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Partnership Program for long-term care insurance: the right model for addressing uncertainties with the future?

Published online by Cambridge University Press:  16 July 2015

SAVANNAH BERGQUIST ,
JOAN COSTA-FONT  and
KATHERINE SWARTZ
SAVANNAH BERGQUIST
Affiliation:
PhD student, Health Policy Program, Harvard University, Cambridge, Massachusetts, USA.
JOAN COSTA-FONT
Affiliation:
European Institute, Department of Social Policy, London School of Economics, UK.
KATHERINE SWARTZ*
Affiliation:
Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
*
Address for correspondence: Katherine Swartz, Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, 677 Huntington Ave., Boston, MA 02459, USA E-mail: [email protected]
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Abstract

Public policies that provide incentives for higher middle-income people to purchase private long-term care insurance (LTCI) have been proposed as a way to shield large numbers of middle-income people from the risk of needing costly long-term care. A proposal to promote purchases of private LTCI that has gained modest traction in the United States of America is the Partnership Program. The structure and public–private nature of the Partnership Programs are reviewed along with the trends in sales of both regular private LTCI policies and Partnership LTCI policies to show that both experienced low purchase rates. Implementation efforts for the Partnership Programs were very modest, in part because many were launched when the Affordable Care Act was passed. At the same time, several well-known insurers withdrew from selling private LTCI. Understanding why the Partnership Program is not a success provides lessons for other counties interested in creating similar public–private ventures.

Keywords

long-term care insurancelong-term carePartnership ProgramsMedicaid crowd-out
Type
Forum Article
Information
Ageing & Society , Volume 36 , Issue 9 , October 2016 , pp. 1779 - 1793
Copyright
Copyright © Cambridge University Press 2015 

