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Cato Weekly Podcast • December 11, 2025 

# Better Care for Billions Less: Fixing Medicaid’s Long-Term Care Incentives 

Cato’s Michael Cannon and the Center for Long-Term Care Reform’s Stephen Moses examine how Medicaid’s long-term-care eligibility rules let middle- and upper-middle-class households shelter assets and shift costs onto taxpayers, driving up spending and lowering quality for the poor. Drawing on Moses’s new Cato paper Better Long-Term Care for Billions Less, they explain how perverse incentives, generous exemptions, and weak estate recovery undermine private planning and inflate a program already consuming one-third of Medicaid’s budget.

#### Show Note 

[![Taxes, Health Care](/sites/cato.org/files/styles/content_teaser/public/2025-02/taxes-and-health-care%20Cropped.jpg?itok=P1xUGesA)](https://www.cato.org/policy-analysis/better-long-term-care-billions-less) 

Study 

### [Better Long-Term Care for Billions Less](/policy-analysis/better-long-term-care-billions-less) 

By Stephen A. Moses 

Eliminating Medicaid long-term care subsidies for individuals who could meet or could have planned to meet their own LTC needs would improve LTC quality and reduce the burdens Medicaid imposes on taxpayers.

[![Creative Commons License](/build/cato_2020/images/creative-commons.svg)](http://creativecommons.org/licenses/by-nc-sa/4.0/) 
This work is licensed under a [Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License](https://creativecommons.org/licenses/by-nc-sa/4.0/). 

##### Featuring 

[![Michael F. Cannon](/sites/cato.org/files/styles/author_picture/public/2021-01/Michael%20Cannon.jpg?itok=0UROn8Dc)](/people/michael-f-cannon) 

##### [Michael F. Cannon](/people/michael-f-cannon)

Director of Health Policy Studies, Cato Institute

[ 

](https://x.com/mfcannon) [ 

](mailto:mcannon@cato.org) 

![Stephen A. Moses](/sites/cato.org/files/styles/author_picture/public/2025-11/stephen-a-mosis-cropped.jpg?itok=LuDnhQj8) 

##### Stephen A. Moses 

President, Center for Long-Term Care Reform; Visiting Fellow, Paragon Health Institute