Aging in America: Exploring the Long-Term Care Puzzle and Barriers to Private Insurance Coverage

The role of the long-term care insurance intermediary is a crucial but little-examined factor in the decision to purchase insurance coverage. In this mixed methods study, geographic analysis of trained intermediaries is associated with greater take-up of private ownership of long-term care insurance. Quantitative results suggest that access to a trained insurance intermediary increases the odds of obtaining coverage by four percent. Qualitative results highlight the classical market inefficiencies associated with low long-term care insurance take-up stemming from information asymmetry and the crucial demand-side factor of trust. Distrust of the delivery layer, underwriters, and government lies at the heart of the non-purchase decision. Policy implications include the improvement of LTCI ownership rates through greater access to trained agents to facilitate trust and understanding among long-term care insurance consumers.