LTC Bullet:  Long-Term Care News and Analysis

Friday, November 18, 2016

Seattle—

LTC Comment:  Center for Long-Term Care Reform Premium members have the option to receive our LTC Clipping Service and weekly LTC E-Alerts newsletters.  Today, we’d like to share a sample of these members-only services with a wider audience.  Our topic is the news this week, so we’ll keep our ***news*** section brief and get straight to the point.

*** ILTCI CONFERENCE UPDATE:   We’re looking forward to the 17th Annual Inter-Company Long-Term Care Insurance Conference, which will convene March 26 to 29, 2017 at the Hyatt Regency in Jacksonville, Florida.   Click here to read their most recent announcement including their keynote speaker selection, information on their Predictive Modeling Workshop and details regarding sponsor and exhibitor early bird discounts. See you in Jacksonville! ***


LTC Bullet:  Long-Term Care News and Analysis

Many Center for Long-Term Care Reform Premium members are familiar with our LTC Clipping Service, and from what we hear, get great value from this benefit of Premium membership.

For those who don’t already know, our LTC Clipping Service is an excellent way to stay on top of current and critical long-term care news without having to spend hours a day researching on the internet.  We send our Clipping Service subscribers an average of 2-3 emails per workday with a must-read-article link, a pull quote and some brief analysis.  We’re sensitive to the fact that we all receive too many emails, so we’re very careful to send along only the most important LTC news items. 

As an added benefit and for convenient reference, we keep a running archive of the clippings we send in our new LTC Clippings Archive, dating back to January 2016.  This archive is organized by LTC-related subject and sub-category.  While CLTCR Premium members will continue to receive their LTC Clippings in real time, they and Individual members, have access to the Clippings Archive through our Members-Only Zone website.  Here’s a breakdown of the Archive’s subject categories: 

  • INSURANCE (Long-Term Care Insurance, Critical Illness Insurance, Hybrid and Miscellaneous [including alternative financing solutions])
  • LONG-TERM CARE (General, Cost, Assisted Living, Nursing Homes, Home Care, Caregiving, Veterans Affairs and Government Solutions)
  • MEDICAID (General and Medicaid Planning and Crowd-Out Effect)
  • MEDICARE (and Medi-Gap and Medicare Advantage)
  • SOCIAL SECURITY
  • ALZHEIMER'S DISEASE
  • POLITICS, LEGISLATION AND PUBLIC POLICY
  • ECONOMICS, DEMOGRAPHICS AND DATA
  • RETIREMENT PLANNING
  • HEALTH AND HEALTHCARE
  • OTHER

If you’re reading this, chances are you play a valuable role in protecting people from the risk and cost of long-term care and to that end we think the Clipping Service allows our subscribers to be more effective doing so.  Based on their feedback, we think our subscribers feel the same.  For example:

I depend on the clipping service to keep me abreast of all LTC breaking news. It is a huge time-saver and contributes to my overall sense of confidence and knowledge as a LTCi specialist. I really think the service gives me an “edge,” and helps keep me one step ahead of my competitors. Conveying the insights I gain from the clipping service often enables me to more easily and relevantly educate my clients on the importance of LTCi ownership. -- Honey Leveen

Your clipping service is the best.  I seldom give out insurance company brochures to prospects, much preferring the third party endorsement of published articles that are far more believable than an insurance company brochure.  The news does a great job of creating urgency to act as well.  You bundle them and send to my inbox for me to use, wonderful!  I’m speaking to a group at lunch today and will be handing out an article that was published two days ago that you alerted me to.  Keep up the good work, saves me time, and makes me money. -- Romeo Raabe

Please find below a sample collection of clippings we’ve sent to our Clipping Service subscribers over the past two weeks.  Read through them and if you think that receiving news items like these in real time would be valuable to you, please consider subscribing at the Premium membership level.  By doing so, you can stay on the forefront of professional knowledge and help us fight for rational long-term care policy reform.  

