Even as the costs for LTSS have risen, demand for such care has also increased due to a larger aging population. According to the report, a small but noticeable share of the older adult population will end up with long-term health costs well over $250,000. This is because the vast majority of people have no protection against the financial costs of long-term disability. Although Medicaid protects certain classes of people from particular diseases, budgetary constraints have put pressure on politicians and policy makers, especially at the state level, to cut back even further on essential benefits.
In the report, the Scan Foundation and NASI propose to institute an insurance-based model to ensure that many more people, not just those who qualify for Medicaid, have a chance to protect themselves against LTSS costs. The Foundation proposes a universal compulsory program, much like the one implemented in the Affordable Care Act, that compels people to buy long-term care insurance, thereby spreading this risk broadly.
This could be done by:
- adding LTSS coverage to Part A of traditional Medicare;
- adding the ability to enroll voluntarily through Medicare Advantage (MA);
- requiring MA plans to provide LTSS coverage; or
- creating a Medicare Part E, which would cover custodial nursing care, traditional care services, and the like. Enrollment in Part E could be either voluntary (with a short, limited sign-up window) or mandatory.
Read the report.
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