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For decades, policymakers have struggled to address the challenges of financing long-term services and supports, with little success. To better understand new insurance-based alternatives and their effects on people age 65 and older, we analyze several proposals, including mandatory and voluntary options. Although none of these new plans is ideal, each would be an improvement over today’s ineffective financing system, which imposes large out-of-pocket costs on families and shifts costs to the underfunded Medicaid system once those families have exhausted their financial resources. We find substantial trade-offs between voluntary and mandatory insurance and smaller but important differences among voluntary programs.