Skip to main content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Which Way for Long-Term Services and Supports Financing Reform?

Publication Date
Aug 31, 2016

Despite the high costs for long-term services and supports (LTSS), the current financing system inadequately protects people from the financial devastation of long-term disabling conditions such as Alzheimer's disease or stroke. Private long-term care (LTC) insurance coverage is low and Medicare does not cover LTSS. Consequently, many individuals must pay out of pocket for LTSS and risk using up their savings and assets, or go without care.

The Survey demonstrates that many Americans do not yet have strong opinions on how LTSS financing should be reformed, but generally favor voluntary approaches. The challenge for policymakers is to find a reform strategy that will both successfully address the problems of the LTSS systems and have broad political support.

This Issue Brief exams the general public's opinions about LTSS financing responsibility, financing preferences, and the role of government and private insurers in providing LTC insurance coverage. It was authored by Joshua M. Wiener, Galina Khatutsky, Nga Thach and Angela M. Greene from RTI International. The authors gratefully acknowledge contributions of William Marton and Samuel Shipley of ASPE/HHS. They also wish to thank Genworth Financial for conducting special data analyses of its cost of LTC survey and making the results available. The views expressed in this brief are those of the authors and do not express the views of HHS or RTI International.