Long-term care: Markets or mandates?

Video

Event Summary

The high costs of long-term care (LTC) -- medical and nonmedical services for those who cannot care for themselves -- place a growing burden on the elderly and disabled, on their families, and on state and federal budgets. At an AEI event on Friday morning, a panel of experts discussed how to protect Americans from the rising costs of long-term care.

Mark Warshawsky of the Long Term Care Commission kick-started the discussion with some questions, specifically asking whether Americans, in an attempt to finance long-term care costs, spend down their assets to become eligible for Medicaid.

Joshua Weiner of RTI international confirmed the pervasiveness of the "Medicaid spend-down" phenomenon; according to his research, 10 percent of the non-Medicaid population over the age of 50 spent down their assets over a 10- to 12-year period.

Steve Moses of the Center for Long Term Care Reform disagreed with Weiner's assessment of Medicaid spend-down.  Moses argued that, according to Medicaid eligibility policy specialists across the country, Medicaid eligibility requirements are easy to circumvent, such that many people -- particularly those with the means to hire eligibility lawyers and specialists -- can qualify without spending down significant wealth.

Matt Salo of the National Association of Medicaid Directors emphasized that regardless of whether people spend down to become eligible, LTC spending constitutes the majority of Medicaid spending, and the rise in LTC costs will increasingly strain state budgets.

--Catherine Griffin

Event Description

To protect Americans from the costs of long-term health care for the elderly and disabled, President Obama’s health law established the Community Living Assistance Services and Supports Act (CLASS). Less than two years later, the Obama administration announced that CLASS could not operate without large and growing deficits, and the program was terminated. In its wake, the Commission on Long-Term Care — created by the fiscal cliff legislation — is charged with developing a new way to finance long-term care services and supports. The commission’s report is due in September 2013.

At this event, Mark Warshawsky, a well-known expert in retirement finance and a newly appointed commissioner, will explain the implications of another publicly funded long-term care insurance program. A panel will then debate whether another government program is the best way to ensure that families can afford to provide the necessary services for their aging loved ones.

If you are unable to attend, we welcome you to watch the event live on this page. Full video will be posted within 24 hours.

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About the Author

 

Joseph
Antos
  • Joseph Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute (AEI), where his research focuses on the economics of health policy — including the Affordable Care Act, Medicare, the uninsured, and the overall reform of the health care system and its financing. He also studies the impact of health care expenditures on federal budget policy.

    Before joining AEI, Antos was assistant director for health and human resources at the Congressional Budget Office (CBO). He has also held senior positions in the US Department of Health and Human Services, the Office of Management and Budget, and the President’s Council of Economic Advisers. He recently completed a seven-year term as health adviser to CBO, and two terms as a commissioner of the Maryland Health Services Cost Review Commission. In 2013, he was also named adjunct associate professor of emergency medicine at George Washington University.

    Antos has a Ph.D. and an M.A. in economics from the University of Rochester and a B.A. in mathematics from Cornell University.



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  • Phone: 202-862-5938
    Email: jantos@aei.org
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    Email: Neil.McCray@aei.org

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