As the Super Committee falters in its effort to reduce federal spending, mandated budget reductions create further pressure on the funding of long-term care

  By Chris Orestis

From the December 19, 2011 issue of National Underwriter Life & Health Magazine (Click HERE)

Earlier this year, the so-called Super Committee could not overcome partisan differences over spending cuts and new revenues (taxes) within their mandated deadline and conceded defeat. That unfortunate outcome triggers mandated reductions in the federal budget of $1.3 trillion that will have an immediate impact on Medicare and Medicaid. This will be particularly disruptive for seniors and long term care providers already trying to absorb the 11.1% rate reduction that CMS instituted in October, 2011. After the demise of the CLASS Act, the long term care funding infrastructure of the United States is facing extreme pressure. Lackluster sales, rate increases and carrier casualties in the LTCi market combined with additional entitlement cuts as a result of the Super Committee outcome will conspire to make an already precarious situation worse.

People do not understand and are not prepared to pay the costs of long term care. In years past, seniors could rely either on the government, family, or equity in assets such as a home to offset a lack of savings. In today’s new economic reality, family members are struggling to take care of themselves, the government is making cuts and building barriers to entry for long term care coverage, and the value of assets such as homes have been eviscerated. In fact, today there is currently three times more in-force life insurance in the United States at almost $30 trillion (NAIC) than there is home equity with less than $10 trillion (Zillow Home Equity Index).

For the first time in American history there is more debt than equity in America’s homes. For seniors unprepared for long term care this new reality is a big problem. One of the most reliable sources of long term care funding for years has been home equity and then government backstops once assets have been depleted. This mix is now severely disrupted and a search for additional assets to help unprepared seniors pay for long term care is on.

Providers of long term care services such as nursing homes, assisted living communities and home health agencies, as well as state governments, are realizing that there is tremendous value for the consumer in converting life insurance policies to help pay for the costs of long term care. By converting a life insurance policy instead of abandoning it, the policy owner’s care can be covered by the monthly long term care benefit payout and the life insurance asset can be spent-down in a Medicaid compliant fashion.

With traditional resources to pay for long term care on the decline, it will take creative private market solutions and the use of non-traditional assets to make up the difference.

To read the entire article published in National Underwriter, click here.

Long term care funding options with Chris Orestis, Click Here for VIDEO

By Paul Wilson, ProducersWEB 

I recently sat down with Chris Orestis, a 15 year veteran of both the insurance and long term care industries. Chris spent several years representing the health and life insurance industry as Vice President and Senior Vice President respectively for the Health Insurance Association of America (HIAA) and the American Council of Life Insurers (ACLI). He is an expert on insurance and long term care issues, and is a frequent speaker, featured columnist and contributing editor to a number of industry publications.

His company, Life Care Funding Group, assists people in need of funds to cover the costs of senior housing and long term care. LCFG specializes in converting the death benefit of an in-force life insurance policy into a long term care benefit to cover the costs of skilled nursing home care, assisted living, home health care and hospice.

In the first part of the interview, Chris talks about the current state of the long term care insurance industry. He also discusses the "wake-up call" facing producers and carriers and details some of the challenges, opportunities and responsibilities resulting from the current economic climate. He goes on to explain his recent involvement in the passage of the National Conference of Insurance Legislator's (NCOIL) Life Insurance Consumer Disclosure Model Law, which ensures policy owners "will be informed that they have a number of options to consider first that could make a significant difference in their lives, and at a time when they need it most.”

In the second part of the video, Chris provides further detail about the NCOIL Model Law and its effects on the industry, and talks about his company's partnerships with assisted living communities and nursing homes to help clients convert their life insurance policies into long term care benefit plans. Finally, he looks into his crystal ball and gives his best guess as to the future of the life insurance industry, LTCI industry and disability insurance.

By Harris Meyer

When her 86-year-old mother, a retired nurse with Alzheimer’s disease, started wandering away from her Tallahassee, Fla., home in 2007, LuMarie Polivka-West knew it was time to move her and her 94-year-old father into an assisted-living facility.

But because of the collapse in the real estate market, she couldn’t quickly sell her parents’ house to pay for a $3,200-per-month assisted-living apartment. So, for another year, while waiting for the house to sell, Polivka-West and her two brothers each contributed $600 a month to help their parents afford the assisted-living unit. "It was a significant cost to me and my brothers," says Polivka-West, the senior director of policy at the Florida Health Care Association, a nursing home trade group. As for her parents, "It didn’t cause them anxiety, just us," she says. "We didn’t let them know."

In the fourth year of a depressed real estate market, experts say thousands of seniors remain unable to move into senior housing because they can’t sell their homes quickly enough or for the price they need. The upshot: Greater pressure on families to pay for parents’ and grandparents’ placements, or to care for them themselves.

