WASHINGTON, Aug. 29 -- The Center on Budget & Policy Priorities issued the following news release:

More than 1 in 3 adults under age 65 enrolled in Medicaid have a disability. Medicaid provides essential medical care and supportive services that help many of these individuals remain in their homes and communities.

Radically changing Medicaid's structure to a block grant or per capita cap, as in recent Republican proposals to repeal the Affordable Care Act, would threaten the essential services that people with disabilities rely on to maintain their health and independence.

Medicaid Provides Crucial Services for People with Disabilities and Their Families

More than 23 million adults under age 65 -- about 12 percent of all adults -- have a disability. Medicaid provides a broad range of medical and long-term care services to meet the needs of people with disabilities. These services include primary and preventive care, medical treatment for illnesses and chronic conditions, and nursing home care.

* Medicaid is the primary payer for essential long-term services and supports. In addition to nursing home care, Medicaid supports home- and community-based services, such as personal and attendant care services that help people with disabilities live in their homes and communities. Medicaid also covers wheelchairs, lifts, and supportive housing services. This care is typically unavailable through private insurance and is too costly for all but the wealthiest people to fund out of pocket.

* Medicaid also helps people with disabilities find and hold jobs. Some states provide supportive employment programs that offer services such as skills assessment, job search, job development and placement, and job training to help people with disabilities join the workforce and remain employed.

* Medicaid provides services for children with disabilities in schools. Many children with disabilities rely on individualized education plans (IEPs) detailing the education and related services they need. IEPs often include services that Medicaid covers for children, such as physical and speech therapy. Schools' ability to leverage Medicaid funding enables them to meet their requirements under the Individuals with Disabilities Education Act and provide the range of services needed to educate students with disabilities.

Medicaid Provides Access to Comprehensive, High-Quality Care

Medicaid's access to providers is comparable to private insurance, and it provides a broader range of benefits.

* Medicaid helps people with disabilities get the care they need. Medicaid beneficiaries with disabilities are less likely to report unmet medical needs than people with other sources of coverage.

* Medicaid beneficiaries have access to health care services that are comparable to -- but less costly than -- what they would receive from job-based or individual market coverage. People with Medicaid coverage have a regular health care provider at rates comparable to people with private coverage.

* Medicaid offers high-quality care. Medicaid beneficiaries are likelier than those with private coverage to say their care was excellent or good.

State Innovations Help Meet the Needs of People with Disabilities

States have flexibility under Medicaid to innovate and improve the delivery of health care services. Using existing state flexibility under Medicaid, for example:

* States help people with disabilities live at home in the community. For example, 44 states participate in the Money Follows the Person program, which helps Medicaid beneficiaries safely and successfully transition from nursing facilities to their own home, the home of a caregiver, or a community-based residential facility.

* States are finding new ways to provide appropriate, timely, and cost-effective care. For example, Medicaid providers in Minnesota's Hennepin County created a partnership in 2011 to care for the county's highest-need patients. Their team-based model has demonstrated extraordinary results: emergency department visits dropped nearly 10 percent, while primary care visits and the share of members receiving recommended care increased.

Cutting Medicaid Funding and Rolling Back the Medicaid Expansion Would Jeopardize Coverage for People with Disabilities

Recent proposals in Congress would have imposed a rigid, arbitrary cap on federal funding for state Medicaid programs and effectively ended the Affordable Care Act's Medicaid expansion. These proposals would have reduced Medicaid enrollment by millions of people and cut hundreds of billions of dollars in federal spending over the next decade, threatening health care for large numbers of Medicaid beneficiaries and leaving people with disabilities particularly vulnerable.

Medicaid cuts would:

* Leave states holding the bag. A cap on federal Medicaid funding would leave states responsible for 100 percent of the costs above their arbitrary federal funding cap, including costs stemming from new treatments, public health emergencies (like the current opioid crisis), or changing demographics.

* Threaten existing services when new costs arise. As new treatments emerge or as demand for treatment increases, states might cover these added costs by scaling back services that people with disabilities now rely on for care and independence, especially if these services are covered at a state's option.

* Put people with disabilities at risk of losing coverage. The Affordable Care Act's Medicaid expansion covers 11 million people. Many of them struggle with a chronic illness or a disability (such as a mental health condition) that wouldn't, by itself, qualify them for Medicaid. Only 36 percent of non-elderly Medicaid beneficiaries with disabilities receive Supplemental Security Income, which allows them to enroll in Medicaid even without the expansion. While others may be eligible for Medicaid based on other criteria, many could lose Medicaid coverage under the House bill and wind up uninsured.

States facing large cuts in federal funding would likely scale back services for people with disabilities. The largest share of Medicaid funding for "optional" services (those not required by the federal government) goes for home- and community-based care for seniors and people with disabilities, including children with complex health care needs. In 2013, Medicaid spent more than $83 billion on optional services for people with disabilities, including home- and community-based services such as case management, home health aides, personal care services, and respite care. Other optional programs that help people stay independent in their homes include Community First Choice, Money Follows the Person, and Medicaid buy-in programs. Because home- and community-based services make up such a large share of states' optional Medicaid spending, they are likely targets for cutbacks in case of severe cuts in federal funding.

