Congressional Budget Office analyzes long-term care policies

Share this content:
States may not have the infrastructure to support a potential increase in home- and community-based services, according to the Congressional Budget Office. The agency released a report highlighting the projected costs and ramifications of more than 100 healthcare policies, including many proposed for long-term care.

A proposal (McKnight's, 11/13/08) that would require states to make home care and community-based care a mandatory option under Medicaid, and allow beneficiaries to chose between home, community and institutional care, could cost up to $90 billion over the next decade, according to the report. Report authors say that, while the plan would expand service options to more Medicaid beneficiaries, most states may not have the necessary infrastructure to accommodate the increased demand for HCBS, and would need to pay substantial up-front investments.

Other policies the CBO analyzes in its report include: increased use of advance directives; individual long-term care insurance accounts; and increased federal matching funds for HCBS. The CBO notes that, during 2005, the federal government funded 69% of all long-term care, and projected Medicaid spending in 2009 will be roughly $66 billion, or one third of the program's federal spending on benefits.