2015 long-term care planning outlook: Washington

The respite may give the remaining players the same kind of freedom to “take a disciplined approach to pricing” that helped get the disability insurers out of their funk in the 1990s, and helped get the trial-lawyer-plagued major medical insurers out of their own funk just 15 years ago.

3. Long-term care (LTC) providers seem to be noticing how much better patients with private LTCI are at paying for their care.

The Homewatch Caregivers home care franchise, for example, has been active at reaching out to LifeHealthPro.com, and franchise owners interviewed have talked about how much more quickly and more smoothly private LTCI carriers pay benefits than Medicaid programs pay. 

4. Policymakers in countries where socialism is just another way of thinking, not a cussword, are also having trouble figuring long-term care finance out.

Japan is famous for taking good care of its elderly, and it has a large, government-run, mandatory LTC insurance program. But it is having to raise premiums for the program, due to higher-than-expected costs, and it has more than 500,000 people on nursing home care waiting lists.

The United Kingdom has a single-payer acute health care system and a public LTC benefits system, but officials have responded to their program’s problems by letting people with assets qualify for benefits only after meeting a £72,000 deductible.

The world’s LTC financing problems may give the pioneers in the United States some protective cover. Apparently, one of the chief reasons the pioneers have had trouble is that figuring how to pay for LTC services for large numbers of people is hard.

5. Republicans are on top in the Senate.

Republicans have aging parents, too, and some of them are already aging into the “oldest old” category.

Traditionally, many of the Republicans in Washington have been warm to the idea of supporting private LTCI, LTC delivery and caregiver support programs, and a willingness to back private LTCI incentives has sometimes split moderate Democrats from more liberal Democrats.

Republicans may now be able to get enough Democratic support for private LTC planning and LTCI incentives to get them to the president’s desk. The question then will be whether Obama will side with the moderate Democrats and sign the bills, or see the bills as an attack on the idea of adding basic LTC benefits to Medicare and veto them.

See also: 5 predictions for the LTC insurance industry in 2014