Federal policymakers have struggled unsuccessfully since at least the 1980s to create a national long term care (LTC) policy. LTC coverage is available however it can only be obtained by pursing a complicated asset depletion process to qualify for coverage under the Medicaid program. (Medicare is frequently assumed to provide LTC. It does not.) The 2010 Affordable Care Act's CLASS Act, that would have created a voluntary, public long-term care insurance option for employees, was determined in 2011 to be actuarially unworkable and in 2013 was repealed. The 2013 American Taxpayer Relief Act's Commission on Long Term Care produced a report that contained service delivery and workforce recommendations but did not reach agreement regarding financing. Though most comparative countries provide for LTC, the US remains without despite the fact with a rapidly aging population the demand for LTC services will significantly increase this decade and beyond (e.g., the number of Medicare beneficiaries is expected to grow from 55 to 80 million this decade), private LTC is largely unaffordable and less than 10% of the middle income population age 45 or older owns a commercial LTC insurance policy.
During this 28-minute interview, Prof Feder begins by explaining why the 2013 LTC C0mmission failed to reach agreement regarding financing a LTC policy. She moreover discusses or unpacks her and her colleagues 2018 paper (noted below) that, in sum, proposes a public catastrophic insurance along with a gap-filling private long term services and supports (LTSS) insurance, i.e., who is eligible, when, the amount of the benefit, how paid and financed. She discusses recent Congressional efforts by Rep. Frank Pallone and others to legislate a policy and provides comment regarding the recently-released Biden campaign proposal regarding caregiver support (also noted below).
Judy Feder is a Professor of Public Policy and, from 1999 to 2008 served as Dean of what is now the McCourt School of Public Policy, at Georgetown University. Prof. Feder's health policy research began at the Brookings Institution, continued at the Urban Institute, and, since 1984, has been pursued at Georgetown. Prof. Feder previously served as the Staff Director of the Congressionally-formed Committee on Comprehensive Health Care, known as the Claude Pepper Commission in 1989-90; served as Principal Deputy Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services; as a Senior Fellow at the Center for American Progress (2008-2011); and, today as an Institute Fellow at the Urban Institute. Prof. Feder is an elected member of the National Academy of Medicine, the National Academy of Public Administration, and the National Academy of Social Insurance; a former chair and board member of AcademyHealth and former board member of the National Academy of Social Insurance; and, a member of the Center for American Progress Action Fund Board and of the Hamilton Project’s Advisory Council. In 2006 and 2008, Prof. Feder was the Democratic nominee for Congress in Virginia’s 10th congressional district. Prof. Feder earned her B.A. from Brandeis and her Master's and Ph.D. from Harvard.
The 2018 paper, "A New Public-Private Partnership: Catastrophic Public and Front-End Private LTC Insurance" is at: https://www.umb.edu/mccormack.umb.edu/uploads/gerontology/Public_Catastrophic_Insurance_Paper_for_Bipartisan_Policy_Center_1-25-2018.pdf.
The Biden campaign's July 21 "caregiving and education workforce" plan is at: https://www.documentcloud.org/documents/6998636-07-20-20-Caregiving-and-Education-Workforce-Plan.html.