We Need Comprehensive Long-Term Care Reform, And We Need It Now

By Norma B. Coe, PhD, for The Hill

By 2050, 18.9 million Americans will be over the age of 85 and, if patterns continue, more than 40 percent of them will need long-term care (LTC) — the care that helps people with everyday activities. Our current insurance and provider systems are not adequate to meet these needs. Although it will be expensive to overhaul our fragmented and broken system, it will be more costly not to act.   

A commonly touted barrier to comprehensive reform is financing. However, just because the federal government is not footing the bill does not mean that no one is paying for it. These costs are largely borne by the backbone of the long-term care system in this country: women. These are the same women who have left the workforce in droves because of child care responsibilities during the COVID pandemic, the same women who are currently caring for seniors too afraid to go to a nursing home, where 0.5 percent of the population lives and up to 50 percent of the COVID-19 deaths have occurred. 

President Biden has released his plan for older Americans, which provides substantial support for caregivers:12 weeks of paid family leave; a new $5,000 tax credit for expenses associated with caregiving; Social Security working credits for time spent caregiving, which will help low-income caregivers when they approach retirement; and a substantial revamping of Medicaid, the insurance program for the poor and currently the largest provider of LTC services, to include home- and community-based care in all states.