New York's need for long-term care is particularly significant. In 1996, elderly New Yorkers comprised 13 percent of the state's population, a figure expected to grow to about 16 percent by 2020. The state also ranks first in the percentage of elderly who are on Medicaid—22 percent in 1996—creating high pressure on this public component of the long-term care financing system. A profile of the state's Medicaid home care service users suggests that the overall needs of the long-term care population are substantial: the majority of recipients have severe physical limitations and multiple chronic health conditions, and more than half are cognitively impaired. In addition, Medicare does not cover long-term care to any significant extent, and few older New Yorkers. less than 3 percent of those over age 65—have private long-term care insurance.
