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LTC Bullet:

Bill Introduced to Study LTC in the 21st Century

Tuesday May 18, 1999


On May 6, 1999, Congressman Michael Bilirakis (R-FL) introduced HR1716, "a bill to provide for the study of long-term care needs in the 21st century". The bill proposes a one-year study to review core issues surrounding long-term care that continue to befuddle many lawmakers and policy experts. How will the demand for long-term care change in coming years? How should care be provided? Who will pay the bill? Are we moving in the right direction?

Bilirakis' bill directs the Secretary of the U.S. Department of Health and Human Services to work with the Institute of Medicine (of the National Academy of Sciences) as well as private and public sector consultants in forming recommendations. The Center for Long-Term Care Financing has contacted Rep. Bilirakis to offer our analysis and assistance.

The text of the HR1716 follows:

"Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,


(a) IN GENERAL- The Secretary of Health and Human Services shall provide, in accordance with this section for a study in order to determine--

(1) future demand for long-term health care services (including institutional and home and community-based services) in the United States in order to meet the needs in the 21st century; and

(2) long-term options to finance the provision of such services.

(b) DETAILS- The study shall include the following:

(1) An identification of the relevant demographic characteristics affecting demand for long-term health care services, at least through the year 2030.

(2) The possibility of coverage of community-based and other long-term health care services under different federal programs, including through the medicare and medicaid programs, grants to States, housing services, and changes in tax policy.

(3) How to improve the quality of long-term health care services.

(4) The integration of long-term health care services for individuals between different classes of health care providers (such as hospitals, nursing facilities, and home care agencies) and different Federal programs (such as the medicare and medicaid programs).

(5) The possibility of expanding private sector initiatives, including long-term care insurance, to meet the need to finance such services.

(6) An examination of the effect of enactment of the Health Insurance Portability and Accountability Act of 1996 on the provision and financing of long-term health care services, including on portability and affordability of private long-term care insurance, the impact of insurance options on low-income older Americans, and the options for eligibility to improve access to such insurance.

(7) The financial impact of the provision of long-term health care services on caregivers and other family members.


(1) IN GENERAL- Not later than 1 year after the date of the enactment of this Act, the Secretary shall provide for a report on the study under this section.

(2) RECOMMENDATIONS- The report shall include recommendations regarding each of the following:

(A) The most effective and efficient manner that the Federal government may use its resources to educate the public on planning for needs for long-term health care services.

(B) The public, private, and joint public-private strategies for meeting identified needs for long-term health care services.

(C) The appropriate continuing role of States in the financing of long-term health care services.

(3) INCLUSION OF COST ESTIMATES- The report shall include cost estimates of the various options for which recommendations are made.


(1) USE OF INSTITUTE OF MEDICINE- The Secretary of Health and Human Services shall seek to enter into an appropriate arrangement with the Institute of Medicine of the National Academy of Sciences to conduct the study under this section. If such an arrangement cannot be made, the Secretary may provide for the conduct of the study by any other qualified non-governmental entity.

(2) CONSULTATION- The study should be conducted in consultation with experts from a wide-range of groups from the public and private sectors.