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Shouldering the Cost

People should not have to go broke to get the supports they need. New sources of funding, both public and private, would ensure that people have access to necessary supports and services. The CLASS program, created under the Affordable Care Act, is an important, voluntary new option to help people cover these expenses.

Ideally, a universal program of social insurance financed by the public, like Medicare and Social

Security, could cover the long-term supports and services that will help our population age as independently as possible. By spreading the cost across the entire population, we could achieve universal protection—at a price households can afford. Private insurance could fill any gaps in the public benefit. All private insurance for long-term services and supports must be subject to strong consumer protections.

Care in Your Own Home

States can do much more to help people with chronic conditions remain in their homes. One key is to revamp state Medicaid policies that favor institutionalization over in-home services. Supports for independent living not only reflect the preference of most families, but save money over time, which makes this priority even more sensible for states with budget woes. Medicaid’s pro-institution bias is outdated and unresponsive to the needs of most beneficiaries. At the same time, independent living is not the right answer for everyone. Funding should support care in the most appropriate setting— home, community or institutional. Individual preferences should be respected whenever possible.