MIAMI -- Gillian Lloyd's parents did everything right: They saved compulsively for their retirement and brought aides into their home when they needed help. Yet they still face impossible questions of how to continue paying for care in their final years.

"It's an absolute quagmire," said Lloyd, a 53-year-old school administrator who is managing her parents' care and fearful there isn't enough money to pay for it. "I feel like I'm in an untenable situation."

Even as the health care debate rages in Washington, scant attention has been given to providing long-term care for the elderly and disabled. While lawmakers struggle to come up with a plan, millions of stressed families are being driven into poverty, and state and federal budgets are being stretched to their limits.

Lloyd's parents have burned through nearly all the half-million dollars they have in savings paying aides $24 an hour, 19 hours a day. When the money is gone, she doesn't know what to do with her 84-year-old mother, who is mentally acute but physically plagued by Parkinson's disease, and her 85-year-old father, who is physically well but suffering from dementia.

"I was surprised at how financially strapped you had to be in order to get help," Lloyd said.

For all the warm words President Barack Obama has said about Ted Kennedy, he has remained largely silent on a long-term care plan -- one of the pieces the late senator saw as key to an overhaul bill.

Such a plan is included in the bill Kennedy's health committee wrote but is not regarded as a must-have component. However, the provision could make the bill more palatable to seniors who have reservations about the overhaul.

"The other Democrats in the Senate don't seem very enthusiastic about it. The Obama administration doesn't seem very enthusiastic about it," said Howard Gleckman, a researcher at the Urban Institute who is author of "Caring for Our Parents."

"And it just seems to be one of those issues where everybody says, 'Yeah, we've got to deal with it, but we're not going to deal with it now."'

Kennedy's bill included the Community Living Assistance Services and Supports Act, known as the CLASS Act, which would allow Americans to buy long-term care insurance from the government for around $65 a month. Students and younger workers would pay far less, around $5 monthly. In return, they'd qualify for a cash benefit when such care is needed.

Nobody sees CLASS Act as solving the entire long-term care crisis. But it would address an issue that has vexed policymakers and caregivers for decades and mark the first time the government provided nursing homes, in-home aides and other care for the masses.

Many wrongly believe Medicare covers long-term stays in nursing homes and other such services, but only the country's poorest qualify under Medicaid. Diabetics who endure amputations and can't live alone, Alzheimer's patients who need round-the-clock care, and those who suffer strokes and can no longer navigate their home alone are among those faced with tough care choices.

The numbers on the issue are telling: Nearly 70 percent of all 65-year-olds will need some long-term care before they die. An estimated $160 billion is spent on such services each year, not counting all the unpaid hours family members care for a loved one. Most paid long-term care currently comes through Medicaid, and with costs ballooning, officials say it's unsustainable.

Bobbie Winter, a 66-year-old social worker from Des Plaines, Ill., learned the hard truth of long-term care when she assumed care of her aunt, Helen Newman.

Newman had spent around $100,000 in assets paying for her care over the past several years. Medicare covered the first 90 days of a stay in a nursing home after she broke her hip earlier this year, but on the final day, the nursing home told Winter she needed to pay $8,700 to cover the next month. Nobody had the money but Newman still needed nursing home care.

She died the next day, practically penniless.

"The few assets she had left went toward the funeral and her gravestone and a few outstanding bills," said Winter. "She didn't even have jewelry to leave."

Health and Human Services Secretary Kathleen Sebelius wrote a letter to Kennedy in July saying the administration supports the inclusion of the CLASS Act in the health overhaul bill, and Obama endorsed the legislation as a senator. But Kennedy's death has many believing there is no champion to ensure its ultimate inclusion.

Dr. Robert Butler, the head of the International Longevity Center who is considered the country's foremost geriatrician, is unconvinced long-term care will ultimately improve in any new plan.

"Maybe something will happen," said Butler, a Pulitzer Prize winner for his book "Why Survive? Being Old In America," and the first director of the National Institute on Aging. "But whether it will include long-term care is much more dubious."

The aging of baby boomers has heightened awareness of the long-term care issue. People who support government-sponsored long-term care, which an estimated 10 million Americans currently need, say a health overhaul bill would be incomplete without it.

"We cannot fix part of the health care system," said Sen. Herb Kohl, D-Wis., chairman of the Senate aging committee. "We must fix the entire system."

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