Projections show majority of seniors will be denied home care support in 5 years

The Albanese Government’s Support at Home reforms, celebrated as a landmark step in community aged care, are already shaping up to be a disaster in waiting. Far from solving the home care crisis, they will entrench it. According to projections from Kathy Eagar, a respected aged care economist and former adviser to the Aged Care Royal Commission, the country faces a disturbing shortfall of care at home packages that will stretch far into the next decade.

Even with the government’s much-publicised release of 83,000 new packages, there will still be more than 200,000 people missing out each year. By 2035, the shortfall will climb to an extraordinary 367,000 places.

This is not just a policy gap. It is a national scandal. The government has boasted of the “largest ever” release of home care places, yet the figures show the extra packages are a drop in the ocean. For older Australians desperate for support to remain safe in their own homes, this is the grim reality behind the political spin.

Kathy Eagar has been blunt in her assessment. She has warned that the new Support at Home program is so badly designed it will increase pressure on public hospitals and residential aged care facilities, rather than relieving them.

Her forecasts are based on the government’s own population projections and forward estimates. The first of the baby boomer generation will turn 80 in 2026, which is the average age when Australians begin to need aged care support at home. Demand will surge from then on, yet the government has made no provision for extra packages beyond what it has already announced.

When you crunch the numbers, the scale of the looming disaster is clear. In 2025, more than 530,000 people will need care at home, yet only 299,765 packages will be available. That leaves 230,000 people stranded without support.

By 2030, the shortfall grows to more than 300,000. By 2035, with more than 6.4 million Australians aged over 65 and over two million aged above 80, the gap between need and supply will surpass 450,000. In other words, within a decade the government will be funding less than half the required care at home places.

What makes this situation even worse is the way the government has misrepresented the scale of the crisis. The Senate Inquiry into Aged Care Service Delivery recently exposed the true number of frail seniors waiting for home care support. More than 200,000 people are in the queue, including 120,000 who are waiting just to be assessed and another 90,000 who have already been approved but are still without a package.

ntil that Inquiry forced the facts into the open, the Minister for Aged Care and Seniors, Sam Rae, had been claiming that only 90,000 were waiting. He insisted the release of 83,000 new packages would effectively solve the problem. The truth is those extra places will not even scratch the surface.

Even these waiting list figures are an underestimate. They do not include the thousands of older Australians waiting for support from the Commonwealth Home Support Program, which provides services such as Meals on Wheels, community transport, home nursing and neighbourhood aid.

This program supports more than 800,000 people each year at a fraction of the cost of package-based care, yet the government has deliberately never collected waiting list data for it. Reports from around the country suggest it too has very long waiting times. The government’s plan is eventually to abolish CHSP altogether and fold it into Support at Home, a move that will push hundreds of thousands more people into a system already unable to cope.

Because Support at Home has far higher administrative and compliance costs than CHSP, the change will also make aged care more expensive for both government and providers.

The design flaws in Support at Home go far beyond the numbers. The program links consumer co-payments directly to the number of hours of support required. This means that those who are more frail and vulnerable, and who need the most help, will be hit with the highest bills.

It is a system that effectively punishes people for being old and unwell. The government has rejected the long-standing principle that fees should be based on capacity to pay. Instead, it has designed a model that will burden people on low incomes with charges they cannot afford.

Eagar has described this bluntly. Frail and vulnerable people will not get the care they need because they will not be able to pay for it. The so-called hardship provisions are a cruel joke. The application for a fee reduction runs to 17 pages, a bureaucratic obstacle course that many of the most fragile citizens will never be able to navigate.

The consequence will be that older people go without support, or they end up in hospital emergency departments after a fall, a medication error or from sheer neglect. In the end, costs to the health and aged care system will rise, even as the government trumpets its budget savings.

The rhetoric of Support at Home is that it will give older Australians choice and control. The reality is different. It imports many of the worst features of the National Disability Insurance Scheme, transforming every interaction into a financial transaction. Instead of relationship-based care provided by trusted services and familiar faces, frail seniors are handed a cashless credit card and told to navigate a competitive market.

This may suit articulate middle-class consumers who can shop around and switch providers, but it leaves behind the majority who are vulnerable, isolated and easily exploited.

The government’s approach is also riddled with contradictions. It says it wants to reduce demand for residential care, yet the design of Support at Home will inevitably drive people into institutions. It says it is building a rights-based aged care system, yet it has created a program where access is rationed, affordability is questionable, and the rights of older people to live safely and independently are constantly undermined.

The Albanese Government continues to repeat that 83,000 new packages represent a historic investment. It ignores the reality that by its own forward estimates, this number will be grossly insufficient within a year, and catastrophic within a decade. It has no demand strategy, no workforce plan, and no realistic financing model to meet the needs of a rapidly ageing population. Instead, it is clinging to the hope that older Australians will quietly absorb the hardship.

The truth is that this is not a failure of foresight. It is a choice. By rejecting the recommendation of the Aged Care Royal Commission for one integrated program covering both residential and home care, the government has widened the divide and chosen to preserve a system that is already unravelling. It has chosen to push more costs onto older people and their families, to ration services through endless waiting lists, and to gamble that most will not have the voice or strength to fight back.

Support at Home is not a Labor program in spirit or in design. It is an inheritance from the Howard-era vision of a privatised, transactional care economy. It reflects the Coalition’s long-standing hostility to community-based models such as CHSP, which are cheaper, fairer and built on trust. Labor’s decision to embrace and expand this framework, rather than overturn it, reveals a government more concerned with containing budgets than with protecting the dignity of its citizens.

As Eagar has argued, there is still time for the government to act differently. It could commit to expanding CHSP as a separate, relationship-based program alongside Support at Home, giving people a genuine choice of care model. It could design a fairer contribution system, with capped fees linked to income rather than frailty, and with automatic hardship protections instead of 17-page forms. It could finally develop a serious national strategy for demand, workforce and financing, instead of cobbling together patches that fall apart within months.

But right now, none of this is happening. What is happening is that hundreds of thousands of older Australians are waiting in line for care that will never arrive, or staring at bills they cannot pay. The Albanese Government insists that Support at Home will give people the right to age with dignity in their own homes. In practice, it is delivering a system where dignity is conditional, support is rationed, and independence is a privilege reserved for those who can afford it.

Australia is standing on the edge of a demographic wave that will reshape its society. The first of the baby boomers will need aged care in earnest within a year. By 2035, millions more will join them.

The government has been warned, repeatedly and in detail, by its own advisers, by inquiries and by experts such as Kathy Eagar. Its refusal to act cannot be excused as ignorance. It is wilful neglect. And it is older Australians who will pay the price.