In an article published in Health Affairs on July 24, authors explored opportunities for states to offer some long-term services and supports for individuals that are near Medicaid eligible. This term is defined as people with incomes between 138% and 221% of the poverty level. This population is less likely to have community supports or spouses to provide unpaid family caregiving. They also have higher rates of disability leading to significant unmet need.

States can leverage existing programs through Older Americans Act funds, create new state-only funded programs, or leverage Medicaid demonstrations to mitigate adverse outcomes and avoid nursing home placement. The article highlights a significant weak spot in our health care system: the gap in coverage for long-term care services in conventional insurance or Medicare and offers options for states to consider in meeting their own aging population’s needs.