The Affordability of Long-Term Care and Support Services: Findings from a KFF Survey
For more details about LTSS, including the populations who use LTSS, cost estimates and policy, see KFF’s reports on Long-Term Services and Supports (LTSS) and Medicaid’s role in financing these services.
This survey, like most public opinion surveys, excludes responses from the institutionalized population, so findings may not fully represent the views of all individuals who currently use long-term services and supports. To help account for this, some questions in the survey ask respondents questions about the experiences of their loved ones who have used these services in the past two years.
As of 2020, KFF estimates that Medicaid paid 54% of the approximately $400 billion spent on LTSS in the U.S. See KFF’s issue brief, 10 Things About Long-Term Services and Supports (LTSS), for more information.
The American Association for Long-term Care Insurance estimates that 7.5 million Americans have some long-term care insurance in place, suggesting there is some level of over-reporting on this survey question. Given the level of confusion around how long-term care is paid for, one possible explanation is that some people may wrongly assume that their existing private health care insurance will also cover long-term care support services if needed, and so may answer yes to this question even if they have not purchased a separate long-term care insurance plan.
The $100,000 estimate for one year of nursing home costs is derived from Genworth’s estimates of the monthly median costs of a nursing home facility in the United States. Roughly averaging the monthly cost of a semi-private room ($7,908) and a private room ($9,034) in a nursing home facility resulted in an estimated annual cost of $102,000, which was simplified to $100,000 for the purposes of the survey questionnaire.
The $60,000 estimate for one year of in-home care or assisted living facility costs is derived from Genworth’s estimates of the monthly median costs of a home health aide and an assisted living facility in the United States. Roughly averaging the monthly cost of homemaker services ($4,957), a home health aide ($5,148), and an assisted living facility ($4,500) resulted in an estimated annual cost of $60,000.
This question was asked of adults who said they received paid long-term care at a residential facility or from paid nurses or aides in the last two years, those who said they financially contributed to the cost of the long-term care that a loved one received in the last two years, and those who said they personally provided unpaid care to a loved one in the last two years.