Senate inching closer to passing bill with CLASS Act in it

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It appears increasingly likely that proponents of the CLASS Act will have “happy holidays” after all.

It's somewhat hard to believe, but senators are expected to vote tomorrow morning—Christmas Eve—on their healthcare reform bill. After passing a couple of other crucial test votes, the Senate has rounded up its Democrats and two independents to form a 60-proof filibuster majority. (And who says they don't believe in Santa Claus?)

While the complete bill still has provisions that scare long-term care providers, such as significant cuts to Medicare for nursing home care, there are also some goodies in the legislation. One of them— at least according to supporters, such as the American Association of Homes and Services for the Aging, as well as consumer groups supporting seniors and the disabled—is the Community Living Assistance Services and Supports (CLASS) Act.

Of course, not everyone is in favor of the provision, which would allow workers to contribute premiums to a trust. Those workers could then draw an estimated $75 a day in cash from the fund if they suffer a disability, or are unable to perform two or more activities of daily living.

Critics argue it would be expensive and put our country in debt. They also say it would only attract a small, sicker portion of the population and, therefore, premiums would soar.

All of this, of course, is fodder for discussion. And, well, lest we forget, the bill hasn't been passed yet.

But talk to those backing it and it's hard not to be a little excited.

Here's why: If it works, it could help that growing number of older adults with chronic illness function with a greater degree of financial independence. As more people are living longer, such a program may just what we need. 

“I really believe it's the best and maybe the last [chance] for a realistic program that will help baby boomers,” James Firman, president and chief executive of the National Council on Aging, told me recently. “If we wait 10 more years or so for this to come along, it's going to be too late. I think baby boomers in particular will be the prime purchasers of this product.” 

Speaking on the consumer side of issues, Firman and his colleagues offer other potential benefits: it would be universally available; it could create a large high-risk pool; no one would have to impoverish themselves to receive the benefit; and the home-care cash benefit of $75 would be feasible.

He mentions another upside: The program would take some of the pressure off Medicaid, which pays for the majority of nursing home care. It not only would help pay for home care but nursing home care, if that becomes necessary, as well. And if it raises awareness of long-term care insurance, well, so much the better for the thinly stretched government program. 

“I think the CLASS provision … has the ability to bend the Medicaid cost downward,” Firman said.

As for the argument that premiums would be too expensive, he noted that the price would depend on how the government age rates the premiums. In other words, someone who is 25 would not pay as much as someone who is 55. And what about the program adding to or subtracting from the deficit? Firman believes that such talk should be eliminated from the debate.

It only is relevant as it relates to government accounting and the way the Congressional Budget Office scores bills, he said.

“I think it's just confusing the conversation,” he said. 

What is true, according to Firman: It would be solvent and fiscally sound, it wouldn't cost taxpayers a dime, and it would reduce Medicaid costs.

I'd vote for that.   


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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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