Prepare yourself for big new cuts in government support for elder care. In his State of the Union address last evening, President Obama called for a five-year freeze on a narrow slice of the federal budget. Unfortunately, programs subject to the freeze would include many that are critically important to the frail elderly and younger people with disabilities--especially those living in [...]
The news for critical long-term care services and supports provided by the states--either through Medicaid or other funding--keeps getting worse. The toxic combination of a still-slow economy, huge structural budget pressures on all levels of government, and growing demands for aging and disability services is leading to ongoing cuts in both critical benefits to individuals and payments to providers. The latest evidence comes from [...]
In the decade between 1999 and 2008, almost 3,000 nursing homes closed while the number of skilled nursing facility beds shrunk by nearly 100,000, or about 5 percent, according to a new study in the Archives of Internal Medicine. In a nation with more nursing homes than McDonald's, and at a time when long-term care can be provided in other settings, that may not be [...]
Last year, the Minnesota Citizen's League asked me to help with a very ambitious project: The group wanted to find ways to improve our broken system of long-term care financing. Earlier this month, the non-profit, non-partisan League came up with its recommendations. I don't agree with them all, but among their far-reaching proposals are some ideas that I hope have legs. The League's white paper, [...]
The co-chairs of President Obama's bipartisan deficit commision have proposed a far-reaching plan to reduce the nation's massive deficit. It includes big changes for both current and future seniors. Among them: higher Social Security taxes and reforms in the design of benefits, reduced payments to Medicare providers and greater cost sharing by Medicare beneficiaries, and, perhaps most dramatic, a fundamental change in federal payments for Medicaid long-term [...]
Kudos to President Obama for making a "recess appointment" of Don Berwick to run the Centers for Medicare and Medicaid Services (CMS). Berwick may be the ideal choice for the job. He is the right candidate at exactly the right time. The new health law makes possible broad reforms in the way we deliver health and long-term care. But it by no [...]
Medicaid long-term care is well on its way to destroying state budgets, according to a new study by the international consulting firm Deloitte LLC. By 2030, according to estimates by the firm's Center for Health Solutions, Medicaid long-term care benefits for both home and nursing facility care will absorb a staggering 18 percent of total state budgets if current trends continue. Overall state [...]
For the first time since President Bush's ill-fated effort to privatize Social Security five years ago, the future of the nation's flagship retirement program is back on the policy agenda. For example, Social Security will almost certainly be an issue for President Obama's deficit reduction commission. Unfortunately, we may be headed for the same non-productive shouting match we had over the Bush [...]
The health reform bill passed by Congress last night includes big changes in the way we pay for long-term care, both at home and in nursing facilities. The reforms will give the elderly and disabled far more flexibility in the way they get care and, at the same time, begin turning long-term care from largely a welfare program to an insurance system. The biggest change [...]
Connie Garner, the top Senate staffer on long-term care issues, said today that she is certain the CLASS Act, which would create a new national long-term care insurance program, will be included in the final health bill being considered by Congress. "I don't have any question CLASS will survive," Garner told a long-term care conference sponsored by the journal Health Affairs. [...]