The rise in the aging population will increase the number of people needing LTSS. By 2050, the 85 or older population will more than triple (growing by 208 percent), while the population younger than 65 will increase by only 12 percent. The number of seniors needing LTSS is expected to rise from 6.3 million in 2015 to an estimated 15 million by 2050. Although the need for long-term care will continue to rise, the availability of family caregivers is projected to decline. In a little over a decade—by 2030—there is projected to be a national shortage of 3.8 million unpaid family caregivers and 151,000 paid care workers. By 2040, the shortfall is expected to grow to 11 million family caregivers and 355,000 paid workers.

With the need for LTSS projected to rise and the availability of family caregivers projected to decline, there will be a growing need for paid long-term services and supports. Because of state budget constraints and other financial demands, state Medicaid programs—the primary public payers of LTSS—will face challenges  trying to meet the growing  demand. Our current system of relying heavily on Medicaid to finance long-term services and supports will overburden states, likely at the expense of pursuing other critical budget priorities. In addition, increased need for Medicaid LTSS will put substantial strain on the program’s ability to provide other forms of much-needed basic health care coverage for low-income individuals and families.

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