Of admissions, knitting and bandwagons: CLASS danger

Supporters of the CLASS Act were cringing this week, just as they were two weeks ago when McKnight’s reported on some loaded remarks from the nation’s Medicare and Medicaid top overseer.

McKnight’s keeps the long-term care profession well informed about breaking news and other items of interest. But when the New York Times piggybacks on the story, as it did on Monday, that brings it to the rest of the world’s attention as few other news outlets can.

The occasion? Health and Health and Human Services Secretary Kathleen Sebelius admitting the Community Living Assistance Services and Support (CLASS) program needs big changes to achieve fiscal solvency. For a controversial program that weathered fierce debate in Washington, such a flinch is not a good sign.

When any administration official opens the door even just a crack, as Sebelius more than did, that could mean a lot of potential trouble down the road. This is politics after all. The CLASS Act, which is particularly beloved by the long-term care advocates at LeadingAge, wouldn’t be the first knitting that becomes unraveled in Washington by starting with a single strand.

By Sebelius acknowledging its current form is “totally unsustainable”—totally unsustainable?! It hasn’t even started yet—she essentially handed the program’s numerous opponents all the bows and arrows they might need to finish the job. True, she also defended the program, the government’s first long-term coverage benefit. She said, well, it could be made to work.

But remember that this is a voluntary program (opt-out, but still voluntary) that needs public support. To mix metaphors, when the bandwagon slows down or gets people thinking about jumping off, vital momentum is lost. Before you know it, it could be sitting still on the tracks—with nobody aboard, or simply not enough passengers to pay the way.