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Insurance Agents Gain Support on Beacon Hill



By Kyle Cheney

STATE HOUSE, BOSTON, APRIL 5, 2011…..Warning that Massachusetts had fallen behind the nation in setting standards for long-term care insurance for ill, frail and elderly residents, a state senator asserted Thursday that a bill to implement a legal framework for long-term insurance policies – backed by key members of each branch – would pass this year.

“This is the year that this is going to be done, because this is the year that we really do need this bill to be done,” said Sen. Harriette Chandler, the Senate’s assistant majority leader.

Massachusetts is one of four states that haven’t adopted minimum standards for long-term care insurance policies, Chandler said, adding that the lack of standards discourages the long-term care insurance industry from expanding in Massachusetts. Those policies, she said, often direct patients to private coverage, with more options, and away from taxpayer-funded programs like Medicare and Medicaid.

The Patrick administration has backed versions of Chandler’s bill, voicing support last year for provisions enabling the Division of Insurance to regulate long-term care insurance more closely.

The legislation would set minimum standards for the coverage long-term care insurance policies must include, aligning it with standards adopted by 46 other states, would require sellers to educate consumers about the details of their products, and would reduce the amount of coverage necessary to prevent Medicaid from placing a lien on the homes of long-term care recipients who become impoverished.

Backers of the proposal argued that 70 percent of adults eventually require long-term care for ailments like Alzheimer’s disease, frailty, rheumatoid arthritis and stroke recovery. Two in five Americans who require long-term care are under age 65, said Susan Casper, a long-term care insurance specialist who joined Chandler (D-Worcester) at a State House briefing to encourage passage of her bill and promote long-term care insurance as an option for aging Massachusetts residents.

Supporters say private long-term care insurance policies permit policyholders to choose which setting they prefer to receive care: at home, in an assisted-living facility or in a nursing home. Caregivers help with daily tasks like dressing and bathing, cooking and cleaning, doing laundry and transporting patients to the doctor’s office. Without legislation to set standards, they argued that many of these patients receive taxpayer-funded care through Medicaid, which tends to place them in costly nursing home care.

Casper said the typical cost of home care ranges between $36,000 and $110,000 a year, depending on patient needs, and is typically the least costly form of care. Assisted living, she said, costs between $48,000 and $84,000 a year, and nursing home care ranges between $108,000 and $160,000 a year. Based on current health care cost trends, she added, each category of care would rise exponentially over the next 25 years, putting pressure on taxpayers who fund care through Medicaid and Medicare.

According to the most recently compiled Medicaid figures, MassHealth, the state’s Medicaid program, spent $2.6 billion on nursing homes in 2007, compared to $518 million by Medicare and $592 million by private payers.

Chandler, noting that the Senate had passed iterations of the proposal in previous years, said she worried whether the House would back the bill but noted Rep. Ron Mariano (D-Quincy), a supporter of the legislation, was recently promoted to majority leader. Mariano, who filed a version of the legislation, attended a portion of the briefing.

Chandler also said the proposal had been stripped of “controversial” components, including provisions that would’ve offered a tax break to residents who obtain long-term care insurance and one requiring the state employee health plan, the Group Insurance Commission, to develop a long-term care insurance option.

Among the attendees of the forum were residents who said they had obtained long-term care insurance but were now facing drastic spikes in premiums that could force them to cancel policies or risk financial instability.

“We’ll be impoverished and ready for Medicaid by the time we get through paying these bills,” said one woman, who only identified herself as a long-term care insurance policyholder.

Chandler said her legislation would empower the Division of Insurance to “investigate potential solutions to stabilize long-term care insurance rates.”

“This bill does give the DOI the opportunity, the power, to investigate potential solutions to stabilize long-term care insurance rates,” she said.


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