Can Incentives for Long-Term Care Insurance Reduce Medicaid Spending?

The prospect of paying for nursing home care represents a significant financial risk for older Americans. Despite this risk, few individuals buy long-term care insurance and, since many lack the resources to pay out of pocket, they often turn to the means-tested Medicaid program. Concerned about growing Medicaid costs, many states have initiated “partnership” programs that offer a unique incentive for those who buy long-term care insurance: the state relaxes Medicaid’s asset test so that, if the private insurance benefits run out, individuals can retain more of their assets while still being eligible for Medicaid. This brief, which is based on a longer paper, estimates whether these enhanced insurance policies are likely to reduce Medicaid spending on single men and women. The brief is organized as follows. The first section describes the long-term care cost challenge and introduces the partnership programs. The second section explains the methodology for analyzing the programs’ impact on Medicaid outlays. The third section presents the results, which suggest that most of the buyers are those who would otherwise have purchased a traditional – unenhanced – policy. Thus, the final section concludes that, on balance, Medicaid will lose money on the partnership programs.