The first of Minnesota’s new hard-won elder care protections take effect Thursday. State law now prohibits retaliation by long-term care facilities against residents, families and employees who make good faith efforts to report problems and suggest service improvements.
The bulk of the other landmark reforms passed during this year’s legislative session, such as joining every other state in licensing assisted-living facilities, will go into effect two years from now, giving state officials and care providers time to prepare. The changes are welcome and the result of dogged work by care providers, advocates and legislators.
These leaders merit a moment to rest on their laurels but the breather must be brief. Long-term care, especially its financing, remains a complex yet under-the-radar policy challenge even as the costs rise. A recent Health Affairs study drew a troubling conclusion: Within a decade, many elders considered middle-income will need the level of care provided in senior housing, but 54% won’t be able to pay for it.
Solutions at both the state and federal levels are urgently needed. The same teamwork that led to Minnesota’s elder care safeguards this year must be summoned again to address affordability.
Regrettably, not enough people realize that Medicare, the federal government’s health insurance program for seniors, generally doesn’t cover long-term care. Many also don’t realize how expensive this care can be. The yearly bill for nursing home care is $90,000 in Minnesota. The price tag for assisted living: $48,000. The yearly tab for 44 hours a week of home care is $60,000.
There are consequences for aging individuals and for taxpayers when those who need care can’t get it or don’t have private long-term care insurance. Those who exhaust their assets may turn to the publicly funded Medicaid program. About 41,000 Minnesotans over 65 receive long-term care services through this program. That number is projected to increase by 71% from 2018 to 2040.
Other states are exploring solutions to better prepare for long-term care needs. The state of Washington is starting a public long-term insurance plan to be funded through payroll taxes, according to a report from Stateline, an initiative of Pew Charitable Trusts.
Options that have surfaced in Minnesota health policy circles have focused on private-sector solutions, such as allowing the sale of life insurance policies that would transform into a long-term care product as the policyholder ages. Rep. Jennifer Schultz, DFL-Duluth, asked Joseph Gaugler, a University of Minnesota professor, to convene a work group to identify a range of solutions for legislative consideration in 2020.
Strengthening elder care safeguards was a real achievement. Now it’s time to seize the momentum to tackle another critical long-term care challenge — how to pay for it.