Removing Medicaid Loopholes to Improve Long-Term Health Care

Published November 7, 2023
Stephen Moses, one of the leading experts on long term care in the U.S. says the nation can dramatically improve the quality of long-term care if we could get rid of the many loopholes that allow just about anyone to qualify for Medicaid coverage. Few people save for long term care because it is widely accepted that the government will pick up the tab. But government paid care has really impacted the quality of care.  Many of the elderly live their last days in nursing homes.  
 
Moses, and the Paragon Institute released their latest report on the problems with long term care in the U.S., called Long-Term Care: The Solution. In October 2022, Moses and Paragon outlined the problems in Long-Term Care: The Problem.   
 
People prefer to live out their final years in the comfort of their own home but surprisingly, many of the elderly end up in institutional care. That is no accident. Medicaid is the largest payer of long-term care, and one reason is because you don’t have to be impoverished to qualify. This has put a huge strain on the federal budget, on Medicaid reimbursements and significantly compromised the quality and supply of care.  Few innovations exist because there is little presence of a free market. As a result, institutional care has become the “go-to.”
 
This podcast begins with a discussion on Medicaid loopholes, the response from Congress, whether a solution is workable immediately, and how special interests might respond to closing off loopholes. The conversation then turns to why the public needs to be better educated on long-term care. The idea that it must be debilitatingly expensive isn’t true.