The White House Conference on Aging (WHCOA) events have a way of sneaking change into the U.S. long-term care (LTC) system in a flood of speechifying.
Administrations have been holding the conferences every 10 years or so since 1961. Obama has scheduled the next conference to take place July 13.
Organizers of the 2015 conference are encouraging members of the public to "get involved" through many activities that sound as if they came out of a Cub Scout or Brownie merit badge guide. Such as: watching the event stream live; sharing personal stories about "why the issues discussed at the conference are important to you"; interviewing an older adult; hosting a watch party; and completing the sentence "Getting older is getting better because…"
Groups with an interest in aging and independent individuals have participated in a series of regional forums leading up to the main event and repeated many of the same kinds of concerns over and over.
Ten years ago, some of the insurance agents and brokers who were watching the 2005 conference may have despaired at the thought of any concrete changes emerging, especially given the hostility between Democrats and Republicans on Capitol Hill. But policymakers there planted the seeds for the Patient Protection and Affordable Care Act (PPACA) provisions encouraging state Medicaid programs to spend LTC money on home and community-based care, not just on nursing home care.
The policymakers there may have also increased policymaker interest in family caregivers and other providers of unpaid care, and in the effort to encourage consumers to buy private long-term care insurance (LTCI) by using state "Partnership" programs to give buyers of qualified LTCI an easier time qualifying for state Medicaid nursing home benefits if they exhaust the private benefits.
This year, the Obama administration goes into the 2015 conference with the U.S. Department of Health and Human Services (HHS) wrestling with the PPACA commercial health insurance programs and running a new LTC policy agency.
See also: HHS creates LTC policy agency
What could come out of this conference?
For a look at some of the ideas circulating in the aging con-o-sphere, read on.
1. Agents and brokers who feel stress when they hear about the Patient Protection and Affordable Care Act (PPACA) may need to take a deep breath before reading conference-related documents.
The WHCOA staff has helped members of the public get involved in discussions about long-term care, which they call long-term services and supports (LTSS), by posting a policy brief on the topic.
The staff mentions PPACA seven times and the achievements of the Obama administration twice.
The staff notes, for example, that, in 2013, the Obama administration "took an important step forward" in helping paid LTC workers, by having the U.S. Department of Labor extend minimum wage and overtime protections to home care workers.
"Direct care workers, like other low-wage workers, are likely to benefit from greater access to health insurance through the Affordable Care Act," the staff members write.
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2. Some commenters are talking about the need for better LTCI programs, but not necessarily programs that insurers (or even public agencies) could actually create.
"Private options (including long-term care insurance, whole life insurance or life insurance riders, reverse equity mortgages, and annuities) are available to help some people plan ahead for their future care," the WHCOA staff says in the LTSS brief. "But there is currently no comprehensive long-term care financing program available to all older clients."
Several members of the public suggest in the comments section under the brief that the government should create new private LTCI incentive programs. Jennifer Dexter of Easter Seals, for example, writes in support of expanding access to private LTCI.
Some, including Allicyn Wilde of the Service Employees International Union (SEIU) and Dr. Cheryl Townsend Winter of the Washington State Council on Aging, call for the government to create a new public LTSS program.
"Create a social insurance LTSS benefit, such as including a LTSS benefit as part of Medicare," Wilde says.
Townsend Winter says the government should establish mandatory LTSS programs.
But some commenters don't seem to remember the trouble HHS had with trying to make the voluntary LTC insurance program that was supposed to be created by PPACA sustainable. One knock against the PPACA LTC program was that it was doomed because enrollees could be working-age adults who were already severely disabled enough to qualify for LTC benefits.
One of the commenters on the WHCOA LTSS brief says the government needs to create a "voluntary, national long-term care insurance program" that "does not exclude purchasers based on pre-existing health conditions."
