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Congress Grappling With Long-Term Care

In late June, a 15-member congressional commission met for the first time to begin preparing a report that it would issue the Congress by September 30. The Commission on Long-Term Care grew out of the fiscal cliff deal reached earlier this year. As a part of that deal, Congress and the White House agreed to terminate the Community Living Assistance Services and Supports Act, or CLASS, that had been included with the Affordable Care Act. CLASS would have given elderly people a public option for long-term care insurance.

Instead, the January agreement provided for the creation of the commission, a 15-member group is comprised of nonpartisan healthcare experts appointed by both Republicans and Democrats. The commission has a limited staff and budget, and was created to come up with new recommendations on how to address the problem of providing long-term care to the millions of Americans who are now, or who soon shall be, elderly.

Currently, Medicaid pays for about 50% of long-term care expenses in the country. However, only those who qualify for the program can use the government provided healthcare insurance program as a way to pay for nursing home or elder care expenses. Many of those who wish to use Medicaid must first spend their assets so that they qualify as indigent applicants.

The other half the equation is long-term care insurance providers. There has been significant turmoil in the long-term care insurance market, with many insurance carriers choosing to no longer provide coverage. Additionally, many policyholders have seen their premiums increase dramatically in recent years. In 2012 alone, the prices for long-term care insurance increased by 20%, according to the American Association for Long-Term Care Insurance.

Yet many health and long-term care industry experts say there are options available to help deal with the country’s elder care problem. One such solution is to offer optional coverage as a part of private Medicare plans. Medicare Advantage, a privatized managed care alternative to the standard Medicare program, could begin offering private long-term care coverage. There has been some research to show that offering such supplemental coverage could help lower premiums and give insurance providers an incentive to help manage any chronic health problems that seniors have.

Another option could be expanding mandatory participation insurance pools by expanding either Social Security or Medicare. By expanding the protections afforded through the social insurance programs, the costs associated with such long-term care could be absorbed by the broader population.

Regardless of the specific recommendations the commission makes, it doesn’t have a long time to do so. Though it’s possible that Congress could extend the group’s deadline, the commission currently has a little over two months to finalize its report.

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