By Mac Daniel
A newly introduced federal bill would address how to finance LTSS for older adults.
With roughly 10,000 Americans turning 65 every day, questions about how to provide and pay for long-term services and supports (LTSS) for older adults have become more pressing than ever.
More than half of Americans will need LTSS in old age. Yet less than 10% of the population has insurance to cover the costs, and the divisive nature of U.S. politics has been a barrier to tackling LTSS financing issues head-on.
“Everyone in their gut knows that there’s this issue out there,” said Marc Cohen, co-director of the LeadingAge LTSS Center @UMass Boston and research director of the Center for Consumer Engagement in Health Innovation at Community Catalyst. “But very little has been done about it.”
Cohen and his colleagues spent years working on a strategy for financing LTSS first put forward by academics and researchers participating in the Long-Term Care Financing Collaborative. They then expanded on this idea in a paper presented at the Bipartisan Policy Center in 2018. At times, their suggestions gained traction, but not among the people who mattered most—lawmakers who could enact legislation.
On June 30, New York Congressman Tom Suozzi (D-NY), introduced the Well-being Insurance for Seniors to be at Home (WISH) Act, which addresses how to finance LTSS for older adults. The legislation represents the first new solution put forth in almost a decade.
“With the number of disabled elders expected to double in the coming years, fewer family caregivers are available for these aging Americans, and the market for long-term care insurance is not currently sufficient to address these demographic challenges,” Suozzi said in a press release when the legislation was released. “The WISH Act would save the Medicaid program and millions of Americans from financial ruin, would allow people to age at home with dignity, and would create millions of good-paying, middle-class jobs in the home health care industry.”
Private and public interests stood in the way of past legislation addressing LTSS financing. The WISH Act attempts to overcome this divide by creating a public-private partnership that would provide social insurance for catastrophic LTSS expenses and rely on family help, savings, and private long-term care insurance to cover early, up-front costs.
Suozzi’s legislation is aimed at helping individuals with low incomes and families whose savings are often decimated when a loved one requires long-term care. By addressing this dangerous trend, the legislation would also promote health equity and provide a financial parachute to families who would suffer most under the current system. That system leaves the Medicaid program financially stretched, unable to meet the needs of its beneficiaries or to pay rates necessary to support a high-performing workforce.
Read more on the UMass Boston Gerontology Institute blog. Marc Cohen and Stuart M. Butler published a blog about the WISH Act in Health Affairs on Aug. 9.