BILL NUMBER: S8473
SPONSOR: MAYER
 
TITLE OF BILL:
An act directing the department of health to contract with a qualified
entity for a feasibility study and actuarial analysis of long-term
services and supports financing and services options
 
PURPOSE OR GENERAL IDEA OF BILL:
To direct the Department of Health to conduct an analysis of current
public and private long term care financing options in New York State,
to explore the feasibility of creating a public long-term care insurance
option, and to prepare a report with findings and recommendations for
the Governor and Legislature.
 
SUMMARY OF PROVISIONS:
Section 1 authorizes and directs the Department of Health to contract
with a qualified entity to conduct a feasibility study and actuarial
analysis of long-term services and supports financing and service
options.
Section 2 sets out the parameters for the feasibility study and actuari-
al analysis including but not limited to:
*Analysis of public and private long term care financing options and any
gaps that exist in New York State
*Modeling three public long-term care program options to be funded
through a payroll deduction
*Modeling the impact of tax alternatives and other incentives for
purchase of private long term care insurance
Section 3 requires that the Department of Health prepare a report to be
submitted to the Governor and Legislature within one year of the effec-
tive date, containing findings and recommendations.
Section 4 establishes the effective date.
 
JUSTIFICATION:
The New York State Department of Health estimates that by 2030, more
than 5.3 million New Yorkers will be over the age of 60.(1) Many will
need long term care services and supports at some point in their later
years.(2)
Contrary to what many believe, the federal Medicare program does not pay
for long term care; it provides for time-limited rehabilitative care
only.(3) To qualify for long term care through the Medicaid program, New
Yorkers must deplete income or assets and may be left with very little
to get by on.
Private long term care insurance is not an option for many given the
cost, as policies have become increasingly unaffordable.(4) Rate
increases are frequent and, in many cases, staggeringly large. The New
York State Department of Financial Services has reported that as of
December 2022, the number of New Yorkers with long term care insurance
policies was only 386,686,(5) well below the 50% of New Yorkers over 65
who are expected to need long term care services in the future.(6)
The result is a lack of help for those requiring financial assistance to
meet long term care needs. Too many are forced to spend down income and
assets to become eligible for Medicaid, to pay out-of-pocket for care-
givers for themselves or loved ones, or to directly take on care respon-
sibilities for family members. This impacts not only the individuals
needing care, but families as well. For those providing care to family
members, the sacrifices (such as loss of income and career opportu-
nities) are many.(7)
The struggle to pay for long term care is an issue that touches almost
every family in New York State - 50% of us will need long term care at
some point in our lives, and yet we do not have a system in place to
address the high costs of such care. It is long past time to change
that.
In the absence of progress on the federal level, several states have
taken the lead in addressing this pressing issue for their residents.
In 2023 Washington State established the nation's first public long term
care insurance program, WA Cares, which guarantees long term care insur-
ance coverage for every worker in the state.(8) In April 2025, Massachu-
setts released its "Long-Term Services and Supports Feasibility
Study,"(9) funded by the Massachusetts legislature in its FY 2024 state
budget.(10) Other states, including California, Michigan, Hawaii, Minne-
sota, Maine, and Vermont, are exploring solutions. Many have taken the
initial step of funding a study to explore public insurance options.(11)
This bill would put New York on the path towards a viable solution to
the long term care crisis by funding a study to explore public long term
care insurance options.
 
PRIOR LEGISLATIVE HISTORY:
New bill
 
FISCAL IMPLICATIONS:
To be determined.
 
EFFECTIVE DATE:
The act shall take effect immediately.
1 NYS Department of Health, Long Term Care Planning Project, available
at https://www.health.ny.gov/facilities/long_term_care/planning_project/
2 Richard Johnson, What Is the Lifetime Risk of Needing and Receiving
Long-Term Services and Supports?, U.S. Department of Health and Human
Services (April 3, 2019), available at
https://aspe.hhs.gov/reports/what-lifetime-risk-needing-receiving-long-
term-services-supports-0
3 Priya Chidambaram and Alice Burns, 10 Things About Long-Term Services
and Supports, available at https://www.kff.org/medicaid/issue-brief/
10-things-about-long-term-services-and-supports-ltss/
4 Jordan Rau & Reed Abelson, Financial Ruin is Baked into the System, NY
Times (Dec. 15, 2023), available at
https://www.nytimes.com/2023/12/15/health/readers-long-term-care.html
5 Adrienne A. Harris, Superintendent, NYS Department of Taxation and
Finance, Report to the Governor and Legislature on Long Term Care Health
Insurance Plans (Dec. 2022), available at
https://www.dfs.ny.gov/system/files/documents/2023/12/2023_1tc_
biennial_report_20231222.pdf; NYS Department of Taxation and Finance,
Long Term Care Insurance: Looking Back and Thinking Ahead (June 7,
2023), at 1, available at
https://www.dfs.ny.gov/system/files/documents/2023/06/
dfs_ltc_report_20230607.pdf
6 NYS Senate Committees on Aging, Health, and Labor, Addressing the
Crisis in the Long-term Care Workforce (July 27, 2021) at 4, available
at https://www.nysenate.gov/sites/default/files/article/
attachment/long-term_care_workforce_hearing_report_2021.pdf
7 Id at 8 (As many as 10% of family caregivers leave the workforce in
order to provide care at some point in their careers. An AARP report
estimated that in 2017 there were 2.5 million unpaid caregivers in the
state.)
8 See https://wacaresfund.wa.gov/
9 https://www.mass.gov/doc/ long-term-services-and-supports-feasibility-
study-commissioned-by-eohhs/ download
10 MA Gen. Laws ch. 28 of 2023, § 2, line 4000-0300,
https://malegislature.gov/Laws/SessionLaws/Acts/2023/Chapter28
11 MIT CoLab, State by State Long-Term Care Progress, Transforming Long-
Term Care, https://www.transformlongtermcare.com/ progress-by-state