Bipartisan Consensus in Long-Term Care Financing

Emerging Consensus on a Challenging Public Policy Problem


Half of all Americans turning 65 today will one day find themselves needing a high level of help with basic daily activities, such as walking, eating, bathing, and getting out of bed. The average American will face substantial long-term care (LTC) costs in old age. Older adults with longer periods of high need usually end up paying for long-term services and supports (LTSS) through significant amounts of out-of-pocket spending. Many also rely on unpaid family care or go without needed care. Once a person’s savings has been exhausted, LTSS costs are then covered by Medicaid.

In February 2016, three different bipartisan organizations released policy recommendations on financing long-term care.



We partnered with the SCAN Foundation to analyze the policy recommendations from the three groups—Bipartisan Policy Center, LeadingAge Pathways, and Long-Term Care Financing Collaborative. Several common themes emerged in our analysis.

The organizations agreed that multi-pronged solutions are required to increase insurance-based coverage—and will have to utilize the strengths of both the private and public sectors. The groups also agreed that the solution set should include reforms to the private insurance marketplace to provide lower priced policies for the purpose of insuring against the risk of needing a high level of LTSS over a relatively short period of time. It should also include insurance specifically designed to protect against the risk of high LTSS need that occurs over long periods of time and to at least consider further development of a catastrophic insurance program where all Americans would be covered.



All three policy groups identify that much work is needed to shape their respective recommendations into detailed and viable proposals in 2016-2017, as well as educate policymakers and the public about the need for LTC financing reform. The members of these groups have and continue to work extensively on what is one of the most challenging health policy problems that remains, for which there is no easy solution.

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