As a news article on the ElderLawAnswers site details, Sen. Edward M. Kennedy’s just-released health care plan includes a new national long-term care insurance program offering basic help for the elderly and disabled. Under the proposal, Americans would pay a premium of roughly $65 per month. After they had contributed for at least five years, participants would be eligible for a benefit of not less than $50 a day that they could use for care in their home instead of care in a facility.
While insufficient, it’s a huge step in the right direction. No one wants nursing home care, Medicare generally only covers home care for a short period following hospitalization, and few people can afford long-term care insurance. (In 2006, private insurance — including Medicare supplemental policies as well as long-term care insurance — covered only 9 percent of the $180 billion spent on long-term care, according to the Kaiser Family Foundation.)
This means, that if people want to stay home, for the most part they must pay out-of-pocket. Many states’ Medicaid programs have been expanding their home health care coverage, which is a good thing. But consumers must wade through a patchwork of programs and qualify for Medicaid coverage, which has different rules in every state. The complications of this system help keep an army of elder law attorneys and other advocates in business, but it’s not good for consumers.
Sen. Kennedy’s proposal for a broad-based insurance plan for long-term care will help address the huge challenges millions of seniors and their families face every day. While $50 a day is insufficient to pay for the care many seniors and others need, it can help fill the gap. For many middle-income Americans, it may be just enough to make the difference and allow them to stay at home or to afford assisted living care.
In addition, it should be politically palatable because it doesn’t replace the long-term care insurance market. More affluent seniors may still want long-term care insurance to pay for all of their care. And it may make long-term care insurance more affordable for middle-income Americans since they won’t have to buy as much coverage. Finally, under Kennedy’s plan, taxpayers can opt out if they choose. This may undercut the social insurance model, but also may help blunt opposition to the plan.