Experts tout private and public long-term care funding reforms in Senate hearing

Judith Feder, Professor and Dean, Public Policy Institute, Georgetown University, Washington, D.C.

As the trajectory of long-term care costs rises, experts on funding gave varying approaches on how to achieve savings at a Senate hearing. 

The availability of Medicaid presents a deterrent to some for the purchase of private long-term care insurance, said Douglas Holtz-Eakin, Ph.D., president of the American Action Forum at a Senate Special Committee on Aging titled “The Future of Long-Term Care: Saving Money by Serving Seniors.”  

“The availability of Medicaid raises the perceived cost of purchasing private insurance or of saving,” Holtz-Eakin said. “That increase is small for relatively wealthy people who have little likelihood of ever qualifying for Medicaid coverage, but it can be substantial for others.”

He added that one way to do this would be for the government to provide incentives for long-term care insurance.

Others argued a lack of care coordination drives up federal costs. Judith Feder, Ph.D., a fellow at the Urban Institute and former dean of Georgetown's Public Policy Institute, said that Medicare should give top priority to delivery reform initiatives that both target beneficiaries with functional impairments and extend care coordination to encompass long-term care.

“Although people with chronic conditions are front and center in the movement for delivery reform, that movement risks missing the mark,” Feder said. “It is people with chronic conditions and the need for long-term care needs [that is, help with routine activities of life, like bathing and preparing meals], not people with chronic conditions alone, who account for disproportionately high per person Medicare costs.”