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Witnesses tell committee long‑term care costs push families to ‘spend down’; experts urge stronger Medicaid protections and explore Medicare options
Summary
Panelists said the U.S. lacks a coordinated long‑term care system, forcing many families to ‘spend down’ assets to qualify for Medicaid. Witnesses recommended strengthening Medicaid, considering a Medicare long‑term care benefit, and addressing private‑equity ownership in nursing homes.
Committee members and witnesses described long‑term care costs as an immediate and growing crisis for older Americans who lack private coverage.
Alex Lawson told senators “we do not have a long term care system in this country,” and that many families must “spend down” assets until they qualify for Medicaid to pay for long‑term supports and services. Lawson said the average long‑term care cost nationwide is about $100,000 a year and warned that proposed large cuts to Medicaid would “destroy Medicaid” and remove the principal payer for long‑term care.
Senator Kim (during questioning) described the experience of families in New Jersey paying up to tens of thousands monthly for assisted living and asked witnesses what options Congress should examine to prevent family bankruptcies.
Lawson and other witnesses recommended several policy avenues: preserving Medicaid’s current role as the nation’s largest long‑term care payer; considering a long‑term‑care benefit under Medicare; strengthening program integrity to reduce fraud; and pushing back on private‑equity consolidation in the nursing‑home sector. “The idea of bringing long term care as a benefit under Medicare is an extremely good idea,” Lawson said, adding Medicare tends to control cost growth more effectively than some private alternatives.
Committee members asked for further analysis and said they would submit follow‑up questions and requests for materials.
