Description: Rhode Island’s unique “global Medicaid waiver” pursues a potentially dangerous national policy trend: long-term care LTC rebalancing without strong eligibility controls. Resulting cost overruns could seriously damage the state’s social safety net. To maximize the global waiver’s opportunity, minimize its danger, and become a LTC financing model for the country, policy makers need to recognize the issues discussed in this report and pursue the recommended additional research and analysis.

Description: A comment letter to policymakers produced jointly by the SOA and AAA presents findings from their actuarial analysis of the proposed CLASS Act. The analysis indicates that the proposed structure and funding approaches will be unsustainable, and will cover only a very small proportion of the intended population. The opt-out and guaranteed issue provisions of the plan pose a risk that soon the program will either need increased premiums and/or significant reductions.

Description: A summary of concerns about the Community Living Assistance Services and Supports Act, including flaws in the underlying premises, opportunism, inadequate sales incentives, insufficient benefits, adverse selection, and cashflow and solvency issues.