Rep. Frank Pallone Jr.

Draft legislation to create a federal program within Medicare to support those with substantial long-term care costs when they need care “is a promising start toward effective solutions,” LeadingAge President and CEO Katie Smith Sloan told Rep. Frank Pallone Jr. (D-NJ), in technical comments submitted June 15.

Pallone, ranking member of the House Energy and Commerce Committee, had discussed the idea in early May at a New Jersey roundtable with aging services providers and advocates for those with disabilities. His proposed bill, called the Medicare Long-Term Care Services and Supports Act of 2018, includes:

  • A standard cash benefit within Medicare for anyone who is eligible for Medicare and those aged fewer than 65 years who meet certain disability thresholds. The benefit would begin after a two-year waiting period that functions as a deductible. The discussion draft of the proposal also solicits comments on a potential cash deductible alternative for certain beneficiaries.
  • A self-directed benefit that could be used toward all long-term services and supports, including personal care services, home health aide services, transportation, assistance provided by a family caregiver, nursing home care and adult day programs.
  • Incentives for people to seek care at home but also available for nursing homes.
  • Relief for family caregivers in the form of respite care coverage.

LeadingAge said it shares the bill’s goals to “facilitate independence, protect families and individuals from high out-of-pocket expenses, alleviate the burden on family caregivers and address unmet needs.” The organization’s letter discussed policy and implementation.

LeadingAge said it looked forward to working with Pallone, his staff members and others on legislation to provide and finance long-term services and supports.

The American Health Care Association / National Center for Assisted Living also sent a letter to Pallone, Rachel Reeves, NCAL’s director of communications, told McKnight’s Senior Living.

“Mainly, we reiterated our core principles for any proposal looking to reform long-term care financing, which we developed years ago,” she said.

Those principles:

  • Reform public and private long-term care financing to better support high-quality care delivery and expand consumer choices.
  • Ease the burden on Medicaid of financing long-term care for an aging population.
  • Enable and encourage personal responsibility in planning for long-term care needs.
  • Support quality and efficiency in both Medicaid and private long-term care services.

“These comments are more the starting point of a longer discussion needed amongst all stakeholders,” Reeves said. “We are very pleased that Rep. Pallone is looking into this challenging issue, appreciate his thoughtful draft and welcome more detailed conversations on an ongoing basis.”

Argentum did not submit comments but is scheduling a meeting with Pallone, a spokeswoman said.

Argentum COO Maribeth Bersani previously told McKnight’s Senior Living that the organization also “applauds Rep. Pallone for moving forward to address this critical issue.”

A discussion draft, section-by-section summary of the discussion draft and one-page description of the proposal are available online.