Report: Greater than 11M middle-income seniors received’t be capable of afford long-term care by 2033


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In 2033, the number of middle-income seniors will almost double to 16 million adults ages 75 and older. However, more than 11 million of these adults may not be able to afford assisted living by that time, a recent study found. 

The analysis was done by NORC at the University of Chicago and was funded by SCAN Health Plan. It used the University of Michigan Health and Retirement Study with 2018 as a base year and examined individuals who were 60 years and older at that time as they will be 75 and older in 2033.

Middle-income seniors are those who are unlikely to qualify for Medicaid but do not have adequate resources to pay for the housing and care options they need. In 2018, the number of middle-income seniors was 8.4 million and will increase by 89% come 2033, the NORC report found. This population is also becoming more racially and ethnically diverse, with people of color anticipated to represent up to 22% in 2033.

“We need a long-term care system and one that is responsive to the cultural needs and preferences of a more diverse set of older adults and families,” said Dr. Sarita Mohanty, president and CEO of the SCAN Foundation, in a news release.

By 2033, 72% of middle-income seniors, or 11.5 million people, will have less than $65,000 in income and annuitized assets. This is the average amount needed to pay for private assisted living and medical care, the study said. Even if they sold their homes, 39%, or 6.1 million, still wouldn’t be able to pay these costs.

But seniors are in need of long-term care, the researchers stated. By 2033, 9.5 million middle-income seniors will be unmarried, widowed or divorced, an increase from 3.7 million in 2018. Additionally, four in 10 middle-income seniors do not have kids living nearby. Spouses and children are often the most common caregivers.

By the age of 75, many seniors experience health issues, the report said. For those in the middle-income bracket, 54% will have three or more chronic health conditions and 56% will have mobility limitations in 2033. This number will rise when they turn 85, with 55% who will have three or more chronic conditions and 68% who will have mobility limitations.

The researchers called for efforts to be taken to improve the affordability of long-term care for seniors, particularly for those of lower income.

“Without a comprehensive long-term care system in this country, for all but the lowest-income individuals, the costs of senior housing and caregiving support falls to seniors and their families,” said Caroline Pearson, senior vice president at NORC and the lead author. “Sadly, most middle-income seniors may not have the financial resources to pay for the care they want and need.”

As for how to create solutions for long-term care affordability, Pearson said it needs to be a collaborative effort.

“We need a combined public and private response to address the long-term care needs of the Forgotten Middle,” she said in an email. “Policymakers should examine healthcare and housing policies that can extend funding for personal care and caregiving support to avoid middle-income seniors spending down to nursing homes. The long-term care industry must also work to bring more affordable senior housing and in-home care options to the market.”

Photo: xavierarnau, Getty Images



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