“By not enabling older people to stay at home longer, the new restrictive home support system will create a nation burdened by nursing homes instead of a country that respects and values its elders and their culture.” This powerful statement from a colleague captures the heart of the issue.
The flawed Support at Home system
The new Support at Home program, effective from 1 November 2025, introduces individual contributions based on a percentage of services used, creating an inequitable and unsustainable model for older Australians. This approach risks stripping people of their money and dignity, forcing many into privatised residential care.
Individual contribution rates
From 1 November 2025, contributions for in-home services are based on pension status, income, and assets:
| Pension Status | Clinical Care | Independence | Everyday Living |
| Full Pensioner | 0% | 5% | 17.5% |
| Part Pensioner/Commonwealth Seniors Health Card | 0% | 5–50%* | 17.5–80%* |
| Self-Funded Retiree | 0% | 50% | 80% |
*Dependent on income and assets.
Case study: Bill
Bill, a retired part-pensioner, owns his home and has $10,000 in savings plus a superannuation income, totalling $45,500 annually. Under the new system, Bill contributes 14% towards his Support at Home services, with the government covering 86%.
However, as his care needs increase, so do his costs—while his income remains static.
For someone like Bill requiring 12 hours of weekly support (e.g., showers, cleaning, meal preparation, shopping, and transport), indicative costs are:
For a pensioner on $525.65/week, this is simply unaffordable.
The design flaw
The user-pays model ties contributions to service usage, not income, creating a system where those with higher care needs pay more despite fixed incomes. Many older Australians, particularly those with disabilities or complex health needs, require at least 12–20 hours of weekly support to remain at home. Co-payments of $150–$200/week are unrealistic for pensioners or low-income retirees.
In 2024, 88% of home care package recipients were exempt from income-tested fees. The shift to percentage-based contributions ignores this reality, offering no meaningful hardship support or safety nets. For example:
This unpredictable cost structure makes budgeting impossible, especially when service needs fluctuate.
Consequences
For Bill, a homeowner, increased care needs or unexpected expenses (e.g., home repairs) could deplete his $10,000 savings quickly. His options are stark: sell his home, take out a reverse mortgage for temporary relief, or enter residential care, where the proceeds from his home sale would be consumed by fees.
For Bill’s sister, Billie, a renter with the same income, the situation is even worse. Unable to afford co-payments, she would be forced into fully subsidised, privatised residential care, uprooting her from her community.
This system fails to deliver the modest support needed to keep older Australians at home, pushing them towards institutional care and undermining their independence.
A fairer solution
The 2018–21 Aged Care Royal Commission, informed by 99 days of hearings, 641 witnesses, and over 10,000 submissions, warned against a two-tier aged care system. It recommended funding aged care through a hypothecated tax or levy to share costs across the community. A Flinders University study found 61% of taxpayers support paying more income tax for a quality aged care system.
Instead of the flawed individual contributions model, the government should retain the current income-tested fee structure. This maintains a user-pays approach where feasible, without risking financial elder abuse.
Support at Home is not ready
The Senate must amend the Support at Home rules to remove individual contributions and reinstate income-tested fees. Write to the Aged Care Minister, your local MP, and Senators to demand justification for a system that forces vulnerable older Australians into privatised residential care.
Let’s build an aged care system that respects and supports our elders to live independently, not one that penalises frailty.
