No clear strategy to fund ballooning need for senior care

By 2030, 1 in 5 Minnesotans will be 65 years old or older.

And those numbers alone will pressure on the state's long-term care systems in ways never seen before. "[Even] if services weren't getting more expensive, just the sheer number of people that will be accessing services increases the investment significantly," said Rajean Moone, executive director of the Minnesota Leadership Council on Aging.

"And many of these are entitlement programs, so the increase is not capped. If you qualify for Medical Assistance, you'll get Medical Assistance and we'll pay for the services that you need."

Medical Assistance — the state's Medicaid program — pays for a lot of seniors' long-term care services like nursing homes, assisted living or home care services, among other things. When someone paying for long term care has nearly exhausted their savings, they qualify for Medical Assistance, which then pays for the care.

The state now spends about $1 billion a year on long-term care services and support. The cost to taxpayers will balloon under the current system, as this demographic group ages, said Moone.

"We're talking about a significant increase in Medical Assistance expenditures on services for older Minnesotans," he said. "In the next 10 years, that's going to potentially grow by 73 percent."

How Minnesota addresses those rising costs — either through increased funding or cost-cutting — while also funding other priorities like education and infrastructure, is far from settled.

"We need to talk about it now because this is such a huge challenge," said Sen. Kent Eken, DFL-Twin Valley.

Eken has proposed a long-shot idea — a constitutional amendment that would dedicate funding to long-term care in the state. Eken's goal is to ensure senior care doesn't compete with general fund dollars from other priorities such as infrastructure or education.

"If we don't, it will jeopardize other areas like education for our children because you're going to have to be taking resources from our children's education in order to provide the care for our seniors if we don't find an independent source of revenue for our seniors," he said.

His colleague across the aisle, Sen. Karin Housley, R-St. Mary's Point, isn't a fan of using the constitution to address the issue. But she agrees it's imperative to find ways to address those rising costs.

"It's a tough one, so we do have to come up with some innovative ways to be able to take care of them without breaking the state," she said.

Housley would like to see the state tax on social security income eliminated to give seniors more money to pay for care and tax credits for long-term care insurance. But she also said there are innovations that could keep long-term care costs down.

"There are so many exciting technologies to help keep people in their homes longer, which is the most cost-efficient way to do it," Housley said.

Apart from evolving technologies, there's also a push for middle-income seniors better prepared for the need for care. The state Commerce Department is working to get more long-term care insurance products available in the state.

Both Housley and Eken, who also serves on the family care and aging committee, say they'll begin addressing the long-term care funding and policy needs when the Legislative session starts next year.

There are lots of other policy ideas — many with a focus on helping seniors to save money or to buy insurance that will protect their finances. But many are in the early stages of development. "I think the state is starting to think about what can we do now to address the costs in the future," said Lynn Blewett, a professor of health policy at the University of Minnesota's School of Public Health. Along with pushing savings opportunities for seniors and insurance options, Blewett said housing options are also important if people are planning on staying in their homes.

"The programs need to get in and on the ground sooner than later," she said.