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BPC Releases Recommendations to Improve the Availability of Long-Term Care

Washington, DC – Today, the Bipartisan Policy Center released federal policy recommendations to expand the availability of home and community-based services (HCBS) for low- and middle-income individuals requiring long-term services and supports (LTSS). The report, Bipartisan Solutions to Improve the Availability of Long-Term Care, addresses the challenges associated with providing care to those who require LTSS, including the cost of care and caregiver shortages.

Since 2014, the average cost of facility and in-home care services has increased faster than the rate of inflation, with the median national annual cost of LTSS in 2020 ranging from $19,240 for adult day health care to $105,850 for a private room in a nursing home. In 2019, total LTTS spending in the U.S. was about 13% of all national spending on personal health care that year. About half of 65-year-olds today will need LTSS at some point in their life, and demand is expected to grow as baby boomers age and require more care.

BPC’s recommendations to Congress focus on five key issue areas:

  • expanding access to HCBS,
  • addressing disparities in the delivery of HCBS,
  • creating a caregiver tax credit,
  • improving the viability of long-term care insurance, and
  • establishing a public education campaign for long-term care.

“Medicare and Medicaid-covered LTSS are only available to those below a certain income-level, forcing many to pay out-of-pocket,” said Bill Hoagland, BPC senior vice president. “Making home and community-based services available through fully integrated care models for those with long term care needs who don’t qualify for Medicaid is a critical step in addressing these financing gaps and ensuring individuals can access the care they need.”

The report’s recommendations would enable Congress to improve the availability of LTSS for individuals with long-term care needs across a range of income levels, through public and private health insurance programs.

“There is an outstanding need for LTSS in the United States, and reliance on these services is only expected to grow,” said Katherine Hayes, BPC director of health policy. “Our report, among other things, advises Congress to create a refundable tax credit for caregivers to help cover the costs of LTSS-related care for those who do not qualify for Medicaid.”

The report also outlines an initial cost estimate of subsidizing some level of LTSS for Medicare beneficiaries with LTSS needs and without current Medicaid coverage.

The report concludes: “No single politically viable solution exists to address the nation’s LTSS needs. Bipartisan policy solutions that improve upon the LTSS delivery system could help to address the growing demand for these critical services in the United States. BPC’s recommendations have the potential to expand access to LTSS for individuals with long-term care needs across a range of income levels, through public and private health insurance programs. We encourage long-term care planning by improving public education, while also providing some financial relief for unpaid family caregivers who remain critical providers in the LTSS delivery system. We hope these recommendations advance discussions among policymakers to support bipartisan policy solutions that improve access to LTSS for children, adults, and seniors with functional or cognitive impairment.”

Read the full report.