Californians know they need long-term care coverage, but don’t buy it

For the second time in as many months, a survey of Californians has found they are more aware than ever of the potential need for long-term health care in the future. But, paradoxically, fewer are taking steps to prepare for that costly possibility.

Those are the results of the latest Field Poll Long-Term Care Survey, which was commissioned by the California Partnership for Long-Term Care, an arm of the state Department of Health Care Services.

This article is one in an occasional series on aging with dignity, independent living and public policy that affects both. For a complete archive of the articles, click here.


The telephone survey of 950 registered California voters in early- to mid-June also found that a large majority, 71 percent, are aware that standard health insurance generally does not cover long-term care services such as nursing homes or at-home assistance with bathing, eating or dressing. That is twice the percentage that was aware of the limits of health insurance policies in 1994, when the first Long-Term Care Survey was conducted.

The newest poll also found that only 6 percent of those queried believe state programs will cover their long-term care needs – a nearly 400 percent decline since the 1994 survey.

Still, only 10 percent of Californians have bought long-term care insurance, the poll found. Moreover, state Department of Insurance records show that sales of long-term care policies have fallen from more than 57,600 in 2000 to less than 35,900 in 2008, a partnership spokeswoman noted.

“With baby boomers just beginning to retire, we will soon see an unprecedented increase in people needing long-term care,” said Brenda Bufford, director of the partnership. “While it’s encouraging that Californians are better informed, the drop in preparation is concerning. This trend puts an entire generation’s long-term stability at risk.”

The $23,000 poll offered respondents who had not bought long-term care insurance an opportunity to give multiple reasons why they hadn’t. Fifty-nine percent said the policies cost too much, and more than half said they hadn’t thought about the subject.

A third said they expect family assets and income will finance their needs, while almost 30 percent expressed a distrust of insurance companies to follow-through with coverage when needed. Respondents also said they expect their families or the government to care for them, or found the policies to be too confusing.

Those findings are not much different than the attitudes toward long-term care insurance back in 1994, when the first of a series of five surveys was completed. For example, the poll 17 years ago found that two-thirds hadn’t thought about the subject while 60 percent said the policies cost too much. (The other polls were conducted in 1996, 2001 and 2005.)

“The disconnect between a basic understanding of long-term care realities and taking action to protect against the potentially crippling cost of long-term care is alarming,” said Bufford. “It’s unfortunate that one constant in our polling is that individuals continue to ignore confronting an understandably uncomfortable issue.”

Last month, a survey conducted by the UCLA Center for Health Policy Research and the SCAN Foundation reported that most older adults underestimate how likely they are to need help with daily living as they grow older, and few are prepared to handle the potentially huge costs of that assistance.

The controversial health care reform act that Congress and President Barack Obama enacted last year included a provision that aims to start a voluntary, government-sponsored long-term care insurance program by October 2012. But the start date for the Community Living Assistance Services and Supports Act – also known as CLASS — is likely to slip by as much as a year as the administration grapples with designing coverage that is both affordable and actuarially sound.

The program’s advocates cite statistics showing that two out of three adults over 65 will need long-term care that provides personal assistance over a lengthy period of time. They also note that nursing home care can be highly costly – an average of $91,000 a year in California — and that Medicaid will only cover those costs when a person’s financial resources are close to exhaustion.

The California Partnership for Long-Term Care aims to educate the public about the need for long-term care insurance. It recently launched a new website — – that offers information on policies and links to insurers who offer them.

Herbert A. Sample is a freelance writer based in Los Angeles. He can be reached at

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