Significant barriers to appropriate Medicaid funding for long-term care services persist, despite states’ greater flexibility to dole out LTC benefits in recent years, a new study reports.

In addition, many commonly recommended alternatives to current funding schemes don’t take into account that low-income beneficiaries cannot afford to take part in them, study authors note. They also criticized the Medicaid program for a confusing array of options, eligibility criteria and funding details.

“Greater coverage of private long-term care insurance and use of home equity programs, such as reverse mortgages, are not applicable to many low-income elderly and disabled people served by the [Medicaid] program,” authors said in the new report from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.

Many individuals also cannot take advantage of tax subsidies and state discount programs for lack of personal funds, the report adds. Medicaid currently pays for about half of all U.S. nursing home care and 42% of all long-term care expenditures.

The full version of “Long-Term Services and Supports: The Future Role and Challenges for Medicaid” can be seen at http://www.kff.org/medicaid/upload/7671.pdf.