Pressure is mounting on the Albanese government after a compelling report by ABC journalists Anne Connolly, Kirsten Robb and Xanthe Kleinig on last night’s 7.30 report pulled back the curtain on the new reality facing older Australians as a result of the incoming co-payment structure of the Support at Home program.
The controversial program will impose mandatory co-payments on new entrants seeking in-home care, potentially pricing out the most vulnerable and directly contradicting the transformative vision of the 2021 Royal Commission into Aged Care Quality and Safety. Titled Neglect for its revelations of systemic failures, the commission called for a rights-based system free from financial barriers. The government’s pivot to means-tested fees risks perpetuating the very inequities it sought to eradicate.
The 7.30 report began at Brisbane’s Donald Simpson Centre, where every fortnight people with dementia and their partners gather for coffee and a chat. While the meetings are meant to provide connection, the discussion turned quickly to the looming reforms. The change that most concerned attendees was the co-payment scheme.
“I think I’ve contributed a hell of a lot in taxes over the years, so I think it’s a bit unfair,” said one elderly man.
Doug Taylor, almost 80, organised the meeting. For over a decade, he has cared for his wife Eileen, who lives with dementia. Now battling prostate cancer, osteoarthritis and sciatica, Doug finds himself needing support too. Eileen’s existing home care package remains protected under transitional rules, but Doug will enter a system transformed by the Support at Home program, where “non-clinical” services such as personal hygiene and household help come with hefty co-payments.
Recently, after coming home from the meeting, Doug found that Eileen had fallen. Her care package continues unchanged, but Doug himself may soon face paying up to 80 per cent of fees under the new rules. The couple survive on a part pension and some savings.
“I’m not against paying anything,” Doug told 7.30, “but I guess some of the figures that I’ve heard sound really extreme, so whatever savings you might have are not going to last very long.” He also expressed frustration that the government has overlooked the very recommendations that were supposed to guide reform. “We had a Royal Commission that says look we’ve looked at the aged care system and these are our recommendations, and they ignored them mostly.”
Under the new scheme, all new participants, including full pensioners, must contribute based on their income and assets. Clinical care such as nursing will remain fully government-funded, but everyday “non-clinical” supports will not. For “independence” tasks like showering or medication assistance, contributions will range from 5 to 50 per cent of the provider’s fee, estimated at around $100 per hour.
“Everyday living” services such as cleaning, cooking or laundry will carry even steeper rates of 17.5 to 80 per cent, with the Department of Health estimating the average hourly cost at $95. This translates to part-pensioners and self-funded retirees paying about $50 for an hour of personal care or $76 for domestic assistance. For full pensioners, these costs could mean choosing between essentials.
Natalie Siegel-Brown, the Inspector-General of Aged Care, told 7.30 that people are already questioning whether they can afford basic care. “There are people who are actively thinking about forgoing care. There are people thinking ‘I can’t afford to have a shower every day’,” she said.
Beverly Baker from the Older Women’s Network called the structure “an obscenity”, pointing out that it forces people to prioritise between personal hygiene and food. “A shower is essential hygienic care,” she said. “To ask people to choose between that and food is really an obscenity.”
Unsurprisingly, Aged Care Minister Sam Rae and Health Minister Mark Butler declined interview requests for the 7.30 report.
The report has sparked strong reactions online. Some commenters fear many older Australians will decline services simply because they do not know how to apply for hardship provisions, with providers often unwilling or unable to assist. Others point out the sheer absurdity of charging $50 for a shower, noting that this could add up to hundreds of dollars a week before housing, bills and food are even considered.
There is also deep concern about changes to Refundable Accommodation Deposits, with some asking what providers will be obliged to do with the money they are allowed to keep. Critics argue that government spending priorities are misplaced, comparing the billions allocated to defence projects with the relatively modest sums needed to properly fund aged care.
Industry and community voices alike agree on one point: the aged care system is already broken, and co-payments risk making it worse.
