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Senate Aging Committee Chairman Makes Case for Inclusion of Long-Term Care in National Health Reform


The Senate Special Committee on Aging held a hearing on March 4th to call for the inclusion of improvements to long-term care services and supports as part of emerging blueprints for national health reform.  In addition to Chairman Herb Kohl’s  (D-WI)call for long term care to be addressed in the national health reform, Senator Edward Kennedy (D-MA), Chair of the Senate Health, Education, Labor & Pensions Committee who along with the Senate Finance Committee will likely draft the health reform legislation in the Senate, stated his support that long term care be addressed in health reform proposals. 

The hearing had several panelists who discussed the success of home and community-based alternatives to institutional care.  The testimony was very compelling regarding the progress that is being made by states in partnership with the federal government to rebalance long term care options for seniors and disabled adults.  Panelists who presented at the hearing included Thomas Hamilton from the Center for Medicare & Medicaid Services; Wisconsin Department of Health Services Secretary Karen Timberlake; and Florida Agency for Health Care Administration Secretary Holly Benson.

Below we have listed some key points that were presented at the hearing and have included links to the testimony of all presenters who testified at the hearing.


  • In fiscal year 2007, spending for Home and Community Based (HCBS) waiver programs, personal care, and home health services accounted for 47% of all Medicaid long term care expenditures. Medicaid Spending for skilled nursing care accounted for 53%. CMS noted this change as proof that progress is being made on rebalancing efforts.

  • Of Americans with ongoing long term care needs, 17% reside in nursing homes while the other 83% live in the community where the majority of their care is      provided by unpaid family members and friends.

  • It is estimated that there are currently 8 million people aged 65 and older receiving paid long term care services.  The number is expected to rise to 10 million in 2020.

  • In a recent study examining the long term care needs, use, and costs of care that current 65-year-olds will face over the rest of their lives, it was predicted that:

65% will spend some time at home needing long term care services
30% will receive care at home for more than 2 years; and
11% will require care for more than 5 years

Statements of Committee Members:


  • Senator Herb Kohl (D-WI), Chairman

  • Senator Mel Martinez (R-FL), Ranking Member

Witness Testimony:

Thomas Hamilton, Director, Survey and Certification Group, Center for Medicare & Medicaid Services, Washington, DC
Karen Timberlake, Secretary, Wisconsin Department of Health Services, Madison, Wisconsin
Holly Benson, Secretary, Florida Agency for Health Care Administration, Tallahassee, Florida
Henry Claypool, Washington Liaison, PHI, New York, New York
Melanie Bella, Senior Vice President for Policy, Center for Health Care Strategies, Hamilton, New Jersey
Judy Feder, Senior Fellow, Center for American Progress Action Fund, Washington, DC