8 Reasons the Presidential Candidates Should Be Talking about Long-Term Care
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8 Reasons the Presidential Candidates Should Be Talking about Long-Term Care

August 20, 2012

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While health reform has been a central issue in the 2012 presidential election, see if you can find the candidates’ positions on long-term care.

The lack of attention is alarming. Every day, millions American families struggle with providing long-term care for themselves or a loved one.

Long-term care includes a broad range of assistance with everyday activities, such as dressing, bathing, using the bathroom, preparing meals, taking medication, and managing a home. Access to these services and supports allows individuals to age with dignity and independence.  

Long-term care is a major national issue in need of bold thinking, debate, and solutions. Not talking about it won’t make it go away. 

We've developed eight reasons why the candidates should be talking about this issue:

1. The need is now.

About 12 million Americans with disabilities need long-term services and supports, nearly half of them under 65 years old.

2. The need is growing.

As the U.S. population ages, the number of individuals needing long-term care is projected to double to 27 million by 2050. Over 70% of Americans who reach age 65 will need some form of long-term care in their lives.

3. Most Americans are not prepared for the high costs of long-term care.

Medicare doesn’t cover it, and less than 10% of Americans have private long-term care insurance. Private long-term care insurance plans are unaffordable for many Americans and unavailable to most individuals with disabilities due to underwriting practices.

4. Federal and state funding is dwindling.

Medicaid is the primary funding stream for long-term care, financing about 62% of total spending. But it requires individuals to impoverish themselves to receive the services they need. And due to the economic downturn, some states are cutting Medicaid services. 

5. Nursing homes are not the answer.

The vast majority of Americans want to receive care at home. Yet there remains a strong “institutional bias” within Medicaid. The majority of funding goes to services in nursing homes and other institutions, even though home and community-based services are more cost-effective.

6. Waiting lists for Medicaid home and community-based services have doubled over the past decade.

Lack of available home and community-based services denies Americans choice, independence, productivity, and their rights against discrimination under the U.S. Supreme Court Olmstead decision. 

7. Family caregivers are getting burned out.

The vast majority of long-term care is delivered informally by more than 65.7 million family members. Family members providing care often face negative impacts on their own health, ability to work, and other financial hardships. Caregiving has economic consequences for U.S. businesses, as well, in terms of lost productivity and higher health care costs.

8. There is a severe shortage of direct-care workers.

The current direct-care workforce is at 3 million, and an additional 1.8 million workers will be needed over the next decade to keep pace with growing demand. The quality of home care jobs is poor due to low wages, few benefits, high turnover, and a high level of job stress and hazards.

For Advocates

If you're an advocate for long-term care, here are some additional resources for you:

  • Webinars
    Listen to recordings of webinars on how to help your state implement health reform provisions that expand Medicaid home- and community-based services (HCBS)

  • Advocacy Toolkit
    Get information to understand and protect HCBS in your state.

  • Online Community
    Share ideas and resources with HCBS advocates nationwide.


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Public Policy Priorities

See the issues we're fighting for in the 114th Congress, including the budget, Older Americans Act, and long-term services and supports.