Rising home health costs breaking the middle class
By: Ken Altucker
USA Today
..... Home care and assisted living costs for older adults and people with disabilities have surged over the past five years, straining middle-class families, AARP said in a March 12 [2026] report.
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More than half of adults who turned 65 between 2021 and 2025 will need long-term care services in their lifetime, according to the Department of Health and Human Services.
..... But families often aren't financially prepared, said Alan Weil, director of AARP's public policy institute.
..... "It hits families harder than they expect - and at a higher cost," he said.
..... Authors said the report underscores an affordability crisis.
..... The cost of the most common types of long-term services - home care and assisted living - surged nearly 50% from 2019 through 2024, far outpacing the median income growth of 22% for senior households.
..... Costs of other long-term services also grew more quickly than income for households that must pay for this care without public aid. Adult day service costs jumped 33%, and nursing home care increased up to 25%, AARP said.
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Average annual costs for care range from $26,000 for adult day services to more than $127,000 for a private nursing home, AARP said. Meanwhile, older adults receive an average Social Security benefit of $23,700 per year and have an average annual household income of nearly $60,000.
..... Costs vary widely by state. For instance, home health aide services range from $34,320 in Louisiana to $68,640 in South Dakota.
..... The report also measured affordability, tracking the service costs against average household income. By that measure, home health aides are most affordable in Maryland and least affordable in Maine.
..... Families aren't properly informed about these price tags. An AARP survey in 2022 found that about half of respondents aged 50 or older mistakenly believed Medicare covers care in a nursing home or home care from a home health aide.
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Medicaid does pay for nursing home care for millions of low-income adults. But for middle-income families who don't qualify for Medicaid, costs can rise quickly. About 1 in 7 older adults had out-of-pocket costs that exceeded $100,000 in 2020, AARP said.
..... For families who can't afford to hire help the burden of providing care often falls on unpaid caregivers. these caregivers, often relatives, contributed the equivalent of about $600 billion in care om 2021, AARP said.
..... Looking at causes of the surge, long-term care experts not affiliated with AARP point out that federal and state governments greatly expanded Medicaid assistance to long-term care services during the COVID-19 pandemic. The support addressed a shortage of nursing home and home health workers during the worst days of the pandemic.
..... Other factors in the price surge include minimum wage hikes that raised expenses for lower-wage workers, including nursing home employees and home health aides.
..... Marc Cohen, co-director of LeadingAge LTSS Center at UMass Boston, said ricing care costs often land disproportionately on people who pay for their own services. That's because Medicaid often reimburses care at lower payments by shifting costs to self-payers.