When Will Political Campaigns Start Taking Long-Term Care Seriously?

Prediction: In the 2028 presidential election, long-term care will become a mainstream campaign issue for the first time.

It seems clear that long-term care won’t be a major issue this year, for many reasons. But in 2026, the Medicare trust fund is projected to show a deficit. The oldest Boomers will turn 80 that year, as well. By 2028, those born in the Baby Boom’s peak years will have turned 65. Social Security will be just a few years from deficits, as well.

In other words, 2028 will be very different from 2024. And today, we already know the long-term care system is troubled. (Really, it is not a system at all, but a maze with lots of dead ends, as Anne Tumlinson, David Grabowski and I wrote in 2021.)

Whether a family is looking for home care or assisted living, the cost is steep. And Generation X and Millennials have become the first “triple mortgage” generations. Boomers like me only had to worry about paying off a home mortgage. But younger generations effectively are carrying two additional mortgages — their student loans and the long-term care bills of their parents.

For many, many families, the triple mortgage is an unbearable load. That’s why it’s not surprising to see increasing public support for the government shouldering some of the responsibilities of care payment (see this recent piece in McKnight’s Senior Living).

As pressure on families — and on the system — builds in the next four years, the issue will spill into politics. Candidates are going to be asked “What’s your solution?”

Up until now, politicians conveniently kicked the can down the road when asked about long-term care and funding. They would say “I’ll always support Social Security and Medicare,” and “I would never turn my back on seniors.” No one insisted they get more specific. They will soon.