According to the report, CA is #9 in ranking. The proposed Medicaid cuts will hurt its ranking; 1 in 5 Californians uses Medi-Cal, our state's program.
If one lives in the coastal urban areas, community and care programs are available but the best care, of course, costs proportionately more here, due to high RE and the usual population density issues.
Many retiree homeowners sell and move to areas of lower cost (turn those blue states red, or at least purple, LOL!). That's not a recent phenomenom, btw; we've seen it going on for at least 35 yrs. People are more mobile in the West; the majority come from somewhere else to begin with, and when you've moved across the country once, it's easier to do the next time.
Most people don't know how to even begin doing financial and retirement planning. So they put it off, until it's too late. We find most people we know don't even take the idea seriously until about 6 mos. before their planned retirement date.
Also, LTCi is expensive. It has been expensive for over a decade. Our policies are 19 yrs old and they were grossly underpriced in the beginning. I suspected this and told my DH we had to plan for sizable premium increases in the future.
We now pay 4x the premium we started with - market rates, except the market no longer offers policies as good as ours.
We have friends who are getting LTCi, with the highest limits available. They will pay a little less than half what we pay - but their policies are nowhere near as generous as ours.
Most people also grossly underestimate what home health care and convalescent/skilled nursing care actually costs. In 2013 one of the largest full service seniorcare facilities quoted us a price of over $10K/monthly for skilled nursing/Memory Care. As there have been four price increases since, I would expect that cost is now over $12K/monthly.
It is also a common misapprehension that people "only need care for two years on average" before dying. Actuarial statistics are pointing very definitively towards a generation of elderly who become slowly sicker and disabled, but whose longevity continues to improve as medical technology advances.