Contact Damon at 206-283-7036 / damon@centerltc.com to start your Premium Membership immediately or go directly to our secure online subscription page and sign up for as little as $21 per month.

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11/17/2016, “ACSIA Partners Seeks 150 New Agents to Serve Growing Segments of Its Long-Term Care Planning Business,” PR Newswire

Quote:  “The long-term care insurance market seems to be in turmoil thanks to rate increases, waning consumer demand, and carriers exiting the business. Pessimism prevails, but not for ACSIA Partners, one of America's largest long-term care insurance agencies.

“The company is not immune to the industry turmoil. ‘Our traditional business, individual LTC insurance, has temporarily levelled off,’ she says, ‘but it's still substantial and continuing; and two new segments are surging: hybrid care solutions and worksite plans.’”   

LTC Comment:  Earlier this week we saw one major player in long-term care insurance maintain its commitment to the LTCI market.  Now, another company is “quite bullish” on the prospects for traditional LTCI, hybrid products and group LTC plans, according to this press release.

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11/16/2016, “Column: Who’s paying the true cost of Medicare,” by Philip Moeller, PBS Newshour

Quote: “During 2014, the most recent full year covered by official government reports, nearly $600 billion flowed into Medicare and an even larger amount flowed out — $613 billion. Of this $600 billion, how much do you think came from payroll taxes? If you said less than half, you get to keep playing the Medicare money game. Medicare collected $227 billion in payroll taxes in 2014, or about 38 percent of its revenues. That leaves $373 billion unaccounted for. Premiums represent our dollars, too, so perhaps adding what we pay in Medicare premiums will justify the notion that we pay for Medicare. What do you think? Sixty percent? Fifty? Forty? Thirty? How about 21.5 percent, which translates into $80 billion in Medicare premiums.

“As health care hurtles toward such game-changing capabilities, however, consumer empowerment lags far behind. To date, there is little evidence that we pay much attention. Studies show that when consumers do know the true costs of health care, they don’t engage in comparison shopping so much as simply cut back their use of health care.”

LTC Comment:  Who pays the true cost of Medicare?  That’s a truly nebulous question that yields myriad answers and implications.  Many people rely on the solvency of Medicare, but one particularly vulnerable group--nursing homes (and their residents)--depend on it to make up for low Medicaid reimbursements.

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11/15/2016, “Expect Medicaid to Change, but Not Shrivel, Under Donald Trump,” by Robert Pear, New York Times

Quote:  “Without even waiting for legislation, the Trump administration is almost certain to give states more leeway to run their Medicaid programs as they wish, federal and state officials say.  A number of states have already proposed co-payments and work requirements for people on Medicaid.  In an effort to protect beneficiaries, the Obama administration has limited the use of co-payments and has not allowed work requirements. But state officials say that such changes are likely to be allowed in some form in a Trump administration.

LTC Comment:  With block grants, co-payments and work requirements on the table, maybe the new administration will also consider reducing Medicaid LTC’s home equity exemption from a maximum of $828,000 and putting some limits on currently unlimited exempt assets such as a business, car, IRAs, home furnishings, personal belongings, etc.

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11/15/2016, “Mutual of Omaha stands by long-term care insurance,” by Allison Bell, LifeHealthPRO

Quote: “A major long-term care insurance issuer is reaffirming its commitment to the long-term care insurance market.

“‘We believe that LTCI provides value through product profitability and company diversification,’ Walling writes. ‘The product aligns with our mission to help our customers protect what they care about and achieve their financial goals.’ The aging of the U.S. population should continue to help the market for long-term care insurance grow, and Mutual of Omaha believes there is no viable government-provided alternative, Walling says. [Emphasis added.]

“Another player in the market, LifeSecure Insurance Co. of Brighton, Michigan, ended sales of new individual long-term care insurance products Oct. 31, but it's staying in the multi-life long-term care insurance market.

“‘LifeSecure has always been an impassioned advocate of LTCI, and we remain optimistic about the future of this very important product line,’ the company says in a memo sent to producers in October. “We believe that there continues to be a growing need for LTCI and LTC planning in general.’”

