For many years, Congress and industry groups have debated how to best narrow the role of Medicaid in financing long-term supports and services (LTSS) and broaden the role of insurance.
Stakeholders generally accept that an insurance-based system is preferable to a welfare-based one; but any such shift depends on Congress’ ability to reach a compromise.
There are only two ways to increase insurance coverage: offer it and hope people choose to enroll, or mandate enrollment. Avalere’s research shows that enrollment in a voluntary long-term care insurance program would not be large enough to shift our financing system from Medicaid to private insurance.
Using new data from the Research Triangle Institute and Avalere’s long-term care model, we can estimate the impact of mandatory and voluntary insurance on Medicaid spending.
Without a mandate for long-term care insurance, policymakers are implicitly making the choice to maintain Medicaid funding as the primary source of payment for LTSS.