Disparities in Medicaid support for and the quality of nursing facility long-term care across the states

The “baby-boom” generation is poised for retirement. Yet the American states exhibit sharp inequalities in the public support they provide for nursing facility long-term care for the elderly, a form of health care that few Americans can afford to purchase privately. Further, remarkable disparities exist, both within and among states, in the quality of nursing facility care. We describe cross-state variation in Medicaid support for and the quality of nursing facility care, offer regression models that provisionally explain the sources of these inequalities, comment on the social implications of these disparities and recommend a solution.