A strong sales year can make a product look easier to position than it really is. Production climbs, more financial professionals enter the market and the product starts to show up in a wider range of planning conversations.

Success can make it tempting to assume the industry has mastered the product. But I don’t think indexed universal life has reached that point yet.

IUL entered 2026 after outperforming a record-setting individual life market. Premium continues to rise faster than the number of policies, indicating that the industry isn’t simply reaching more consumers. Larger or more heavily funded cases seem to be driving some of this growth.

For financial professionals looking toward the second half of the year, the takeaway goes beyond stronger demand. In my view, more premium per case raises the standard for case design, consumer education and long-term service.

More premium raises the stakes

LIMRA reported that IUL new annualized premium with excess premium reached $1.1 billion in the first quarter of 2026, up 9% from the same period in 2025. IUL represented 25% of total new individual life premium, and six of the 10 largest carriers posted double-digit growth.

Policy count, however, was flat. Premium growth without policy growth suggests that more dollars are going into each policy. Financial professionals can’t treat those cases as routine transactions.

Larger premiums can support meaningful protection and accumulation goals, but maximizing premium isn’t the objective. The funding strategy should reflect the consumer’s goals, risk tolerance and ability to support the policy over time. Poor alignment can magnify the consequences of misunderstood assumptions or weak policy management.

In my experience, a better second-half strategy starts with planning questions. Product comparisons come later. Does the consumer have a lasting need for life insurance? Can they commit to the proposed funding schedule? How would a change in income affect the plan? What role does the policy serve alongside existing savings, retirement accounts and other coverage

IUL can be a powerful tool for the right individual, but it must be positioned with clarity.

Record IUL sales don’t tell the whole story

IUL’s momentum developed within a record year for the broader life insurance market. Total new individual life premium exceeded $17.5 billion in 2025, up 10% year over year. IUL accounted for $4.5 billion of that total, setting quarterly and annual sales records while increasing new premiums 17% and policy sales 8%.

Several forces are contributing to that momentum. Consumers continue to look for tax-efficient retirement strategies, stronger equity markets have supported interest in indexed products, and more financial professionals are becoming comfortable incorporating IUL into broader planning conversations. Expanded distribution and enhanced products have also helped drive demand.

A wider product shelf brings more responsibility. Product design, loan provisions, indexed account options, expenses and underwriting philosophies can vary significantly among carriers. Objective product evaluation and disciplined case design are important when determining where IUL fits and where another solution would better serve the consumer.

More options don’t make IUL the right fit for everyone. Sales figures show what the market is buying. Still, they don’t show whether consumers understand how the policy works or whether it will stay aligned with its original objective over several decades.

The strongest IUL discussions connect three elements: the protection need, the consumer’s funding capacity and realistic expectations for policy performance. Leaving one of these elements underdeveloped can weaken the entire recommendation.

An illustration needs a conversation around it

An illustration is only the starting point. It can demonstrate how a policy could perform under specific assumptions. Still, the real work is helping consumers understand those assumptions, what could change over time and how those changes could affect the policy.  The discussion should also cover surrender periods and charges as well as any other terms and conditions of the policy.

Regulators continue to examine that issue. The National Association of Insurance Commissioners (NAIC) says revisions to Actuarial Guideline 49-A took effect in 2026 to enhance consumer-protection disclosures for IUL illustrations. The NAIC is still looking at ways to make life insurance illustrations and disclosures clearer.

A compliant illustration gives the conversation structure. It can’t have the conversation for us. Financial professionals should explain which values are guaranteed, which depend on future crediting, and how policy charges, premiums, withdrawals and loans can affect results.

A useful explanation addresses questions such as:

• What could happen if credited interest falls below the illustrated rate?
• How would reduced or missed premiums affect the policy?
• Which policy elements can the carrier change?
• How could withdrawals or loans affect cash value and the death benefit?
• What would signal the need for additional funding or another adjustment?

Thorough answers support informed decisions, set realistic expectations and create a stronger foundation for future policy reviews.

Stronger service can turn momentum into progress

For some, policies are sold and then largely forgotten. Annual reviews should be part of the planning process from Day 1, not a service added later if a concern arises.

A consistent review process lets financial professionals compare actual results with the original assumptions, revisit funding and policy performance, examine any loans or withdrawals, and confirm beneficiary designations. Reviews also create space to account for changes in income, family responsibilities, business interests, financial goals or risk tolerance.

Service expectations should be established before the policy is issued. Consumers need to know that annual reviews are part of owning the policy, what information they should retain and which financial or life changes should prompt an earlier discussion.

The industry’s work extends far beyond larger IUL cases. LIMRA’s 2025 Insurance Barometer Study found that about 100 million American adults believe they need more life insurance. Record IUL premiums don’t mean the industry has closed that protection need.

The second half of 2026 gives us a chance to define what IUL momentum will represent. The bigger opportunity lies in strengthening every IUL recommendation through clearer education, proactive policy management, objective product evaluation, and disciplined planning.

Record sales brought IUL more attention. Turning that attention into lasting progress will depend on whether we help consumers choose suitable coverage, understand what they own, and manage it effectively over time.

© Entire contents copyright 2026 by InsuranceNewsNet.com Inc. All rights reserved. No part of this article may be reprinted without the expressed written consent from InsuranceNewsNet.com.