Available online 26 September 2023, 102822

Author links open overlay panelAbstract

I estimate the impact of an information campaign on long-term care planning behaviors. I identify this effect using the staggered timing of the federal-state “Own Your Future” campaign, which urged individuals to plan ahead for long-term care needs and reached 26 states over five years. I find the campaign increased long-term care insurance coverage for individuals in the top quintile of the asset distribution by four percentage points, or seventeen percent. A back-of-the-envelope calculation indicates Medicaid savings of $483 million in present value.

Section snippetsThe “Own Your Future” information campaign

The “Own Your Future ” (OYF) consumer awareness campaign encouraged individuals to plan ahead for their long-term care (LTC) needs. Following a research and development phase that took place from 2000 to 2005, the U.S. Department of Health and Human Services (HHS) partnered with 24 states and the District of Columbia to implement the campaign. Interested states were required to submit a proposal to the Centers for Medicare & Medicaid Services (CMS) of HHS. The applications were evaluated by

Theoretical impact of the campaign

In a world of complete information, an information campaign would not be expected to change behavior. But imperfections in the LTC market could lead to an information campaign influencing behavior. First, survey evidence indicates a lack of full knowledge of LTC planning options. For example, an OYF pre-campaign survey found that 80% of individuals believed that Medicare would cover at least some of their long-term care expenses (Long Term Care Group, Inc. and Lifeplans, Inc., 2006). However,

Data sources

The primary data for this analysis is the Health and Retirement Study (HRS). The Health and Retirement Study is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. The HRS is a longitudinal panel study of older Americans, with surveys conducted every two years and new cohorts added periodically. The sample consists of the randomly-selected respondents and their spouses. The survey includes thorough questions about

Empirical strategy

I use a difference-in-differences strategy to estimate the impact of OYF on planning behaviors. This design compares the difference between individuals’ planning behaviors in areas with OYF (treatment states) and without OYF (control states) before and after the campaign, leveraging the staggered state OYF campaigns. Under the identifying assumption discussed below, differential changes in planning behaviors between treated and untreated individuals before and after the campaign can be causally

Insurance coverage increases

Panel A of Table 3 presents the main difference-in-differences regression results of the impact of OYF on LTCI coverage. Column (1) includes individual control variables, column (2) adds person fixed effects, and column (3) adds state-specific linear time trends. The point estimates indicate about a 1.0 percentage point increase in LTCI coverage after OYF exposure, statistically significant at the 5% level. Columns (4), (5), and (6) repeat the same specifications but allow for heterogeneity by

Back-of-the-envelope medicaid savings calculation

One of the stated goals of the OYF campaign was to reduce Medicaid expenditures. Therefore, in this section, I estimate the expected Medicaid savings from the increase in LTCI coverage induced by OYF. The calculation uses the estimates from this paper on the response of LTCI coverage to OYF and estimates from the literature on the effect of LTCI on Medicaid spending. Although I find the largest response in LTCI coverage for individuals with higher assets, savings are still possible since some

Discussion and conclusion

The “Own Your Future ” information campaign urged older working-age individuals to plan ahead for their future long-term care needs, taking steps such as discussing caregiving plans with family, researching reverse mortgages, or purchasing long-term care insurance. Over the course of the five-year campaign, the federal government partnered with states across the country to disseminate this message via press conferences, print and television advertisements, and letters sent from the governor to

CRediT authorship contribution statement

Jessica H. Brown: Conceptualization, Methodology, Software, Validation, Formal analysis, Investigation, Data curation, Writing – original draft, Writing – review & editing, Visualization.

Uncited References

Health and Retirement Study, Cross-Wave Geographic Information (State) 1992-2018 v8.2, Early restricted data set (2022), Health and Retirement Study, RAND HRS Family Data 2014 (V1) (2018), Health and Retirement Study, RAND HRS Longitudinal File 2018 (V2) public use dataset (2022), RAND HRS Longitudinal File 2018 (V2) (2022), RAND HRSFamily Data 2014 (V1) (2018)

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