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Brian Kaskie, Medicaid Long Term Services and Supports:The Road Well Traveled by Josh Wiener, Public Policy & Aging Report, Volume 28, Issue 2, 2018, Pages 45–47, https://doi.org/10.1093/ppar/pry015
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The Affordable Care Act of 2010 supported an unprecedented expansion of the Medicaid health insurance program; by the end of 2015, Medicaid had become the single largest health insurance program in the United States, providing coverage to more than 66 million Americans (Colello, 2017). Not only has Medicaid grown in terms of the total number of recipients and expenditures, it has become increasingly diversified from one state to the next. While some states have expanded eligibility criteria to enroll more recipients, other states have introduced cost-sharing policies and a few have fully transferred program operations to managed health care companies (Rosenbaum, Schmucker, Rothenberg, & Gunsales, 2016). Amid this substantial growth and diversification, at least two constants remain: (1) the continued demand for long-term care services and supports (LTSS) among the aging American population; and (2) the critical role served by state Medicaid programs as the primary payer for LTSS provided to our nation’s aging population. In 2015, more than 14 million persons over the age of 65 used some type of LTSS; a total of $351.8 billion was spent on LTSS, accounting for 12.9% of all U.S. health care expenditures; and Medicaid payments for LTSS amounted to $149.4 billion, accounting for 42.5% of all U.S. LTSS expenditures and 31% of all Medicaid spending (CMS, 2017).
