Long-Term
Services and Supports

Currently, more than 10 million Americans rely on long-term services and supports for their health and well-being. And that number will only increase dramatically as Baby Boomers age. Yet the United States has never had a system that ensures access to affordable and appropriate long-term care.

Health reform lays the foundation for changing that. It provides new opportunities for states to expand and strengthen home- and community-based programs in Medicaid, the major payer for long-term services. Medicaid coverage for these critical services is optional and varies widely from state to state. Health reform also establishes a voluntary insurance program for long-term services, the Community Living Assistance Services and Supports program (CLASS).

This section of our website looks at current long-term services coverage, the new options and programs that are part of health reform, and how these new options can make a difference nationally and at the state level. Even though health reform lays a foundation for improving access to long-term services, much more needs to be done. Under “Other Issues,” you can find information on legislative proposals to improve long-term care, promising practices, and innovative ways to cover and provide care in the United States and internationally.

The Latest

Recent Developments

The American Tax Relief Act of 2012 (the legislation that came out of the fiscal cliff deal), signed into law on January 2, 2013, repealed the Community Living Assistance Services and Supports (CLASS) Act, a voluntary, national long-term care insurance program created by the Affordable Care Act and established a Commission on Long-Term Care. Implementation of the CLASS Act was suspended on October 12, 2011, in response to an actuarial and legal analysis of the program conducted by HHS. The Commission is responsible conducting a comprehensive evaluation of current access to long-term care, examining workforce issues, and developing a comprehensive plan to establish, implement, and finance a coordinated long-term services and supports delivery system. The Commission will be comprised of 15 members, appointed within 30 days of the enactment of the Tax Relief Act.  

From the Kaiser Commission on Medicaid and the Uninsured:

Medicaid Home and Community-Based Services Programs: 2009 Data Update summarizes the key trends in expenditures and participation in the three main Medicaid home and community-based services programs. It also highlights results from a 2011 survey on provider reimbursement policies and participant eligibility and enrollment. (December 2012)