Health Reform Must Endure for the Long Term

by Mark Mellman

Health reform has dominated the news lately, but many Americans are wondering what reform will actually entail for them.

According to a recent survey conducted by my firm, most believe that healthcare reform will provide coverage for long-term services and supports. These are medical services for people who can’t care for themselves for extended periods of time due to illness or disability. And they’re of critical importance, as 60 percent of Americans over the age of 65 will require long-term care during their lives.

But it’s hardly a foregone conclusion that the final health reform package will ensure that Americans have access to affordable long-term services. If our leaders fail to act, America will soon face a long-term care crisis.

Americans are generally under the impression that they’ll be taken care of once they reach their golden years. According to an AARP survey, 59 percent of Americans over the age of 45 believe that Medicare will pay for nursing home care. Unfortunately, that’s not the case. The Department of Health and Human Services explicitly states, “Medicare does not pay for what comprises the majority of long-term care services.”

Other Americans believe their health insurance policies will cover nursing home care. Not so, generally speaking.

Many seniors are therefore reliant on Medicaid — the government health plan for the poor — to pay for long-term services and supports. By some accounts, two-thirds of nursing home residents are Medicaid beneficiaries. In fact, the program pays for almost half of all long-term care in America. Nearly one-third of Medicaid dollars go to long-term care.

Of course, Medicaid was never intended to serve as the chief elder care provider in the nation. And tragically, many elderly folks purposely impoverish themselves so they can receive the care they need from Medicaid.

Will the congressional healthcare reform effort fix this state of affairs? Most Americans think so. Sixty-one percent expect that reform will provide care for Alzheimer’s patients (61 percent). Similar majorities think that the reform effort will help pay for assisted living facilities (57 percent) and will assist older and disabled people in taking their medications (64 percent).

Two bills under consideration — one from the Senate HELP Committee and the other from the House Energy and Commerce Committee — would deliver the solutions the American people expect. Both would create a voluntary insurance program wherein, for premiums of just a couple dollars a day, the elderly, the disabled, or anyone who needs assistance caring for themselves could receive a benefit of up to $37,000 a year.

This program would be a welcome addition to our nation’s healthcare infrastructure.

Although many Americans recognize that they or their families may need long-term services down the road, 70 percent have not made plans to pay for such care. In fact, more than two-thirds of those who expect to need care for a family member in the next five years do not know how they’d pay for it. Eighty-one percent are unprepared for the financial demands they will face.

In the absence of reform, millions of baby boomers will not be able to pay for the long-term services they need without forfeiting all their assets. Even then, it’s unclear whether Medicaid will have enough funding to cover everyone.

Finding a way to make long-term care affordable for generations to come is a vital part of healthcare reform. Families and taxpayers alike are depending on it.

(Mark Mellman is President of The Mellman Group, a polling and strategic communications firm that counts among its clients leading political figures, Fortune 500 companies, and some of the nation’s most important public interest groups.)

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