This paper was developed for the Bipartisan Policy Center (BPC) by lead authors Marc Cohen, Center Research Director, and Judy Feder, who is affiliated with the Center as a Consumer Voices for Innovation Senior Leader.

Current U.S. policy toward the financing of long-term services and supports (LTSS) underserves people who need care, overburdens families who care for them, and strains state budgets supporting Medicaid services when personal resources fall short.

The fundamental LTSS financing problem is the absence of an effective insurance mechanism to protect people against the costs of extensive LTSS they may require over the course of their lives. Building on the direction of recent bipartisan recommendations, the authors developed and analyzed a proposal to combine public catastrophic insurance (protection after a waiting period) with gap-filling private LTSS insurance to promote comprehensive insurance protection, focused on middle-income people.

Drs. Cohen and Feder discussed the report on a panel at an event hosted by the BPC on January 31, 2018, in Washington, D.C.  A video recording of the BPC event can be viewed in its entirety here.


Marc Cohen, Ph.D., Co-Director LeadingAge LTSS Center @UMass Boston, University of Massachusetts Boston, McCormack Graduate School, and Research Director, Center for Consumer Engagement in Health Innovation, Community Catalyst, Boston

Judith Feder, Ph.D., Professor, McCourt School of Public Policy at Georgetown University and Urban Institute Fellow, Urban Institute, Washington, DC

Melissa Favreault, Ph.D., Senior Fellow, Urban Institute, Washington, DC