LTC Bullet: LA Times Highlights Center’s LTC Choice Plan

Tuesday January 11, 2000


Last Sunday’s (1/9/00) Los Angeles Times contained an op-ed piece by Betsy McCaughey Ross entitled "Bradley’s Plan is a Loss for Seniors." Most of the article critiques presidential contender Bill Bradley’s health care plan. The excerpt below, however, explains why the Center for Long-Term Care Financing’s LTC Choice plan would be a more sensible approach. Ms. McCaughey Ross is a Senior Fellow at the Hudson Institute and former Lieutenant Governor of New York state.

"Currently, even middle-class seniors who own homes often are eligible for long-term care assistance under Medicaid. Liberal state rules allow them to deduct enormous medical costs from their income in order to qualify as ‘medically needy.’ Some people deplore Medicaid for the middle class as a gravy train; others consider it a well-deserved benefit for the elderly who have paid taxes and would be wiped out financially by nursing home bills. Either way, there's no question that Medicaid is important to many seniors. Two-thirds of nursing home residents are on it.

"Right now, the federal government and the states share the cost of all Medicaid programs, including health care for the poor and long-term care for the elderly. Bradley proposes a swap. Under his plan, the federal government assumes the total cost of enrolling low-income people in health plans, letting the states off the hook entirely. In return, the states would bear the total cost of long-term care on their own. ‘The feds would love to get rid of long-term care, because it is the 800-pound gorilla of social problems,’ explains Stephen A. Moses, president of the Center for Long-Term Care Financing, a senior advocacy group in Seattle.

"There is no question that the current system needs changing. Easy access to Medicaid assistance has anesthetized the public to cost and the need to save for old age. Because Medicaid generally will pay for nursing homes but not assisted living and other care, there is a perverse incentive for over-institutionalization. Too many people deteriorate in nursing homes who would do better in assisted living or adult day care at lower cost, if they could get the public to help pay.

"One answer might be to make Medicaid assistance a loan rather than an entitlement for middle-class seniors and, at the same time, allow them greater flexibility in choosing between a nursing home and another kind of care. In exchange for picking up the tab, Medicaid would be reimbursed later out of their estates. That could replenish Medicaid coffers to help people who are truly needy."