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References

Ahlstrom, A., Clements, E., Tumlinson, A. and Lambrew, J. 2004. The Long-term Care Partnership Program: Issues and Options. George Washington University, Washington DC.Google Scholar
Alper, J. 2007. The partnership for long-term care: a public–private partnership for financing long-term care. In Isaacs, S. L. and Knickman, J. R. (eds), The Robert Wood Johnson Foundation Anthology: To Improve Health and Health Care. Volume X, Jossey-Bass, Somerset, New Jersey.Google Scholar
America's Health Insurance Plans 2012. Who Buys Long-term Care Insurance in 2010–2011? America's Health Insurance Plans. Available online at https://www.ahip.org/WhoBuysLTCInsurance2010-2011/ [Accessed May 2015].Google Scholar
Barr, N. 2010. Long-term care: a suitable case for social insurance. Social Policy & Administration, 44, 4, 359–74.Google Scholar
Bergquist, S., Costa-Font, J. and Swartz, K. 2015. Long term care partnerships: are they ‘fit for purpose’? CESifo Working Paper Series 5155, CESifo Group, Munich, Germany.Google Scholar
Brown, J. R., Coe, N. B. and Finkelstein, A. 2007. Medicaid crowd-out of private long-term care insurance demand: evidence from the Health and Retirement Survey. In Poterba, J. (ed.), Tax Policy and the Economy. Volume 21, MIT Press, Cambridge, Massachusetts, 1–34.Google Scholar
Brown, J. R. and Finkelstein, A. 2004. The interaction of public and private insurance: Medicaid and the long-term care insurance market. National Bureau of Economic Research Working Paper Series 10989, National Bureau of Economic Research, Cambridge, Massachusetts.Google Scholar
Brown, J. R. and Finkelstein, A. 2007. Why is the market for long-term care insurance so small? Journal of Public Economics, 91, 10, 1967–91.CrossRefGoogle Scholar
Brown, J. R. and Finkelstein, A. 2011. Insuring long-term care in the United States. Journal of Economic Perspectives, 25, 4, 119–42.CrossRefGoogle Scholar
Colombo, F., Llena-Nozal, A., Mercier, J. and Tjadens, F. 2011. Help Wanted? Providing and Paying for Long-term Care. OECD Health Policy Studies, OECD Publishing, Paris.Google Scholar
Costa-Font, J. and Courbage, C. 2015. Crowding out of long-term care insurance: evidence from European expectations data. Health Economics, 24, supplement 1, 74–88.Google Scholar
Costa-Font, J., Courbage, C. and Swartz, K. 2015. Financing long-term care: ex-ante, ex-post or both? Health Economics, 24, supplement 1, 45–57.Google Scholar
Dilnot Commission 2011. Fairer Funding for All – Commission's Recommendations to Government. Available online at http://webarchive.nationalarchives.gov.uk/20130221130239/http://dilnotcommission.dh.gov.uk/our-report/ [Accessed March 2015].Google Scholar
Elmendorf, D. W. and Sheiner, L. M. 2000. Should America save for its old age? Fiscal policy, population aging, and national saving. Journal of Economic Perspectives, 14, 3, 57–74.Google Scholar
Frank, R. G. 2012. Long-term care financing in the United States: sources and institutions. Applied Economic Perspectives and Policy, 34, 2, 333–45.Google Scholar
Goda, G. S. 2011. The impact of state tax subsidies for private long-term care insurance on coverage and Medicaid expenditures. Journal of Public Economics, 95, 7/8, 744–57.Google Scholar
Greene, K. 2012. Long-term care: what now? Wall Street Journal, 9 March. Available online at http://www.wsj.com/articles/SB10001424052970203961204577269842991276650 [Accessed February 2015].Google Scholar
Johnson, S. R. 2015. Financing questions loom as private LTC insurers falter. Modern Healthcare, 7 January. Available online at http://www.modernhealthcare.com/article/20150117/MAGAZINE/301179971 [Accessed March 2015].Google Scholar
Kaye, H. S., Harringhton, C. and LaPlante, M. P. 2010. Long term care: who gets it, who provides it, who pays and how much? Health Affairs, 29, 1, 11–21.CrossRefGoogle ScholarPubMed
Kemper, P., Komisar, H. L. and Alecxih, L. 2005. Long term care over an uncertain future: what can current retirees expect? Inquiry, 42, 4, 335–50.Google Scholar
Meiners, M. R. 2009. Issue Brief: Long-term Care Partnership: Considerations for Cost-effectiveness. Center for Health Care Strategies, Hamilton, New Jersey.Google Scholar
Meiners, M. R. 2012. Partnership long-term care insurance: lessons for CLASS program development. Journal of Aging & Social Policy, 24, 2, 152–68.Google Scholar
Meiners, M. R., McKay, H. L. and Mahoney, K. J. 2002. Partnership insurance. Journal of Aging & Social Policy, 14, 3/4, 75–93.Google Scholar
Pauly, M. V. 1990. The rational nonpurchase of long-term care insurance. Journal of Political Economy, 98, 1, 153–68.Google Scholar
Reaves, E. L. and Musumeci, M. B. 2014. Medicaid and Long Term Services and Supports: A Primer. Kaiser Family Foundation Report, July. Available online at http://kff.org/medicaid/report/medicaid-and-long-term-services-and-supports-a-primer/ [Accessed April 2015].Google Scholar
Robert Wood Johnson Foundation 2014. Long-term Care: What Are the Issues? Health Policy Snapshot Issue Brief, February. Available online at http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2014/rwjf410654 [Accessed April 2015].Google Scholar
Society of Actuaries 2005. Session 62D, Long-term Care Insurance Industry Snapshot. Paper presented at the Life Spring Meeting, 22 May, New Orleans, Louisiana.Google Scholar
Sun, W. and Webb, A. 2013. Can long-term care insurance Partnership Programs increase coverage and reduce Medicaid costs? Center for Retirement Research Working Paper 2013–8, Boston College, Boston.Google Scholar
United States Department of Health and Human Services, Assistant Secretary for Planning and Evaluation 2006. Historical and Projected Trends in Medicaid. United States Department of Health and Human Services, Washington DC.Google Scholar
United States Government Accountability Office (US GAO) 2007. Long-term Care Insurance: Partnership Programs Include Benefits That Protect Policyholders and Are Unlikely to Result in Medicaid Savings. GAO-07-231, US GAO, Washington DC.Google Scholar
Wiener, J. M., Anderson, W. L., Khatutsky, G., Kaganova, Y. and O'Keeffe, J. 2013. Medicaid Spend Down: New Estimates and Implications for Long-term Services and Supports Financing Reform. Report for the SCAN Foundation, March. Available online at http://thescanfoundation.org/sites/thescanfoundation.org/files/rti_medicaid-spend-down_3-20-13_1.pdf [Accessed February 2015].Google Scholar