Long-term care financing: lessons from France

Area of Science:

• Gerontology and Public Health
• Health Services Research
• Health Economics

Background:

• Aging populations increase demand for long-term services and supports (LTSS).
• France implemented universal, income-adjusted public LTSS in 2002 for those 60+, while the US relies on means-tested benefits.
• Both nations have private long-term care insurance (LTCI) markets, but with differing structures and outcomes.

Purpose of the Study:

• To explore France's public and private LTSS financing model.
• To assess its potential to inform US long-term care financing reform.
• To understand factors influencing French and US LTCI market development.

Main Methods:

• Consultation with insurance experts.
• Detailed review of public reports and academic studies.
• Analysis of public and private LTCI systems in France.

Main Results:

• France offers universal, income-adjusted public LTSS for those 60+, with low benefit amounts.
• Private supplemental insurance covers 11% of French adults, primarily middle-income.
• French private LTCI sales are growing, but public/private partnership prospects have diminished.

Conclusions:

• France's model demonstrates how affordable, employer-sponsored private LTCI can supplement a public program.
• This approach could benefit middle-income Americans at risk of Medicaid spend-down.
• Concerns remain regarding the overall adequacy of such combined coverage.