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Bipartisan group proposes major long-term care reforms

Brian Anderson

After 3 years of work by a diverse group of policy experts to create a consensus framework for the way long-term care is financed and delivered in the U.S., the Long-Term Care Financing Collaborative this week announced recommendations built around two major reforms: A new universal catastrophic LTCI insurance program and major improvements to Medicaid’s long-term supports and services (LTSS) benefit.

In its report released Feb. 22, the Collaborative recommends a broad package of reforms aimed at empowering people of all incomes to receive high-quality long-term services and supports. The group includes former state Medicaid directors, members from the Brookings Institution, America’s Health Insurance Plans (AHIP) and more.

“Washington conventional wisdom says it is impossible to find a policy solution to the challenges of long-term care financing. The Collaborative showed the conventional wisdom is wrong. People from across the political spectrum with broadly diverse interests did find a workable, consensus resolution to this important problem,” says Howard Gleckman, senior fellow of The Urban Institute and one of the Collaborative’s founders.

• See also: Yes, we can create a universal long-term care insurance program

• Thoughts or comments? Please visit this new thread: Group Advocates for Major U.S. LTCI Reform

“This work represents a true collaboration of ideas resulting in thoughtful recommendations on how to solve our nation’s long-term care financing problem,” adds AHIP’s Susan Coronel. “As this dialogue moves forward, it is critical that funding proposals account for combined partnerships that demonstrate cost savings for individuals and states. A sustainable solution is best achieved through harnessing the combined strengths of government, insurers and caregivers, to ensure the millions who depend on long-term care have access to the services they need.”

Specifically, the Collaborative proposes:

• Clear private and public roles for long-term care financing.

• A new universal catastrophic long-term care insurance program. This would shift today’s welfare-based system to an insurance model.

• Redefining Medicaid LTSS to empower greater autonomy and choice in services and settings.

• Encouraging private long-term care insurance initiatives to lower cost and increase enrollment.

• Increasing retirement savings and improving public education on long-term care costs and needs.

The final report expands on the Collaborative’s July 2015 recommendations for improving delivery of long-term care. That report proposed steps to better coordinate LTSS and medical care, and strengthen support for the family members and communities that provide most assistance for those with long-term care needs. Copies of the reports are available on the Convergence website at www.convergencepolicy.org/ltcfc-final-report/

The Collaborative says its recommendations are based on shared principles, a vision of a better future for those with LTSS needs, and on the best research available.

“The Collaborative’s catastrophic insurance concept meets several key policy objectives – most importantly that Americans would have some shelter from a core risk threatening their retirement and overall economic security,” says Collaborative member Marc Cohen of LifePlans, Inc. “Addressing this ‘back end’ risk would also provide needed relief to states by reducing Medicaid expenditures while leaving room for growth in the private insurance market to address front end needs in an affordable way. Clearly, when compared to a number of alternatives considered, the catastrophic insurance design — which is both affordable and fiscally sustainable — met the greatest number of policy goals on which there was a consensus.”

In a release announcing the recommendations, the Collaborative notes that more than 12 million Americans (both frail older adults and younger people with disabilities) need personal assistance to live independently and with dignity, a number that is expected to double by mid-century. Paid assistance in any setting is expensive and beyond the reach of most families. As a result, family members make enormous physical, emotional, and financial sacrifices to assist parents or other relatives. Profound demographic changes will magnify these burdens in coming years.

For the past 30 years, policymakers attempted to respond to the challenges of financing long-term services and supports, but with little success. The Long-Term Care Financing Collaborative began meeting in 2012 with the goal of developing widely supportable and actionable recommendations for a public and private insurance-based financing system that empowers all people to receive high quality services and supports. Watch the LTCFC Press Conference at: https://scontent.webcaster4.com/web/LTCollaborative

• Thoughts or comments? Please visit this new thread: Group Advocates for Major U.S. LTCI Reform

About: The Collaborative is convened by Convergence Center for Policy Resolution, a non-partisan, non-profit organization that brings together people and groups with conflicting views to build trust, identify solutions, and form alliances for action on critical national issues. For more information about Convergence, please visit www.convergencepolicy.org.



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