Long-Term Services and Support (LTSS) Financing Reform

Part of LeadingAge's 2020 Policy Priorities

LeadingAge Advocacy Goals

  • Promote LTSS financing reform to ensure that people at all economic levels are able to access services when they need them.
  • Support the evolution of an aging-services continuum that builds on today’s successes and helps providers keep moving toward systems and services consumers want.
  • Create policies that enable consumers to transition to different types of services within the continuum.
  • Identify and create solutions to enhance provider access to high-quality aging and LTSS options for the middle market.
  • Support and complement the work of family caregivers.

The Issue

Americans do not, generally, plan for their own likely future need for LTSS, and the federal government has yet to offer a program. Family caregivers provide much of that care and LTSS insurance has shown limited success. Medicare does not cover ongoing LTSS needs. Medicaid finances some LTSS for people who have very limited incomes and assets, and for those whose health and LTSS expenditures drive them into poverty. Individuals at the top end of the income spectrum may be able to self-finance care. Those in the vast and increasing “middle market” have few options to meet their LTSS needs. While many LTSS benefit proposals have been discussed, few address financing. Increasingly, states – disappointed with the lack of federal attention – are discussing LTSS financing proposals of their own.

Advocacy Action 2020

116th Congress

  • Educate Policymakers: Build awareness of the need for LTSS after age 65 and promote proposals to address these needs, especially proposals that include a financing strategy.
  • Proposal for LTSS Financing Reform: We continue to work with Rep. Pallone (D-NJ) on his Medicare Long-Term Care Services and Supports Act draft legislative proposal to establish an LTSS benefit under Medicare.
  • Medicare for All: Many of these proposals have short references to LTSS financing reform. LeadingAge will provide information and technical assistance on how to further flesh out and pay for these conceptual proposals.

Executive Branch

  • Encourage federal agencies (i.e., HHS, Treasury, OMB, White House) to continue developing and supporting LTSS financing reform proposals and conversations.

Actions You Can Take Now

  • Visit the Advocacy Action Center to let your representative and senators know that you support meaningful LTSS financing reform.
  • Host a Coffee Chat with Congress in your community to help your members of Congress understand the importance of LTSS financing reform.
  • Mobilize with the Advocacy Champions toolkit and let your representatives and senators know you support programs that create a sustainable LTSS financing system.

Additional Resources