A Path to a New Long-Term Care Insurance Product?

Posted on May 22, 2018 by Jodi Boyne

A new proposal in Congress could create a new long-term services and support insurance product within the Medicare program. LeadingAge has been invited to submit comments on this draft legislation and is seeking feedback from members. 

The Medicare Long-Term Care Services & Supports Act of 2018 would establish a back-end long-term services and supports benefit designed for everyone, regardless of income or where someone lives, in the Medicare program, mitigating the burden on state Medicaid budgets and family caregivers. The legislation is authored by U.S. Representative Frank Pallone (D-NJ), ranking member of the House Energy & Commerce Committee. 

LeadingAge has been asked to address the following:

Interactions between Medicare and Medicaid: The draft is intended to supplement, not supplant, Medicaid benefits. It allows for state Medicaid programs to claw back certain percentages of the benefit to apply towards needed care, allowing for Medicaid to fill in around the new benefit.

Cash Deductible as an Alternative to a Waiting Period Deductible: This is intended as a back-end benefit structured to fill in the gaps for those with extremely high long-term care needs that are difficult, regardless of any legislative changes made, to insure for in the private market and that Medicaid cannot sustain in coming years.

Financing: The benefit is intended to be fully financed.

Additional Long-Term Care Solutions: Rep. Pallone would welcome thoughts on additional policies to address long-term care needs for individuals with Medicaid and in the private market.

To learn more about the legislation, read Medicare Long-Term Care Services & Supports Act of 2018. Members who are interested in submitting comments should email them by June 1 to Barbara Gay

We do not at this time have a clear understanding of the path this would take to move forward. However, the draft legislation and the support of ranking member of the House Energy & Commerce Committee could generate interest in and focus on the need for a financing mechanism in addition to private pay and Medicare.