Taylor recalls a woman who was on the verge of moving her elderly father, who had Parkinson’s disease, into an independent-living apartment. The Arizona Baptist facility in Phoenix had services to help him with mobility and daily activities. But then her parents decided they would both move into a regular apartment with no services, which cost 40 percent less, because they had sold their home for significantly less than they had anticipated. The daughter told Taylor she was sick with worry about her parents living on their own in that apartment.

In Florida alone, Polivka-West estimates there are 400,000 seniors with dementia living on their own at home, with few or no services. "The U.S. has a large aging population and we do not have a long-term care plan for this country," she frets.

The study, Middle-Income Boomers, Financial Security and the New Retirement, which focused on 500 middle-income Americans between ages 47 and 65 with income between $25,000 and $75,000, found that the pensions and guaranteed income are what the majority (60 percent) of middle-income Baby Boomers envy most about the retirement of previous generations.

The ideas of being taken care of by family members, slowing down and moving to a retirement community, (activities commonly associated with the retirement of previous generations) are being replaced by keeping up with technology (77 percent), working (78 percent) and staying physically fit (81 percent).

The CSR's study reveals, nearly one in three (31 percent) Boomers anticipate having to financially support at least one adult person during retirement and 15 percent expect that person will be an adult child or children, rather than an elderly parent (only 9 percent).

There are several factors contributing to this change in retirement outlook. According to the study, retirement risk has been shifted from employers and the government to individuals with the demise of corporate pension plans in favor of 401(k) plans, discontinuation of many employer-paid retiree health benefits and the future of Social Security and Medicare.

Today, just over half (56 percent) of middle-income Boomers work for an employer that offers a retirement savings plan. This is less than the national average for all workers (72 percent). And of those who contribute to a retirement plan at work, one in four (24 percent) do not receive a match from their employer.

The report also cites one in seven have no pension or retirement accounts at all and 55 percent of middle-income Boomers have saved less than $100,000.

"The retirement of the Baby Boom generation will not only test the limits of government programs such as Medicare and Social Security, but also help shape the definition of retirement itself," said Scott Perry , president of Bankers Life and Casualty Company, a national life and health insurer. "Boomers may have to take more personal responsibility for their retirement financial security than was the case of their parents' generation and plan for the risks that may jeopardize this security, like long-term care, inflation and outliving their money."

Now that we have arrived at the long awaited generational stage in our society that “Baby Boomers” are reaching the age of Medicare eligibility, the need to address the question of who is going to pay for a massive increase in long term care spending has become paramount.  Exacerbating the growing crisis is the impact of the economy on the availability of private pay dollars and government spending.  For the last two years we have watched as one of the primary sources of private funds, equity in the homes of seniors has evaporated.

State and federal budgets feeling the pinch of an eroding tax base and out of control spending on health care have started cutting back on Medicare and Medicaid spending.  The cost of long term care continues to rise every year, and seniors (and their families) confronting the realities of what it costs to provide home based care, assisted living, or long term nursing home care are looking for solutions.

Annual Costs of Long Term Care

-         Skilled Nursing Facility (SNF): $79,935

-         Assisted Living Facility (ALF): $37,572

-         Alzheimer’s Unit: $85,045

-         Home Healthcare: $43,065

Met Life Mature Markets Institute 2009 

One asset to look at for liquidity is an in-force life insurance policy.  A policy owner could look at taking the cash surrender value or a loan against the policy.  But for many policy owners there is little to no cash value and the liquidity available through these routes would be insufficient.  In that case, another option would be to convert their life insurance policy into a long term care benefit plan.

More and more senior care companies around the United States are using this approach to help families overcome a gap in their ability to fund the most appropriate form of senior housing and/or care.  Life Care Funding Group works with over 3,000 assisted living properties, nursing homes and home health agencies around the U.S. to help families convert a life insurance policy they no longer plan to keep in-force and turn it into a long term care beneift plan.

The family was about to let their policy lapse and had no idea that they held a legally recognized asset that they had the right to convert into the most advantageous manner possible.  If they had not been informed of their options they would have discarded the policy and been forced to suffer through with insufficient liquidity.  There has been much debate about how to pay for long term care, but in these and many other cases converting a life insurance policy to address the immediacy of a healthcare funding crisis made all the sense in the world. 

In the case of converting a life insurance policy to cover a financial shortfall preventing someone from securing the best possible long term care options, there could be no more obvious choice.

Read a Testimonial Letter from a family who recently used the Assurance Benefit option to convert a life insurance policy into a long term care benefit plan to care for their father, CLICK HERE: Scan_Doc0016.pdf (717.88 kb)

Now that we have arrived at the long awaited generational stage in our society that “Baby Boomers” are reaching the age of Medicare eligibility, the need to address the question of who is going to pay for a massive increase in long term care spending has become paramount.  Exacerbating the growing crisis is the impact of the economy on the availability of private pay dollars and government spending.  For the last two years we have watched as one of the primary sources of private funds, equity in the homes of seniors has evaporated.  Simultaneously, state and federal budgets feeling the pinch of an eroding tax base and out of control spending on health care have started cutting back on Medicare and Medicaid spending. 

