SAN DIEGO, May 30, 2011 — Whether you favor or oppose national heath care reform, one issue transcends individual politics we can all agree on. It is far more humane and cost effective to take care of people with in-home services to maintain their independence for as long as possible, as opposed to an acute care setting like assisted living or a nursing home.
Originally passed as part of health care reform, The Community Living Assistance Services and Supports (CLASS) Act creates a national, voluntary disability insurance program under which: (1) all employees are automatically enrolled, but are allowed to waive enrollment; (2) payroll deductions pay monthly premiums; and (3) two-tiered benefits are provided, based on the level of disability, to purchase non-medical services and support services the beneficiary needs to maintain independence.
It seemed too good to be true, a simple cost effective program that could help millions of people get the help they need to stay in their homes while simultaneously cutting health care costs by preventing institutionalization in hospitals or assisted living facilities.
Maybe it is.
Now Secretary of Health and Human Services Kathleen Sebelius, who is tasked with implementing the CLASS Act, says it will be difficult to make this program affordable and fiscally sound for the long term without some changes. The premiums needs to be low enough to encourage younger, healthy people to sign up early and for the long term, but can’t be so low the premiums won’t be enough to pay claims.
If employers don’t sign their employees up, or if not enough people under 40 participate, the plan will be in trouble. A recent study by researchers at Boston College determined that if less than one percent of the participants in the CLASS Act are under 40, the average monthly premium would need to be $312 to make the program solvent.
Robust participation was among the greatest concerns of the authors of the CLASS Act. Employers who currently make long-term care insurance available for employee purchase have an average voluntary buy-in rate of below 10 percent among all age groups.
Younger adults don’t think long term care has any relevance to them. Connie Garner is a nurse practitioner who now runs the advocacy group Advance CLASS, a coalition of well-known nonprofits including AARP, Alzheimer’s Association, National Alliance for Caregiving, Inc., National Association of Area Agencies on Aging (N4A), Paralyzed Veterans of America (PVA) and the National Consumer Voice for Quality Long-Term Care (NCCNHR). Garner says the CLASS Act has a serious image problem. Adults believe it only kicks in when a person is elderly and disabled, needing full-time care. The reality? The CLASS Act also makes benefits available to the 35-year-old who becomes paraplegic due to a swimming accident, or needs help while fighting cancer.
The odds of the CLASS Act surviving in its current form are stacking up against it. What needs to be done to save the CLASS Act? Until the plan opens in 2018, what should you be doing now to assure you or someone you love gets help if needed before then? I’ll answer those questions in my next installment.
Until next time, enjoy the ride in good health!
NEXT WEEK: Getting our CLASS Act Together
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