LTC Bullet: LTC Embed Report from Big Sky Country

Tuesday, October 13, 2009

Missoula, Montana--

LTC Comment: Moses proposes a long-term care policy for Montana after the ***news.***

*** CLASS ACTION: The Kaiser Family Foundation ( announced today it will host a "briefing" on the CLASS Act proposal Tuesday, October 20, 2009, 9:30 a.m. to 11 a.m. ET at the Barbara Jordan Conference Center, Kaiser Family Foundation Offices, 1330 G Street, NW, Washington, D.C. (one block west of Metro Center). They say RSVP to Tiffany Ford Fields at or call 202-347-5270. And for further information, contact Chris Lee at or call 202-347-5270. KFF has stacked the presenters in favor of the CLASS Act. If you're near DC and understand the CLASS Act's problem, do attend and ask the tough questions. If you'd like Steve Moses to attend and ask those questions and you can sponsor a trip for that purpose, contact the Center at ***

*** MORE CLASS: We'll have more on the CLASS Act soon, including a trenchant critical analysis by Claude Thau that we hope presenters and attendees at the briefing mentioned above will read. ***

*** NEW WEBSITE WEBINAR. Steve says: "We've published a new, free webinar that shows and explains all the multitudinous features available on the Center's public website and in 'The Zone,' our password-protected companion site for members only. Even long-standing Center members remarked about an earlier version of this program that they had no idea our website was so chock full of valuable information." We've totally updated our "website webinar" to cover lots of new content. Check it out here After you watch this program, YOU WILL want to join the Center and get access to everything at So contact the Center at or call us at 206-283-7036 for details on individual and corporate memberships. ***



LTC Comment: As we do from time to time, today's LTC Bullet provides a report from the front lines of our fight for rational long-term care policy. I'm in Missoula to address a conference of insurance and financial advisors. I intend to open my remarks with the executive summary from this report, followed by a "kicker."


LONG-TERM CARE IN MONTANA: A Blueprint for Cost-Effective Reform



The purpose of this study was to develop a long-term care policy for Montana which reduces public assistance expenditures by diverting affluent citizens to privately financed care while simultaneously ensuring access for everyone to high quality home, community-based, and nursing home care.

Major Findings

Montana has a very generous Medicaid nursing home eligibility benefit. The state also covers all but four of the 31 optional services permitted by federal rules. Most seniors who need nursing home care in Montana qualify easily without spending down. Anyone else, regardless of income and assets, can qualify quickly by retaining the right professional advice. Unfortunately, many Montanans also fall victim to bad advice on how to shelter income and assets to qualify for Medicaid. Consequently, very few seniors purchase private protection for the financial risk of long-term care and approximately 62 percent of nursing home residents end up on Medicaid by default. This problem has placed an enormous strain on state finances and threatens to adversely affect access to and quality of care if program eligibility or provider reimbursements have to be cut.


Montana could save $1 to $5 million per year in the short run and up to $13.4 million or more per year in the long run by aggressively implementing and enforcing restrictions on asset transfers, imposing liens on sheltered property, and recovering benefits paid from recipients' estates. These savings derive from a combination of hard dollar recoveries and cost avoidance as seniors opt for private alternatives to public assistance dependency.


LTC Comment: Now, here's the kicker.

I wrote those words in 1993 after interviewing 61 experts and conferring with then-Governor of Montana Marc Racicot. Check out the whole report here.

In the meantime, Montana's Medicaid nursing home costs have doubled and its home care costs have increased ten-fold.

Instead of potential savings of $5 million to $13 million, the comparable savings today would be $10 million to $25 million if similar recommendations were implemented.

What a shame Montana and the USA did not address their hemorrhaging Medicaid LTC expenditures 16 years ago.

By now, we could have had a healthy government LTC safety net and a thriving private LTC insurance market. Instead, Medicaid verges on bankruptcy and long-term care insurance languishes.

The rest of my remarks in Missoula will explain (1) why the public remains in denial about LTC risk and cost, (2) what's about to change to wake the public up about long-term care financing, and (3) what individuals and their advisors need to know and do to get in front of these dangerous new developments.

Do you also want to know the answers to those questions? Then book Steve Moses for an in-person event, a webinar, or a conference call.

To make the arrangements, contact the Center for Long-Term Care Reform at 206-283-7036 or