Sunday, December 28, 2014

Repealing the CLASS Act Would Accomplish Nothing

If you were old and frail and needed nursing care at home, who would help you pay for it? As things now stand, probably no one. Congress's answer was a long-term care insurance plan called CLASS. But government actuaries say it would cost too much. While some in the administration want to resurrect CLASS, others simply want it to kill it for good.

Repealing the CLASS Act Would Accomplish Nothing

If you were old and frail and needed nursing care at home, who would help you to pay for it? As things now stand, probably no one.

Two-thirds of elderly Americans will need help with daily living at some point. Most would like to get it in their own home. But very few of them can afford the cost. Only one in ten Americans has long-term care insurance. Medicare only helps for a short time immediately after a hospitalization. And Medicaid only helps if you are extremely poor.

Wouldn’t it be nice if the frail elderly could get the help they need without becoming a burden to their families or taxpayers?

Congress thought it saw an answer in the Community Living Assistance Services and Supports Act (CLASS Act for short), which created a long-term care insurance plan to cover home and community-based care. The program was designed to be voluntary and funded by premiums paid by participants with no government support.

Congress included the Act in the health reform law, even though it is only peripherally related to health reform’s main goal of guaranteeing basic health insurance to all. It took effect when health reform was passed in 2010.

Unfortunately, government actuaries have determined that the CLASS insurance plan is not financially sustainable over the long-term. It would require large government subsidies within 30 years to cover an expected spike in claims. Under the Act, the program can’t actually begin until the government can assure its solvency for at least 75 years based solely on voluntary premium payments.

Some in the Obama administration want to keep working on CLASS to try to find a way to make it financially viable. The problem isn’t going to go away, and no one has yet proposed a better solution.

However, opponents of health reform led by Senator John Thune (R – SD) want to repeal the CLASS Act entirely. This would halt in its tracks any effort to develop a workable plan. President Obama has threatened to veto the bill.

Some would go even further. They see the demise of CLASS as a reason to dismantle all of health reform.

What can they be thinking? According to the nonpartisan Congressional Budget Office, repealing the CLASS Act would have no effect on the budget deficit. In fact, it is our only hope of keeping millions of elderly from using Medicaid to pay for nursing care, which could increase the deficit by billions of dollars.

And CLASS’s finances have nothing to do with the way the rest of health reform operates. It is an entirely separate program. Its financial challenges say nothing about the broader reform plan.

Where does this dispute leave the frail elderly who need nursing care? One side would keep trying to find a way to fund long-term care. The other would prevent the government from even attempting to seek a solution.

Do we really want to leave those who need nursing care with nothing? Each one of us could join their ranks some day. That is why AARP and over 50 disability rights groups, unions and advocacy organizations oppose Sen. Thune’s repeal proposal.

Opponents of health reform have made abundantly clear what they are against. But they have yet to propose serious alternatives to address any of America’s health care needs. Some of them are making it seem as though what they really oppose is health care, itself.


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About this blog

Check Up covers regional health news and a wide array of healthcare topics from pharmaceutical happenings to patient safety. Read about some of our bloggers here.

Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
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