We are at a crisis point in our nation’s history.  The cost of long term care continues to rise every year, and seniors (and their families) confronting the realities of what it costs to provide home based care, assisted living, or long term nursing home care are looking for solutions.

For those families with a long term care insurance policy, a portion of these costs may be covered if they meet the necessary eligibility requirements.  And for those families with the last name Gates or Winfrey, they can just cut a check.  But what about the vast and often overlooked middle market?  Where do they find the resources to cover all or a portion of these costs?

For the ANSWER-- Click Here to read the complete article by Chris Orestis published by Insurance News Net Magazine

Two recent reports add more evidence to the alarming trend of financial pressure being pushed back onto seniors and their families as they reach the age that the costs of long term care play a central role in their lives.  In addition to Medicaid cuts in the states and cuts to Medicare being proposed as part of healthcare reform, more money will continue coming out of seniors’ pockets. 

The annual MetLife Mature Markets Institute study tracking the costs of long term care in assisted living, nursing homes and home healthcare was recently released showing significant increases in costs over the last year: 

-         Nursing Home costs rose 3.3%

-         Assisted Living costs rose 3.3%

-         Home Healthcare costs rose 5%

-         Adult Day care costs rose 4.7% 

The increasing costs of long term care can be attributed to the most basic economic principal there is: supply and demand.  The economic crisis has slowed the construction and expansion of facility based care.  Also, more people requiring long term care are having a difficult time selling their homes.  As the population of seniors demanding long term care services of every type increases, the supply of options and dollars is decreasing—driving up the costs. 

In another alarming report, the costs of Medicare premiums will rise 15% next year. This will push the monthly Medicare premium above $100 for the first time in history.  The final outcome of this increase, or measures to offset the increase, is being debated in Congress as part of healthcare reform.  Regardless of the outcome, this will now become a yearly struggle as the population going onto Medicare is exploding-- and just when the country is least prepared financially to accommodate the demand. 

Supply and demand will become a recurring theme over the years as the growing population of seniors needing to pay for long term care confronts the harsh reality of both a shrinking supply of dollars and ability to deliver housing and care. 

To read more about the MetLife Mature Markets study, click here. 

To read more about the increase in Medicare premiums, click here.

The Senior Living industry’s growth is driven by a couple of key factors that can trump the impact of a sagging economy: need and numbers. People don’t move into an assisted living community or a skilled nursing home because they want to—they do it because they need to.  When the health and safety of a loved one is in jeopardy by living alone, families must take action.  Adding to this need driven dynamic is the sheer number of seniors and now Baby Boomers beginning to reach the age where senior living is becoming a factor in the remaining years of their lives. 

Recent reports from leading providers of senior living and long term care such as Emeritus Senior Living, 5 Star Senior Living, Capital Senior Living, Horizon Bay, Belmont Villages, and numerous others bolster this trend.  This industry has shown minor growth or declines in occupancy and revenues across the country this year, but in comparison to many other industries such as automobiles, travel, real estate and financial services, the senior living industry appears to be almost recession proof.   

For families considering the best options for a loved one this is good news.  They can rest assured that there are numerous communities to chose from that are in great fiscal shape.  In addition, many of these same communities are offering “Funding Solutions” programs to help seniors pay for the costs of housing and care so they are not forced to wait for the sale of a home or the recovery of their investments. 

To learn more about these Funding Solutions from Kiplinger.com, click here

In a recent commentary for CNN Politics, Bob Greene wrote a very compelling piece about the economic injustice currently being done to our nation’s senior citizens.  In it he observes that the mantra being repeated in the media to keep everyone from jumping off a cliff is to “wait out the storm”.  We are reminded of the conventional wisdom that economic busts and booms are cyclical, but that in the long term the stock market will steadily increase in value and after a few years people will recover their losses. 

But as readers of this blog know, we have been reminding people that our seniors don’t have that time to wait.  Many are in situations where they need the money from their investments or the sale of their home right now to pay for things such as senior housing and care.  If that money has evaporated ($11 trillion of wealth in America has disappeared in the last year alone!) what will people do if it is no longer safe or possible for them to live without assistance?  The people who built this country, fought its wars, and made our prosperity possible are now the ones left holding the bag. 

Mr. Greene is absolutely correct when he says it is unfair to force this generation to sacrifice again-- just when they should be able to enjoy a peaceful retirement in safe and nurturing surroundings.  Fortunately, there are options that our nation’s seniors and their family can turn too for financial security.  There are Funding Solutions that can be accessed to help ease the hardships of this economic calamity.  We have been writing about this situation and the potential solutions for a long time.  Kiplinger’s Retirement Report (March, 2009) issued an excellent resource analyzing this crisis situation and in it, they discuss Funding Solutions from companies such as Life Care Funding Group (see page 4).

 To read the commentary by Bob Greene, “We owe oldest Americans an apology”, click here.