Facing A Tight Deadline, Long-Term Care
Panel Holds First Meeting
By Susan Jaffe, KHN
June 28, 2013 - The Commission on Long-Term
Care held its first meeting Thursday on Capitol Hill with some
members acknowledging that their late start adds to their
challenges in offering Congress recommendations on how to
finance the expensive services for seniors and disabled
The panel is hobbled with a meager budget
and staffing, and it is facing a three-month deadline for its
report. Speakers at the meeting reminded the commission that the
effort is daunting.
The commission heard a litany of statistics
from four experts who explained how the nation's growing
population of seniors will become more dependent on long-term
care services. But the rising cost of those services threatens
to deplete individuals' savings and add to the nation's budget
problems because of the expenses borne by Medicare and
"We know that 70 percent of people over the
age 65 will need some form of long-term services and support,"
Dr. Bruce Chernof,
the commission’s chairman who also heads the SCAN Foundation
(which helps fund KHN's aging coverage), a research organization
that focuses on elder care.
senior vice president of the research firm Avalere Health, told
the panel that nearly half of the Americans receiving long-term
care are under the age of 65, with only a minority living in
nursing homes. She estimated that total number of people getting
long-term care will be 16.5 million in 2050, a 70 percent
increase from today’s numbers.
Medicare, the health care program for the
elderly and disabled, does not cover unlimited nursing home care
and restricts it to those have spent
three in-patient days in a
hospital. Medicaid, the joint federal-state health
program for low-income people, covers more than
60 percent of the people
living in nursing homes.
Although government programs provide a
significant portion of long-term care, none offer the full range
of services people need, said Kirsten Colello, a health and
aging policy specialist at the Congressional Research Service.
Using long-term care insurance to pay
expenses is not an option for many Americans, as premiums rise
and companies that can’t make a profit
leave the market,
Marc Cohen, an
industry consultant. Most of the long-term care policies
available are sold by only 12 insurers, he said.
G. William Hoagland
of the Bipartisan Policy Center offered the most dismal outlook
for the commission. "Medicare and Medicaid have become the major
source of long-term care, and cannot continue at the current
pace," he said. Americans should be encouraged to increase their
retirement savings so that these programs are relied on as a
the panel as part of the Jan. 2 fiscal cliff deal. It
took three months for congressional leaders and President Barack
Obama to appoint the commission’s 15 members. Under the law, the
panel’s recommendations are due to Congress six months after its
members are appointed. But nearly three months passed before the
commission finally convened.
“We have a very short time line,” said
Chernof. “There are a lot of things we would have liked to do as
a commission, but we will be done by the end of September.”
The last time Congress created a long-term
care commission was in 1988, which became known as the
named for its first chairman, Rep. Claude Pepper, D-Fla. That
commission took two years to complete its work, and by then,
Sen. Jay Rockefeller, D-W.Va., had taken over as chairman.
"The fact is that each of us will need
these services and supports at some point in our lifetimes,"
Rockefeller, who added the commission to the fiscal cliff
compromise, said in a statement Thursday. "The question is
whether most Americans can afford to pay for them."
At the meeting, the commission's vice
chair, Mark Warshawsky, director of retirement research at the
benefits consulting firm Towers Watson, seemed to acknowledge
that the panel was trying to make up for lost time as he thanked
the invited experts for appearing on very short notice.
The commission was formed after the demise
of the voluntary long-term care program created by the federal
health law, called the Community Living Assistance Services and
Supports Act, or CLASS. The Obama administration
after determining that it was unfeasible because high premiums
would discourage healthy people from joining. If enough people
did not voluntarily enroll, the program would not have been
self-sustaining. Congress later repealed CLASS and replaced it
with the commission.
The group is sharply divided politically
with nine members appointed by Democrats and six by Republicans.
"The commission should not be sold short,
coming out of the gate," said Connie Garner, a top aide to the
late Sen. Edward (Ted) Kennedy, D-Mass., who championed CLASS.
"It is keeping the conversation alive."
The commission is planning additional
public meetings, although no dates have been set, said Chernof.
Contact Susan Jaffe at
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