A federal district judge largely blocked an attempt by the Trump Administration to add further limits on Medicaid eligibility beyond the strict curbs Congress adopted in 2025’s HR 1. If the ruling is upheld by higher courts, it could allow beneficiaries and applicants for Medicaid long-term services and supports a bit of flexibility when HR1’s strict work requirements begin to [...]
On behalf of 18 other Senate Democrats, Sen. Ron Wyden of Oregon has asked for public comments on how to fix the nation’s broken model of long-term care for older adults and younger people with disabilities. His 81-page request for information raises a broad range of important questions that need to be answered in any reform effort. But it sometimes [...]
Long-term care is an enormous challenge for middle-income older adults. They face big gaps in how they receive and pay for care. Unlike low-income seniors, they are ineligible for Medicaid’s safety net and unlike the wealthy, they don’t have sufficient resources to pay for a significant amount of care out-of-pocket. And, despite the widespread public perception, Medicare generally does not [...]
When it comes to needing long-term care, millions of middle-income older adults are trapped. They have too much money to qualify for Medicaid’s safety net. Yet, they cannot afford to pay out-of-pocket for significant long-term services and supports. So, they often suffer from avoidable injuries or illness or even die prematurely without the help they need. Now, policy analysts are [...]
Public opinion surveys consistently show older adults want to age in place. But, it turns out, nobody can agree on what that actually means. And those disagreements can have important consequences for policymakers as well as those trying to develop alternative settings for people to age. Aging in place is a big idea with social and political significance but no [...]
Financial services firms traditionally focus on how we save and invest our money or insure ourselves against risk. Now, happily, they are beginning to think about how we spend our assets, especially in old age. And that includes long-term care and health care costs. Their focus on what the biz calls “accumulation” is no surprise. After all, they get paid [...]
Life expectancy for older adults has increased dramatically in recent years. But do more years in old age mean more time struggling with serious illness and frailty? A new study by two highly respected health care economists comes up with a surprising answer: No. Even as seniors are living longer, their overall health in old age appears to be improving [...]
President Trump’s decision to revoke what’s known as Temporary Protective Status for immigrants from a dozen countries will severely damage health and long-term care in the US. More than 1 million people are at risk of being deported as a result of the move, including 350,000 from Haiti, many of whom work in health and long-term care. Trump cancelled TPS [...]
Besides helping protect millions of Americans from the costs of long-term services and supports, well-designed long-term care financing reform also could sharply lower Medicaid costs. Even better: One version of reform, public insurance, could give care recipients and their families significantly more flexibility in designing their own care. Over the long run, a public catastrophic long-term care insurance program could [...]
The nursing home business is tough. Few want to live in them It is hard to make money running a good one. Government regulations make creative care a huge challenge. And they have a reputation, too often deserved, of being unpleasant and even dangerous places to live and work. Yet, I sometimes come across a skilled nursing facility that trashes [...]