Analysis: So far, there's no good answer for how we as a nation will care for a growing number of older people with complex needs once they can no longer take care of themselves
As Americans live longer, more and more families are caring for older adults and facing tough financial circumstances that give rise to a bigger question: How will we as a nation care for a growing number of older people with complex needs once they can no longer take care of themselves? So far, there’s no good answer.
As often happens with social policy, there is innovation emerging from the states to address the challenge – most significantly from the other Washington. Last month, Washington Gov. Jay Inslee signed a first-in-the-nation bill to help finance the long-term care needs of all the state’s residents. Washington state appears to be the first to find a way to make the math and the politics work, and its solution may provide a template for other states, and possibly the federal government, to follow.
As we’ve seen in the years since Obamacare went into effect, mandatory insurance is actuarially desirable and politically torturous. On the other hand, voluntary insurance while more politically palatable, is sustainable only with big public subsidies. The CLASS Act was neither mandatory nor subsidized, so its fiscal future was doomed; Obama administration officials pulled the plug only a year after its passage.
There are certainly reasons to fault the bill. Some might object to the premise of socializing the financing of long-term care. Others may take the opposite tack and claim the benefits are too skimpy, or note the risk of uneven administration. The bill’s original Republican sponsors withdrew their support from final bill, citing concerns about “costs to taxpayers.”
In contrast, Maine has one of the oldest populations in the country and a values system built on independence. A ballot referendum largely supported with out-of-state funds and organizing that would have raised taxes on higher-income households to finance the long-term care workforce went down to defeat last November.
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