companionship.

Rather than confining families to rigid categories that stymie the supply of care and opportunities to provide it, elder-care policy should foster a continuum of options as varied as families’ needs.

The American Caregivers Act , a federal and state legislative model developed by Independent Women’s Voice, where I work, would take a step in that direction by establishing a framework to allow seniors to host vetted college students who provide limited, non-medical assistance and companionship. Caregivers could help with meals, transportation, errands and light household tasks. In exchange, they would receive room, board and a stipend while continuing their college education.

This plan would offer students an affordable place to live and meaningful caregiving experience while giving seniors and their families a lower-cost option for everyday assistance and companionship. The model draws on the sponsor-based framework used by the State Department’s au pair program , which has long connected families with vetted caregivers, while tailoring rules and protections to senior care.

Families, not taxpayers, would finance the arrangements. The proposal creates no new federal entitlement or taxpayer-funded care benefit.

America can’t avoid the growing care needs of an aging population, but another costly federal entitlement isn’t the answer. Policymakers can make it easier for families to meet those needs by creating room for new, affordable models of care.

Seniors’ needs are diverse. Their options should reflect that.

Heather Madden is the vice president for policy initiatives at Independent Women.