I realize that Medicaid spending is an enormous drag on state budgets and is increasing at a frightening rate. I wish there were more recognition in the press that a third of Medicaid expenditures are devoted to long-term care and there is no other obvious alternative way of paying for it.
You can’t just send Mom to live with her eldest daughter any more. That daughter is working a full-time job now. She needs to. Without that job the family won’t be able to afford the mortgage payment. Very few people have enough income or savings to pay for long-term care. Very few people have insurance that will cover it.
35 years ago there was an attempt at finding another solution but it was repealed more quickly than it was enacted. It created an enormous flap. Elders outright refused to pay the insurance premiums.
Consequently, if you’re going to get Medicaid spending under some sort of control, you’ll need to come up with a solution for long-term care to do it. If your solution is compulsory savings, keep in mind that will reduce the consumer spending on which our economy is far too dependent.
If this stuff were easy, we’d’ve done it a long time ago.
Medicaid also covers about half of all births and most children with disabilities (and about 1/3 of disabled adults). Also, I don’t think most people fail to realize that in states which did not go along with the ACA expansion, healthy adults are not eligible for Medicaid no matter how poor they are, and for a family to be eligible, they must earn less than 18% of the federal poverty level. Out of all of these groups, I suspect that only long term care for the elderly will be salvaged somehow since the elderly do vote.
http://www.kff.org/health-reform/state-indicator/medicaid-income-eligibility-limits-for-adults-as-a-percent-of-the-federal-poverty-level/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D