LONG TERM CARE

CONCLUSION
Medicaid’s long-term care services are a critical source of support for millions of poor and lowincome
people. The long-term care system we have today is primarily financed by Medicaid,
and without significant policy changes, Medicaid is likely to be the major source of long-term
care coverage in the future. Medicaid, however, has important gaps and inequities. Medicaid is
not an option for many; for those who do qualify, Medicaid does not provide insurance
protection against large financial losses, but requires impoverishment. Eligibility and benefits
are limited in many states, and waiver programs may not be available to all who need them and
are financially eligible for them. Efforts to address these gaps are needed. Medicaid eligibility
policies could be revised to make the program’s means-testing less harsh. Federal financing
could be expanded to make it easier for states to provide community-based services for people
with long-term care needs. Barring major changes in the structure of long-term care financing,
improving Medicaid’s long-term care protections for people of modest means is likely to be a
key part of any future strategy for meeting the long-term care needs