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Event Summary

US spending on long-term care (LTC) services and supports will increase from the current level of 1.3 percent of GDP to 3 percent of GDP by 2050 if current growth rates continue. At an AEI event on Wednesday, a bipartisan panel of health policy experts met to discuss the challenges of financing LTC and potential alternatives to the status quo.

Bruce Chernof of The SCAN Foundation explained the brief history of the Commission on Long-Term Care and the commission’s recommendations. He also outlined the need for reform in LTC financing: family caregivers currently provide most care, and long-term services and supports are expensive. Judy Feder of Georgetown University offered a proposal for publicly financed LTC that involves establishing a basic public benefit and educating the public. Anne Tumlinson of Avalere Health agreed with Feder, arguing that despite the cost, the only way to adequately address the problem of LTC is to spread the risk with a public benefit.

John Jones of the State University of New York pointed out that according to his Medicaid insurance research, the affluent elderly do receive Medicaid, and their transfers tend to be larger than those of the less-affluent elderly. Offering an alternative to a public LTC benefit, AEI’s Mark Warshawsky proposed a private solution that involves tightening Medicaid eligibility rules, establishing tax incentives for LTC insurance, and encouraging life-care annuities. Despite finding different solutions to the issue of LTC financing, the group agreed that reforming current financing practices is an important public policy problem.
–Neil McCray

Event Description

America is unprepared to meet the coming long-term care needs of the baby boomers. Most of them do not have enough money or insurance to cover a long-term care event, and Medicaid will not have the money either. The Community Living Assistance Services and Supports Act, included as part of the president’s health reform legislation, would have created a new public entitlement but was terminated as fiscally unsustainable. When the Commission on Long-Term Care released its recommendations in September 2013, there was a clear split between commission members who favor private financing methods and those who favor social insurance.

Can Medicaid be counted on to cover long-term care expenses today and into the future? Has Medicaid crowded out the market for private long-term care insurance? Can families be expected to purchase long-term care coverage decades before they are likely to need it? What new financing approaches could effectively protect Americans from the potentially ruinous costs of long-term care? Please join us for a lively discussion featuring experts representing both sides of this debate.

If you are unable to attend this event, we welcome you to watch it live on this page. Full video will be posted within 24 hours.

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Agenda

12:00 PM
Registration and Lunch

12:15 PM
Panelists:
Bruce Chernof, The SCAN Foundation and Commission on Long-Term Care
Judy Feder, Georgetown University and Commission on Long-Term Care
John Jones, State University of New York
Anne Tumlinson, Avalere Health
Mark J. Warshawsky, AEI and Commission on Long-Term Care

Moderator:
Joseph Antos, AEI

1:45 PM
Question-and-Answer Session

2:00 PM
Adjournment


Event Contact Information

For more information, please contact Neil McCray at [email protected], 202.862.5826


Media Contact Information

For media inquiries, please contact [email protected], 202.862.5829.


Speaker Biographies

Bruce Chernof currently serves as the president and CEO of The SCAN Foundation whose mission is to advance the development of a sustainable continuum of care for seniors. Before heading The SCAN Foundation, Dr. Chernof served as the director and chief medical officer for the Los Angeles County Department of Health Services after serving as the department’s senior medical director for clinical affairs and affiliations since December 2004. Currently, Dr. Chernof is an adjunct professor of medicine at UCLA. He served as the founding director of UCLA’s five-year combined medical doctor degree–master’s degree of business administration program. In 2002, the Geffen School of Medicine at UCLA recognized Dr. Chernof with the Award for Excellence in Education for these innovative programs. He has had work published in a variety of journals including Medical Care and the Journal of General Internal Medicine. He recently served as the chair of the federal Commission on Long-Term Care.

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. Her health policy research began at the Brookings Institution, continued at the Urban Institute, and has flourished at Georgetown University since 1984. In the late 1980s, Feder moved from policy research to policy leadership, actively promoting effective health reform as staff director of the congressional Pepper Commission in 1989–90, principal deputy assistant secretary for planning and evaluation at the Department of Health and Human Services in former president Bill Clinton’s first term, senior fellow at the Center for American Progress (2008–11), and as an Institute Fellow at the Urban Institute.

John Jones is an associate professor in the Department of Economics at the University at Albany, The State University of New York. His principal research areas are applied macroeconomics and structural econometrics. Jones’s research interests include life-cycle consumption and labor supply, health economics, dynamic investment decisions, and fiscal policy. In recent work, he has used the Health and Retirement Study and Asset and Health Dynamics Among the Oldest Old data to estimate the cross-sectional distribution and time series dynamics of health care expenditures; analyze how Social Security, Medicare, and employer-provided health insurance affect saving and retirement; and study the savings and medical spending of retirees. His work has been published in Econometrica, the Journal of Political Economy, and the Journal of Monetary Economics.

Anne Tumlinson, senior vice president of Avalere Health, founded and directs Avalere Health’s newly formed Provider Client Solutions practice group, which delivers business intelligence solutions and continuous research programs to health systems, hospitals, and post-acute care providers. Tumlinson’s area of focus is identifying and targeting high-risk, high-cost Medicare beneficiaries, highlighting the relationship between functional impairment and high health care spending. Before this role, she founded and led the post-acute and long-term care consulting practice at Avalere Health for 13 years. Before coming to Avalere, Tumlinson led Medicaid and long-term care policy for the federal Office of Management and Budget, and before that she worked at LifePlans Inc. She started her career as a US congressional aide responsible for the health and long-term care policy portfolio in the office of Rep. John Lewis (D-GA).

Mark J. Warshawsky is an adjunct scholar at AEI and a former director of retirement research at Towers Watson, a global human capital consulting firm where he oversaw research on employer-sponsored retirement programs including analysis of retirement plan funding, investments, payments, and plan design. Warshawsky also studies developments in labor markets and retirement trends, compensation, investment products, retirement distribution strategies, financial planning, and health and long-term care insurance. At AEI, his work focuses on retirement policy and long-term care insurance. He is also president of ReLIAS LLC, a retirement solutions design firm. Warshawsky was a member of the Social Security Advisory Board from December 2006 to September 2012. He was vice chairman of the federal Commission on Long-Term Care in 2013. From 2004 to 2006, he served as assistant secretary for economic policy at the US Department of the Treasury, playing a key role in the development of the Pension Protection Act of 2006. He has also held senior-level positions at the Federal Reserve Board, the Internal Revenue Service, and TIAA-CREF.


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