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Long-term care (LTC) in the United States has evolved over the course of the last century to better serve the needs of seniors and person with disabilities. This long-term care timeline outlines the major milestones in LTC from the nursing home era, which created an institutional bias in LTC, to the era of home and community based services (HCBS) and integration, and into the era of health reform and beyond.
Using the 2011 National Health and Aging Trends Study (NHATS), this brief first examines the need for long-term services and supports (LTSS) among seniors living in the community. It then studies health status, mobility limitations, and housing characteristics of seniors living in the community with an LTSS need.
Medicaid’s Money Follows the Person (MFP) demonstration has helped seniors and people with disabilities move from institutions to the community by providing enhanced federal matching funds to states since 2007. The program operates in 44 states and has served over 90,000 people as of June 2018. The program is credited with helping many states establish formal institution to community transition programs that did not previously exist by enabling them to develop the necessary service and provider infrastructure. With a short-term funding extension set to expire on December 31, 2019, MFP’s future remains uncertain without a longer-term reauthorization by Congress.
To financially qualify for Medicaid long-term services and supports (LTSS), an individual must have a low income and limited assets. In response to concerns that these rules could leave a spouse without adequate means of support when a married individual needs LTSS, Congress created the spousal impoverishment rules in 1988. Originally, these rules required states to protect a portion of a married couple’s income and assets to provide for the “community spouse’s” living expenses when determining nursing home financial eligibility, but gave states the option to apply the rules to home and community-based services (HCBS) waivers.
Section 2404 of the Affordable Care Act (ACA) changed the spousal impoverishment rules to treat Medicaid HCBS and institutional care equally from January 2014 through December 2018. Congress subsequently extended Section 2404 through December 2019. This issue brief answers key questions about the spousal impoverishment rules, presents 50-state data from a 2018 Kaiser Family Foundation survey about state policies and future plans in this area, and considers the implications if Congress does not further extend Section 2404.
This analysis presents the most current data on out-of-pocket health care spending by Medicare beneficiaries, both overall and among different groups of beneficiaries. The analysis explores how much Medicare beneficiaries spend out of pocket in total on health care premiums and health-related services, on average; how much beneficiaries spend out of pocket on different types of health-related services; and what share of income beneficiaries spend on out-of-pocket health care costs.
Long term care facility costs are the largest share of annual out of pocket spending by Medicare beneficiaries — representing 32% of their spending on services annually.
For the first time in a decade, states are reporting no overall growth in Medicaid enrollment last year and expecting minimal growth this year amid a stronger economy, a new Kaiser Family Foundation survey finds.
A new brief from KFF (the Kaiser Family Foundation) examines potential changes to “spousal impoverishment” rules in Medicaid that allow married couples to protect a portion of their income and assets should one spouse seek Medicaid coverage for long-term care.
Caregiver Responsibilities Among Women Download Source Henry J.
Characteristics of Women Family Caregivers Download Source Kaiser Family Foundation, 2008 Kaiser Women’s Health Survey…
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