From Criticism to Comfort: The Relational Benefits of Long-Term Care Insurance.

Objectives: The objective of this study is to examine whether potentially eligible individuals with Partnership Long-Term Care Insurance (PLTCI) program experience stronger social networks and improved interpersonal relationships compared to those without coverage.

Study setting and design: Our analysis utilizes data from the Health and Retirement Study (HRS), a longitudinal survey of U.S. adults aged 50 and older, incorporating responses from the Leave-Behind Questionnaire administered biennially from 2004 to 2018. We merge these data with a dataset tracking state-level implementation of the PLTCI program, enabling us to construct a binary indicator of policy exposure based on respondents' state of residence. Using ordinary least squares (OLS) regression with two-way fixed effects, we estimate the effect of the PLTCI program on the relational outcomes of aging individuals.

Data sources and analytic sample: The analytic sample includes HRS respondents potentially eligible for the PLTCI program at the time of its implementation, focusing on respondents and their spouse no more than 65 years without physical limitations per Activities of Daily Living (ADL) criteria. Depending on data availability, the sample size ranges from approximately 13,000 to 17,000 participants.

Principal findings: The PLTCI program improved perceived relationships with children and spouses. Older adults reported less frequent criticism (4.3% decrease with children, p = 0.04, 95% CI: 0.3%-8.3%; 3.4% with spouse, p = 0.04), feeling let down (3.9% decrease with children, p = 0.01; 3.8% with spouse, p = 0.009), or being annoyed (3.5% decrease with children, p = 0.03). They also felt more comfortable opening up about worries (2.1% increase with children) and relying on close family members during serious problems (3.0% increase with children, p = 0.01). These effects were strongest among individuals aged 55 and older compared to younger individuals, non-Hispanic White respondents compared to non-Hispanic Black respondents, and those with higher household wealth compared to those with lower household wealth.

Conclusions: Beyond financial security, the PLTCI program enhances older adults' social and emotional well-being by improving close relationships. These findings highlight the need to consider both economic and relational outcomes when evaluating long-term care policies.