LTC Comment:  Win some, lose some.  However, the take-home message here is “there is no viable government-provided alternative” to private long-term care insurance.

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11/14/2016, “Think you’re prepared for retirement? Answer these 6 questions.,” by , The Washington Post

Quote:  “Many Baby Boomers are not prepared for retirement, so they need to get much more savvy about their financial lives, and quickly ‘if they’re going to have some peace of mind and security during retirement,’ says Carla Dearing, CEO of SUM180, an online financial planning service. To make sure you are ready, she suggest that you answer these six questions.”

LTC Comment:  We’d like to add:

7. Have you considered how to pay for quality long-term care services when the time comes that you may need to?  Some form of long-term care insurance can be used as "portfolio insurance" in order to protect the nest eggs of retirement planners and ensure quality care when an insurable event occurs.

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11/14/2016, “Study: Many Caregivers Spend $7K Annually Out Of Pocket,” by Rachel Bluth, Kaiser Health News

Quote:  “Denise Sleeper has sold her home, spent most of her retirement savings and quit her job to care for her husband since his Alzheimer’s disease struck two years ago.  . . .  She’s drained $168,000 from the couple’s retirement account since her husband, Scott, was diagnosed with the degenerative illness. At first, she cared for him at home, but he’s in a nursing home now. Sleeper gets by on his disability checks and the $32,000 left in their 401k.

LTC Comment:  This anecdote is either a fabrication or the family self-impoverished voluntarily or through ignorance of the law.  Medicaid pays for LTC, exempts the home up to at least $552K, and protects up to $119,220 for the community spouse.  But then, consider the source:  AARP.  The right take-away from this article is that caretakers do spend a lot of money and time to keep loved ones out of Medicaid nursing homes, which is why everyone should plan, save, invest or insure for LTC risk and cost early.

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11/10/2016, “Trump Medicaid plan could force service cuts, higher taxes,” by John W. Schoen, CNBC

Quote:  “Both Trump and House Speaker Paul Ryan have proposed giving states fixed payments called block grants instead of covering a share of the cost of delivering health care to low-income families.”

LTC Comment:  So far, so good.  Here’s one of the recommendations in our new report titled “Long-Term Care Financing:  The Myth and the Reality”:  “[T]he best approach is to permit individual states to experiment with alternative methods of Medicaid long-term care eligibility determination.  Block granting Medicaid would achieve that objective.  Allowing states to receive federal support for their long-term care programs with fewer strings attached would encourage them to try many different approaches.”  Obviously, we disagree with this article’s assertion that Medicaid block grants would increase costs and decrease services.  Just the opposite will occur.

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11/10/2016, “Blueprint for Reform: A Comprehensive Policy Agenda for a New Administration in 2017,” Heritage Foundation

Quote:  “Blueprint for Reform: A Comprehensive Policy Agenda for a New Administration in 2017
With contributions from various Heritage team members
The Heritage Foundation published a three-part Mandate for Leadership Series of documents over the course of 2016.  Each document educates the American public, specifically including Congress, the new American President, and the new President’s team. All three parts deliver a clear, unified policy vision for Congress and the President to preserve and create opportunities to enable all Americans provide for their families, contribute to their communities, and pursue their dreams.”

LTC Comment:  What was only a pipe dream two days ago, the Heritage Foundation’s master plan has traction in this topsy-turvy new political world.

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11/10/2016, John Hancock ceases sales of traditional long-term-care insurance policies,” by Greg Iacurci, InvestmentNews

Quote: “John Hancock Life Insurance Co. announced Thursday that it will discontinue the sale of individual long-term-care insurance policies starting next year, in yet the most recent blow to an industry that's struggled to overcome the barriers of low interest rates and negative consumer sentiment. The company, among the top three in market share for traditional long-term-care insurance, will no longer issue new policies after February 2017, according to a memo sent to distribution partners and producers. ‘After a recent analysis of the macro-economic trends facing the long-term care (LTC) insurance industry, we have made the difficult decision to discontinue sales of our individual LTC insurance policies in all states,’ the memo stated.”