The arbitrary split between clinical and non-clinical care has been sharply criticised. Siegel-Brown argued that deeming showers “non-clinical” overlooks their role in preventing infections and falls, especially for those with mobility or continence issues. “Personal hygiene has a clear clinical dimension if not in its delivery, then certainly in its absence,” she said, echoing the Royal Commission’s emphasis on interconnected care.
She also warned that the changes could backfire financially. “From a financial perspective, I’m not convinced that the small amount it would cost to fund the contributions by full and part pensioners would be offset by the price of some of these people moving to hospital or residential aged care earlier.”
Labor’s plan for co-payments did not come from the Royal Commission. It originated from a government taskforce established in 2023 that proposed a “user pays” system as a way to keep taxpayer costs down. Critics say this runs directly against the Royal Commission’s call for sustainable funding through a levy, ensuring universal entitlement without financial hurdles.
Economists and aged care leaders agree the reforms will hit pensioners hardest, particularly those without family support. Some warn the policy could even drive up taxpayer costs through premature hospital admissions. State ministers report nearly 2,500 elderly patients are currently “stuck” in hospitals due to aged care shortages, costing the system around $1 billion a year.
Luke Traini, CEO of Trilogy Care, said the scale of the co-payments has not been properly explained to the public. “I don’t think it’s widely known that this is a central part of the new program,” he said. Providers in rural and remote areas face further challenges, with higher travel costs making services even less affordable. This risks service refusals or provider exits, leaving Indigenous elders and Stolen Generations survivors particularly vulnerable, despite the Royal Commission’s calls for co-designed, culturally safe pathways.
The reforms extend into residential care, where new entrants will face means-tested fees for non-clinical supports such as bathing and mobility aids, capped at $100 daily, alongside a “hotelling supplement” for meals and cleaning. Providers can now retain up to 2 per cent annually, or 10 per cent over five years, of Refundable Accommodation Deposits, often exceeding $750,000. This erodes the long-standing guarantee of a full refund upon a resident’s death.
As the November 1 rollout approaches, 7.30’s investigation has intensified calls for the government to pause and review the scheme, in line with Siegel-Brown’s recommendation for independent evaluation and stronger safeguards.
For families like the Taylors, the promise of ageing in place feels increasingly out of reach. Without urgent recalibration, the reforms risk galvanising the neglect that the Royal Commission hoped eradicate.
In my opinion Co-payment will be a burden on people. In one hand we have taken away the fees from the providers, and in another we have burdened the wider population with co payments. Having said we have to wait till the 1st of November and, when it will continue to burden wider population, I am positive reform will take place at one point.
We are in late 70s both have numerous health problems cancer heart and more not using aged care at the moment and think when the time comes we will be searching for a vet
Dont punish the old who have given so much to Australia. They are not the ones who have sat on welfare all their lives. They deserve care and attention as they still have so much to offer. This should be properly funded.
Dont let them suffer and die when we can help them. I vote my taxes are spent on them rather than 2, 3 etc generation welfare recipients who dont give a hoot about anyone but themselves.
One of the main issues here, as I see it, is the exorbitant rates being touted for, e.g., showering and cleaning. How can a provider charge $95 per hour for cleaning or $100 per hour for a shower? I have worked for an aged care provider, and their rates were out of control, and their motives were solely to generate profit for themselves. If the cost is brought down to an acceptable level, then the amount that the client would have to pay would also be significantly reduced.
Agree. I think people will look privately for carers rather than go through my gov. At present the providers seem to be raking in the money.
Quality age-care is an *essential service* and should be funded without individual cost according to needs. When the frail and elderly, regardless of their income are to be billed for assistance in essential hygiene, we’ve reached a new low.
This is only the beginning. This government is planning on cutting welfare spending and winding back the social contract to finance war. Their win at the last election was “wide and shallow” but it could easily evaporate once people understand what they intend to do. Both major parties no longer represent the vast majority of working people who are opposed to cuts and war. Charging pensioners for basic care is a low act.