CLASS Act to survive, even if healthcare reform doesn't

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Larry Minnix sounded weary but determined. The CLASS Act may become a casualty of healthcare reform, but it is not going away, the head of the American Association of Homes and Services for the Aging assured me Wednesday.

Minnix, whose organization has become a leading backer of the legislation, suggested that the plan, which would provide a cash benefit to workers who become disabled, will live even if the current healthcare bill doesn't.

“We're not going away; we're just going to regroup,”  Minnix said by phone from Washington.

Democrats were dealt a major wallop Tuesday when Republican Scott Brown defeated Democrat Martha Coakley in a special election for the open Senate seat in Massachusetts. The outcome resulted in more than a loss of a seat. It has taken away the party's 60th vote to pass healthcare reform. It is not clear what, if any path, the party will take to pass its package.

If necessary, AAHSA will form a new CLASS Act-type plan with the 200-something organizations supporting it and lawmakers, Minnix said.

“We're not without advocate friends or friends in Congress,” he said. “We may go back and see what could be done on a more bipartisan basis.”

The problems that led to the proposal still need to be solved, he insisted.

“Long-term care has got to be funded differently and Medicaid has got to have some relief, and the CLASS Act does both,” Minnix said. 

It can't be easy for Minnix and the rest of his conscientious team to see their work of the last several years begin to smolder along with the rest of the hard-fought provisions for long-term care and healthcare.

But Minnix, with a hint of defeat in his voice, said the organization and partner organizations should be proud of what they accomplished. The provision made it into both bills and won the support of the president. 

“I don't know what else we would have done,” he said. “A year ago, no one would have given us a chance at getting it done. The thing I can't control is voters in Massachusetts.”

How right you are, Larry.

Silver lining?

Meanwhile, one long-term care expert is seeing the current crisis facing healthcare reform as a positive development for long-term care.

Steve Moses, president of the Center for Long-Term Care Reform, feels like the new setback for the legislation offers Congress a chance to establish a better long-range Medicaid plan for the field.

He recently published a document called  “Doing LTC Right” in conjunction with Rhode Island's Ocean State Policy Research Institute.

The report points out the major problems right now with Medicaid, such as the program's somewhat lax rules regarding financial eligibility. In a nutshell, according to the report, the program is losing money because people who have the means to pay for long-term care are using built-in exemptions to join the Medicaid rolls.   

The program also examines the benefits of Rhode Island's long-term care “global Medicaid waiver.” The waiver allows the state to provide more home- and community-based services in exchange for a five-year cap on federal funding.

Taking several steps could improve the waiver program and make Rhode Island a model for the rest of the country, the report says. These include targeting those who truly need Medicaid, expanding estate recovery, imposing more stringent rules on Medicaid eligibility, encouraging people to use long-term care insurance and other private means to pay for long-term care, and educating people about long-term care planning.

It is an interesting analysis. Those who are serious about finding answers to the long-term care and Medicaid problems would be wise to read it.

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McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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