What Can We Learn from LTSS Financing Models in the US?
The American LTSS system perpetuates existing inequities faced by older adults, people with disabilities, family caregivers, and workers. Allison Cook, Founder of Better Aging and Policy Consulting, worked with MIT CoLab to publish a report that examines lessons from four US-based case studies. For each case study, the report investigates how the LTSS financing program structure impacts equity, accessibility, and affordability.
According to the report’s executive summary:
“The WA CARES FUND is a pending social insurance program that will offer up to $36,500 in benefits to those who pay into the system. This groundbreaking state-level LTSS financing program will be better suited to older adults who have had time to pay into the system and for those who do not have longer-term LTSS needs.
Hawaii’s KUPUNA CAREGIVERS PROGRAM offers certain family caregivers a limited amount of LTSS coverage for their loved ones. The first state-funded program of its kind, the Kupuna Caregivers Program has been plagued by wait lists due to budget limitations. The program only covers family caregivers of older adults, excluding caregivers of younger people with disabilities.
250% WORKING DISABLED MEDI-CAL is California’s version of the Medicaid Buy-In program that allows people with disabilities to pay a premium in order to access Medicaid (including Medicaid LTSS). While this program provides coverage for vital services that enable individuals with disabilities to work, income and asset limitations prevent many who could benefit from the services from being eligible.
The LONG-TERM CARE INSURANCE PARTNERSHIP PROGRAM is a federal initiative that allows states to set up programs for individuals to purchase private long-term care insurance programs. As an incentive, if that coverage is used up, the individual can preserve a significantly larger amount of their assets if they enroll in Medicaid. The high cost of premiums, among other factors, has led to low enrollment—and those who do enroll are primarily wealthy (or upper-middle class) and white.”
Read the full report.
