New report calls for universal coverage of long-term care for older adults in U.S.

Health Care , Coronavirus (COVID-19)
Long term care
Long term care
a senior woman and her adult daughter wear protective face masks and clasp hands
A new report co-authored by an expert in aging at OHSU calls for a system of universal coverage to support the long-term care of all older Americans. (Getty Images)

The COVID-19 pandemic’s heavy toll on older Americans highlights the need to strengthen the nation’s safety net for people in need of long-term services and supports, an Oregon Health & Science University researcher and co-authors argue in a new report published by Milbank Quarterly.

The report proposes a system of universal coverage to support the long-term care of all older Americans.

“This approach would protect against financial catastrophe and end the current system that is based on the need to be financially destitute in order to access coverage via Medicaid,” the authors write. “Such an approach would benefit both individuals and families and would also create a far more stable and more generous funding stream to providers.”

Headshot of Walt Dawson, a bearded man wearing glasses
Walt Dawson, D.Phil.

Walt Dawson, D.Phil., assistant professor of neurology in the OHSU School of Medicine, said he believes the pandemic could be an inflection point to improve the U.S. system of long-term services and support.

Dawson, also a senior Atlantic Fellow of Equity in Brain Health with the Global Brain Health Institute, studies the public policy implications of Alzheimer’s disease and other dementias – including the financial impact on families and the public programs that finance care.

The report lays out a series recommendations to repair what it characterized as a fragmented and patchwork system of long-term services and supports for older Americans living with physical and cognitive impairments.

Long-term recommendations

Near-term recommendations

“Although these are not new problems, the pandemic has exacerbated and amplified their impact to a point that they are impossible to ignore,” the report concludes. “The opportunity for reform is now.”

In addition to Dawson, co-authors included Nathan Boucher, Dr.PH., assistant research professor in the Sanford School of Public Policy at Duke University; Robyn Stone, Ph.D., senior vice president of the LeadingAge LTSS Center at the University of Massachusetts Boston; and, Courtney Van Houtven, Ph.D., professor of population health science in the Duke University School of Medicine.


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