Creating Long-Term-Care Insurance Options for Elderly People

Promoting expansion of the Partnership for Long-Term Care

Field of Work: Long-term-care insurance

Problem Synopsis: To help control Medicaid costs and protect consumers who need long-term care, RWJF established a national program in 1987 to promote public/private partnerships that encouraged people to purchase affordable long-term-care insurance, while protecting some of their assets should they ultimately require Medicaid services.

The model continued to evolve in the four states in which it was established (California, Connecticut, Indiana and New York) but federal legislation made it difficult to replicate elsewhere until 2005, when the federal Deficit Reduction Act was passed. With new incentives in place, many states needed seed grants and technical assistance to build the capacity for long-term-care insurance partnerships.

Synopsis of the Work: The Center for Health Care Strategies provided grants of $50,000 each to 10 states, along with technical assistance to state agencies, private insurance companies and consumer advocacy groups to encourage the development of long-term-care insurance partnerships.

Once states establish partnerships and amend their Medicaid plans, private companies can sell long-term-care insurance policies that typically cover a broad range of home, community and institutional services. Under these plans, policyholders are permitted to access Medicaid long-term-care benefits, once they exhaust their private coverage, without having to first spend all of their assets.

Key Results: Nine of the 10 states implemented long-term-care insurance partnership programs, which put a total 96,529 policies in force by June 2010. The Center for Health Care Strategies also provided technical assistance to an additional eight states, seven of which also developed partnership programs, with a total 69,150 policies available as of June 30, 2010.