Amendment #642 to H3900

Long-Term Supports and Services Actuarial Study

Mr. Stanley of Waltham moves to amend the bill in section 2, in item 4000-0300, by inserting at the end the following: "provided further that not more than $500,000 shall be expended for the purpose of contracting for an independent study for actuarial modeling of public, private, and public-private hybrid long-term services and supports financing options to help individuals prepare for, access and afford such services; provided that the study must include modeling of the following for Massachusetts: (a) An analysis of public and private long-term care financing programs that exist in the state, the participation rates for those programs, and any clear gaps that exist, including, but not limited to, gaps in coverage, affordability, and participation, and including factors relevant to the design of a public program; (b) Modeling of three public long-term care insurance programs funded through a payroll deduction two of which would provide a dollar limited long-term care insurance benefit: (i) a front-end limited duration program; (ii) a limited duration, back-end catastrophic program; and, (iii) an unlimited duration, comprehensive program; provided that eligibility for program benefits would be based on the 1996 Health Insurance Portability and Accountability Act (HIPAA) criteria including:  The individual is unable to perform (without “substantial assistance” from another individual) at least 2 activities of daily living for a period of at least 90 days due to a loss of functional capacity. Or, the individual requires “substantial supervision” to protect such individual from threats to health and safety due to “severe” cognitive impairment; provided that sensitivity modeling on key program parameters will also be conducted, including daily benefit amounts, coverage duration, benefit increase options, form of benefit (cash versus service reimbursement), premium levels, and more to be determined between the Department working group and the awarded contractor at the outset of the project; (c) Modeling of the impact of tax alternative and other incentives for the purchase of private long-term care insurance on take-up rates in the state; (d) A public-private reinsurance or risk-sharing model with the purpose of providing a stable and ongoing source of reimbursement to insurers for a portion of the catastrophic long-term services and supports losses in order to provide additional capacity for the state; provided that for Option (b), the awarded contractor shall provide a report with information on: (i) Program participation rates (i.e. number of participants, socio-demographic profile of participants,); (ii) Program costs (i.e. aggregate and individual, premiums, claims, administration); (iii) Distribution of program benefits (i.e. differences from the status quo, amount for new services, amount offsetting Medicaid, socio-demographic profile of individuals receiving the benefits, number of beneficiaries); (iv) Impact on Medicaid expenditures (i.e. savings to the state Medicaid program); (v) Financial and legal risks to the state; provided that for Options (c) and (d),  the awarded contractor shall provide a report with information on: (i) The impact on private long-term care insurance take-up rates; (ii) Socio-demographic profile of individuals projected to purchase long-term care insurance; (iii) Program costs; (iv) Impact on Medicaid Expenditures; provided that the actuarial analysis shall be completed and submitted to the Executive Office of Health and Human Services, chairs of the House and Senate Committees on Ways and Means and Chairs of the Joint Committee on Elder Affairs no later than 270 days after the passage of this act." and in said item by striking out the figures "$123,456,500" and inserting in place thereof the figures "$123,956,500".

Additional co-sponsor(s) added to Amendment #642 to H3900

Long-Term Supports and Services Actuarial Study