LTC Comment: Thanks due to LTC Clippings subscriber, Bruce Moon, for alerting us to this development.

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11/9/2016, “Trump presidency promises long-term care changes,” by Elizabeth Leis Newman, McKnight's LTC News b

Quote:  “While Trump's healthcare agenda lacked detail, House Speaker Paul Ryan (R-WI) has an extensive plan, [Cynthia] Morton [National Association for the Support of Long Term Care Executive Vice President] noted. Agendas can move quickly with a unified House, Senate and White House, she added. Ryan has long had a policy goal of reining in entitlement spending, she continued.”

LTC Comment:  Too early to prognosticate, but one thing’s for sure.  The whole deck for LTC services and financing may be reshuffled . . . or not.  Who wants to predict in the aftermath of the unpredictable? 

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11/7/2016, “Kindred to Exit the Skilled Nursing Facility Business,” by Tim Mullaney, Home Health Care News

Quote:  “The nation’s largest home health and hospice provider is betting even more on this side of the business, announcing Monday that it will entirely cease to own or operate skilled nursing facilities (SNFs).”

LTC Comment:  The LTC provider business continues its transition from institutional to home care.  Only time will tell whether Medicaid’s notoriously low reimbursement rates can sustain access and quality of home care (which people want) when it was inadequate even for nursing home care (which people prefer to avoid.)

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11/8/2016, “Make long-term-care insurance equal portfolio insurance,” by Ken Moraif, MarketWatch

Quote: “Your level of health can change drastically as you age. You may get ill. You may become disabled. Your mental capacity could change. These are unfortunate realities of life and they're very, very expensive, which is why I encourage my clients to consider long-term care insurance, even though my firm does not sell it. Since November is Long-term-Care Awareness month, I'd like to take this opportunity to encourage readers to think about long-term care insurance — or "portfolio insurance" as I like to think of it—too.”

LTC Comment:  In our LTC Clippings, we occasionally mention using LTCi to offset the catastrophic financial risk and cost of long-term care in order to allow retirement planners to direct their resources elsewhere, giving them the peace of mind of knowing they won’t lose their nest egg if an insurable event occurs.  Here’s a CFP—who does not sell long-term care insurance—that espouses a similar mentality:  LTCi as "portfolio insurance."

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11/7/2016, “** BREAKING: Federal judge blocks nursing-home arbitration ban **,” by James M. Berklan, McKnight's Long-Term Care News

Quote: “The American Health Care Association has succeeded in achieving at least a temporary halt to the government's ban on nursing homes' pre-dispute arbitration clauses. Judge Michael Mills said in a 40-page decision released Monday morning that while there might be sympathy for consumers' belief that such clauses might not be in their best interests, a solution lies with Congress, not a federal agency overstepping its authority. This echoes AHCA's argument against the ban, and for an injunction.”

LTC Comment:  Breaking news on the LTC arbitration ban.

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11/4/2016, “Seniors Suffer Amid Widespread Fraud by Medicaid Caretakers,” Kaiser Health News

Quote:  “An Alaska man developed gangrenous toes. A Philadelphia woman froze to death on the street. An Illinois woman died emaciated, covered in excrement.  These patients suffered as their government-paid caretakers neglected them, collecting paychecks under a Medicaid program that gives elderly and disabled people non-medical assistance at home. In some cases, the caretakers convicted of neglect were the victims' own family members.  The Personal Care Services program, which exceeded $14.5 billion in fiscal year 2014, is rife with financial scams, some of which threaten patient safety, according to a recent report from the Office of lnspector General at the U.S. Department of Health and Human Services.”

LTC Comment:  Remember that Boston College Center for Retirement Research (BCCRR) report that concluded people don’t need private LTCI because Medicaid is the preferred choice?  You couldn’t ask for a better refutation of the idiotic conclusion than this article.

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