This, however, would mean retaining a federal presence in Medicaid. Limited expansion would at least spread some of the risks of LTC costs while directing resources to the low and moderate-income population. Those who could afford more protection could purchase private insurance. Public education could help encourage purchase of private LTC insurance. Public standards and other consumer protections for insurance could reduce some of the fears about abuses.
States vary enormously in their per capita annual expenditures on long-term care.
Some of the disparities could be corrected by establishing national minimums, for instance. That is, it could fail to protect the most vulnerable group individuals with moderate incomes. Given these drawbacks, the only viable option for the near term will be improvements at the margin, or prioritizing aspects of the program that can most successfully be enhanced. Limited social insurance. The goal of such a new program would be to preserve living standards for those who reside in the community.