America's Long-Term Care Crisis: BPC Launches Initiative to Find a Politically and Fiscally Viable Path Forward to Improve the Financing and Delivery of Long-Term Care

Apr 07, 2014, 13:25 ET from Bipartisan Policy Center

WASHINGTON, April 7, 2014 /PRNewswire-USNewswire/ -- In the next two decades, an aging population, fewer family caregivers, increasingly limited personal financial resources, and growing strains on federal, state, and family budgets will create an unsustainable demand for long-term care. Over the past 20 years, policymakers have debated different solutions, but have failed to reach consensus on a sustainable means of financing and delivering long-term services and supports.  Failure to find that consensus well before the baby boom generation begins to need long-term services and supports (LTSS) will strain our long-term care safety-net to the breaking point. 

The Bipartisan Policy Center's (BPC) Health Project announced today a new initiative to find a politically viable and fiscally sustainable path forward to improve the financing and delivery of LTSS for America's aging population and working-age Americans with disabilities.

BPC's new Long-Term Care Initiative (LTCI) is led by former Senate Majority Leaders Tom Daschle and Bill Frist, former White House and Congressional Budget Office Director Dr. Alice Rivlin and newly appointed BPC Senior Fellow and former Secretary of Health and Human Services Tommy Thompson.

"Nearly 70 percent of Americans who reach age 65 will, at some point, be unable to care for themselves without assistance," said Senator Daschle. "Issues of long-term care also affect millions of younger people with significant cognitive or physical functional limitations. Yet long-term care gets neither the public attention nor the policy focus that it deserves."

Today, the co-chairs of the new initiative released a white paper, America's Long-Term Care Crisis: Challenges in Financing and Delivery. The paper identifies the major challenges to the financing and delivery of long-term services and supports for seniors and individuals with disabilities under 65 including:

  • The population needing long-term care is expected to double between now and 2050.
  • Significant diversity in populations will need long-term care and will require a wide-range of assistance and types of services.
  • Medicaid, a safety net program, covers the cost of the majority of paid LTSS, at well over $100 billion annually. As the baby boom generation ages, this amount is projected to grow rapidly at a time when federal and state budgets will be stretched.
  • Limited options are available for individuals and families seeking to prepare for potential LTSS costs, and the private long-term care insurance market remains small relative to public programs as a source of LTSS financing.

The BPC initiative will work to find a policy pathway that addresses the nation's current and projected need for long-term care.  It will focus on integrating and emphasizing the role of long-term care within organized systems of care delivery and payment, and exploring sustainable approaches for financing at the individual, family, state, and national levels.

"Currently, the U.S. lacks a comprehensive strategy for the financing and delivery of long-term care," said Secretary Thompson. "Individuals and family caregivers in need of long-term services and support often face limited coverage and ruinous out-of-pocket costs, and state and federal programs shoulder a growing and unsustainable financial burden of America's aging population."

The number of Americans estimated to need long-term care is expected to more than double from 12 million in 2010 to 27 million in 2050. As such, public and private spending on long-term care for the elderly is projected to grow from 1.3 percent of GDP in 2010 to 3 percent of GDP in 2050.

"We as a nation do not have, either in the private or public sector, satisfactory mechanisms for helping people anticipate and pay for long-term care," said Dr. Alice Rivlin.  "When individuals and their families seek help, they find, often to their surprise, that long-term care costs are not covered by Medicare or private health insurance, and learn that they will need to exhaust their resources to obtain coverage through the Medicaid program."

"Without innovative changes in policy, the nation faces challenging trade-offs between spending to meet our commitments to older and low-income Americans and investments in the nation's future prosperity," said Senator Frist.  "We must develop a realistic, yet politically viable set of policy options – including privately funded solutions – to take the burden off of government and instill greater efficiency in the way we deliver long-term care."

The work of the initiative will build on BPC's Health Project's recent Health Care Cost Containment Initiative (HCCI), which released a broad set of recommendations for improving quality and containing cost growth across the entire health care system in its report, A Bipartisan Rx for Patient-Centered Care and System-Wide Cost Containment, as well as the recommendations put forth by the Federal Commission on Long-Term Care and the Leading-Age Task Force.  

A final report of LTCI policy recommendations, accompanied by a quantitative analysis of budget and distributional impacts, will be released later this year.

BPC's Long-Term Care Initiative is supported by a grant from The SCAN Foundation, dedicated to creating a society in which seniors receive medical treatment and human services that are integrated in the setting most appropriate to their needs. For more information, please visit

About the Bipartisan Policy Center                                                                  

Founded in 2007 by former U.S. Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell, Bipartisan Policy Center (BPC) is a non-profit organization that drives principled solutions through rigorous analysis, reasoned negotiation and respectful dialogue.  With projects in multiple issue areas, BPC combines politically balanced policymaking with strong, proactive advocacy and outreach.

SOURCE Bipartisan Policy Center