|Improving the system of financing long-term services and supports for older Americans
|Year of Publication
|Warshawsky, MJ, Marchand, RA
|The Journal of Retirement
|Medicare/Medicaid/Health Insurance, Retirement Planning and Satisfaction
Medicaid currently pays for most of the long-term services and supports (LTSS) provided older Americans. With an aging population, these costs will increase rapidly. Contrary to a widely held view, current Medicaid eligibility rules allow covered households to own significant housing and retirement assets. The authors present new information about the weak efforts of states in asset recovery and discuss the extensive asset holdings, especially in housing and retirement assets, of retired households. Given that Medicaid crowds out the purchase of private long-term care insurance, liberal eligibility rules and uneven enforcement must increase the costs of governments and discourage better-off households from covering LTSS exposure through private insurance and assets. They conclude with targeted recommendations to reform Medicaid and improve the LTSS financing system, following up on proposals made by certain members of the 2013 federal Commission on Long-Term Care.