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California officials probe long‑term care financing for the "overlooked middle"

2948288 · April 9, 2025
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Summary

At a joint Budget Subcommittee hearing, state officials and advocates described a growing financing gap for long‑term services and supports and outlined a new state initiative to study options for middle‑income older Californians who do not qualify for Medi‑Cal but cannot afford private long‑term care.

Assembly Budget Subcommittees 1 and 2 held a joint hearing on long‑term services and supports, focusing on the so‑called “overlooked middle” of older Californians who are too wealthy for Medi‑Cal but lack the resources to pay for long‑term care.

State and nonprofit witnesses described gaps in federal and state coverage and previewed an interagency study that will deliver policy options to the Legislature in 2026. "Medicare does not cover most long‑term care services such as custodial care provided in nursing homes," said Susan Phillip, deputy director for Health Care Delivery Systems at the Department of Health Care Services, noting Medicare’s limits for custodial and home‑and‑community services.

Lawmakers and advocates said the population of older Californians with unmet long‑term care needs is…

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