Long-term care services are not on the front burner of the Presidential campaign. They are not on the back burner. They are, it seems, not even on the stove.  

Most presidential candidates don’t care enough about long-term care services to bother to describe their views on issue. Of the five candidates surveyed by 15 national advocacy groups only two–President Obama and former House Speaker Newt Gingrich–responded to five questions on long-term care. Neither of the two GOP frontrunners, Mitt Romney and Rick Santorum, answered the survey. Nor has Ron Paul. 

Barack Obama had little new to say in his response. He merely recited past efforts aimed at supporting home and community based care, workforce training, and caregivers. He noted the failure of the CLASS Act but offered no new alternatives. He did not say that his most recent budget would freeze or cut funding for many critical supports for the elderly and younger people with disabilities.

Obama’s disinterest is not new. He had little to say about long-term care policy in his 2008 election campaign either.

Gingrich, who has shown real interest in long-term care issues in the past, was typically provocative though sometimes contradictory and often not specific. The former speaker used the survey as a platform to renew his calls for repealing the 2010 Affordable Care Act, turning Medicare from a guaranteed federal benefit  into a defined contribution program, and replacing the existing  Medicaid system with a federal block grant.

Gingrich said consumers should be able to use tax-advantaged Health Savings Accounts and Flexible Savings Accounts to buy long-term care insurance.  This is somewhat curious since Gingrich has also proposeda flat income tax system that would seem to effectively end HSAs and FSAs.

Still Gingrich also said he’d “promote new models of care” that focus on primary medical care and home care. He also embraced the use of new assistive devices, though he didn’t say how consumers would pay for them.

In addition, Gingrich said Medicare should cover training for family caregivers. This is a very interesting idea through it is not clear how such a mandate would be implemented once Gingrich shifts Medicare to a largely private insurance model.

The survey came from 15 groups including The Arc of the United States, Families USA, the National Council on Aging, and the National Senior Citizens Law Center.

Give Gingrich (or his staff) credit for thinking creatively–if somewhat inconsistently– about long-term care services. If Obama has any new ideas, he was not willing to share them. As for Romney, Santorum, and Paul, the issue is clearly not important enough for them to assign a staff person to answer a survey. That’s an indictment of both the candidates and the advocates who seem unable to get their attention.