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date: 16 April 2021

Abstract and Keywords

Despite the growing need for long-term care, the United States does not have a coherent set of long-term care policies. The existing patchwork of programs and services can be difficult for patients and their families to understand and fails to adequately support many of those in need of care. This chapter traces the historical background of long-term care policy and assesses the three formal channels through which individuals currently navigate long-term care. It addresses the strengths and weaknesses of long-term care coverage briefly through Medicare and private long-term care insurance, and much more fully through Medicaid. The chapter concludes by focusing on families, particularly women, who continue to provide extensive care through informal care work. It is the most vulnerable older and disabled Americans, particularly those who are women, black and Hispanic, and single, and their families who face the greatest difficulties under the current system and who will be most affected by future policy changes.

Keywords: long-term care, Medicaid, care work, gender, aging

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