Care for seniors is sucking wealth out of families — especially in Ohio
May 28, 2026 | 4:50 am ET
Description
Capri Gardens Rehabilitation and Nursing Care is an 80 bed skilled nursing facility that offers private rooms, Tuesday, April 13, 2021, Graham Stokes/Photographer
Non-wealthy Americans are taking economic hits from all sides these days. Gas, groceries, housing, utilities and healthcare are all necessities and they’re rapidly getting more expensive.
Less well-known is another necessity — long-term care for seniors — that is also costly and getting costlier. And, because of the way it’s financed, it’s sucking vast amounts of wealth out of the upper middle class on down, a study published in April by the Roosevelt Institute says.
“The result is a system that drains the resources of low-income and middle-class families, eroding their ability to build or transfer wealth across generations,” the report said. “In this way, long-term care is both a symptom and a cause of the nation’s deepening wealth divide. It is a force shaping who gets to grow old with security and who bears the financial cost of care.”
The report said that 62% of those surveyed think Medicare, the health program for people over 65, pays for long-term care. It doesn’t.
It’s financed by Medicaid, the state/federal health program for low-income Americans.
To qualify, you have to meet income and asset guidelines. In Ohio, individual assets have to be less than $2,000 and you can have a maximum monthly income of $2,982, according to the American Council on Aging.
No matter how frugal you were during your working years, no matter how much you saved, you have to pay out of your own pocket until you get down to $2,000.
That means less money to invest in your heirs; to do things like paying the wildly inflating cost of a college education. Instead, the heirs take on that burden, often in the form of student debt.
The Roosevelt Institute, a progressive think tank, said that feeds inequality and makes it hard even for better-off Americans to get ahead.
“Even among upper-middle-class couples with lifetime earnings over $4.75 million, nearly half will spend down their assets paying for long-term care and eventually enroll in Medicaid if they require long-term care for five years or more,” the report said.
The vast majority of Americans — more than 80% — have to spend down and depend on Medicaid if they require long-term care for five or more years, the Roosevelt Institute report said.
If you slice the wealth distribution into fifths, even a majority of the top slice — 53% — have to go on Medicaid after five years, it said. That jumps to 75% of the second-richest tranche, 87% of the third-richest, 91% for the second-poorest and 95% for the group at the bottom, the report said.
The Scripps Gerontology Center at Miami University reports that with 2 million residents over 65, Ohio has the sixth-largest elderly population in the United States. So as those people age and require long-term care, Ohio families are losing a huge chunk of the wealth their elders spent a lifetime accumulating.
And, even as it wipes out intergenerational wealth, the way we finance long-term care is likely to get even harder on American families. That’s because of President Donald Trump’s One Big Beautiful Bill Act.
Many of the Medicaid savings are expected through less enrollment due to new work requirements. But the GOP law also seeks to save $150 billion over 10 years by capping certain state payments to providers such as nursing homes.
The Roosevelt Institute report said that long-term care imposes huge costs even on families who are able to personally provide long-term care to their elders.
“Unpaid family care is not without its own intergenerational costs,” it said. “Unpaid caregivers provided an estimated $600 billion in economic value in 2021, often at the expense of their own career growth and retirement savings.”
The Roosevelt Institute report said the way care for older Americans is financed affects everyone.
“Long-term care is not just an individual health issue, but a structural driver of wealth inequality,” it said. “By maintaining a system that depends on unpaid family caregiving, provides public support only after families have nearly exhausted their savings, and allows private, profit-driven companies to capture rising care costs, the US effectively penalizes aging.”
Columbus, OH
