Ellen O'Brien


Cutting Medicaid is unlikely to substantially increase private sources of long-term care financing, and future financing reform needs to focus on the actual flaws in the current means-tested system of long-term care financing. In order to make this argument, this article briefly describes the goals of the DRA and the policy reforms that seek to limit eligibility for the middle-class elderly. Next, the article draws on a wide range of empirical studies conduct over the past two decades to demonstrate that the impact of Medicaid planning is not quantitatively significant, and that by and large, the elderly assume substantial personal responsibility for long-term care. A discussion concerning weaknesses in the current long-term care financing system and available alternatives to DRA-style reform follows. Finally, this article identifies a set of goals that should guide future long-term care financing reform, including reducing the burdens of financing care that fall disproportionately on people who need long-term care, as well as reducing existing disparities in access and quality that characterize Medicaid coverage today.

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Elder Law Commons