Description: Discussion of the implications of the newly unveiled health care reform proposal by Senator Baucus. Key issues include abandonment of the CLASS Act, inclusion of LTC in cafeteria plans, funding and tax concerns, individual mandate, privacy concerns, play-or-pay employer mandate, impact on Medicare and Medicaid, and gridlock in the legislative finalization process.

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: Presented at the Living to 100 Symposium, January 2011. The Community Living Assistance Services and Supports 'CLASS' Act’s designers and promoters envision the program as a noble plan to relieve the financial strain on Medicaid long-term care and enable disabled and elderly Americans to purchase more home care and suffer less nursing home institutionalization. This paper explains why CLASS, like private long-term care insurance, is doomed to failure unless and until the crowd-out effect of easy access to Medicaid LTC benefits is addressed.

Description: This article provides some state officials' responses to a request for information from legislators related to the study and reform of Medicaid long-term care (LTC) eligibility and estate recovery rules. In those replies, there is strong evidence that Medicaid eligibility and estate recovery rules are subject to frequent and egregious abuses.