Long-Term Care Commission members shed light on financing deliberations, urge continued political pressure

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Dr. Bruce Chernof
Dr. Bruce Chernof

Long-term services and supports should be a major focus of next year's White House Conference on Aging, and advocates should work to keep financing reform in the spotlight during the upcoming mid-term Congressional elections, according to members of the federal Commission on Long-Term Care.

The Commission was convened last year, after Congress scrapped the long-term care component of healthcare reform known as the CLASS Act. The group produced a report with recommendations for overhauling the nation's long-term care delivery and financing systems. Nine articles in the current issue of the Public Policy & Aging Report address the recommendations, and some of these articles were written by Commission members themselves.

Congress was not required to act on the recommendations, and the articles in part argue for continued pressure on lawmakers to take action. The call to put LTSS front-and-center at the next White House Conference on Aging came from Commission Chairman Bruce Chernof, M.D., and co-chairman Mark Warshawsky, Ph.D. Chernof is president and CEO of The Scan Foundation, which supported this edition of PP&AR.

The Commission failed to issue a unified recommendation for how to tackle long-term care financing reform, splitting along largely partisan lines and releasing two alternate plans. The articles delve more deeply into the commissioners' thinking on this issue.

“Many commissioners believed that it would be irresponsible to put forward a specific proposal, particularly involving public financing, when it was not possible in the time available to estimate reliably the scope or magnitude of its cost and to determine the amount of tax and/or premium dollars that would have to be raised to pay for it,” Chernof and Warshawsky wrote.

The Commission's staff director —  G. Lawrence Atkins, Ph.D. — elaborated more on the financing discussions in his article, “Solving the Long-Term Services and Supports Financing Puzzle.” In addition to better data and modeling, a few other specific sticking points need to be addressed to build a viable comprehensive financing solution based on principles that the commissioners agreed on, he wrote. One of these is providing LTC coverage for people of moderate income while still engaging their resources to some extent.

Given the current political stalemate in Congress, large-scale action in the near future is not likely, Atkins acknowledged. He identified several viable short-term, partial fixes. These include “modest” legislation to expand the use of retirement income in paying for care, and developing an advocacy community to keep the issue in the spotlight, even in the imminent mid-terms.