Federal and state policymakers increasingly are interested in creating a public social insurance program for long-term care in the US. Even some Democratic presidential hopefuls have raised the issue, though still only in general terms. That growing interest is great news, and long past due. But what should such a model look like?
Designers face a handful of critical high-level choices. Do they invent a public long-term care (LTC) insurance program that looks like existing stand-alone private insurance? If so, do they cover first-dollar costs, catastrophic risk, or everything? Or, alternatively, do they integrate long-term services and supports (LTSS) with medical care? And whatever they do, how do they pay for it?
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