By NextBestFitMedicaid long-term services (nursing homes, HCBS waivers)
replacedYear 2Federal programs
Today
The main U.S. payer for long-term care, but only after people spend down to poverty; HCBS waivers capped, with waiting lists.
Under the plan
UHP covers LTSS by functional need, with no asset test; HCBS becomes an entitlement; room and board income-tested.
Trade-off
Ends impoverishment for long-term care; risk of the 'woodwork effect' as paid care replaces family care.
Money
- Other health, residential & personal care$320.5B → $353.5B
- Home health care$169.4B → $204.5B
- Nursing facilities & continuing-care communities$219.9B → $225.7B