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...program - called the Community Living Assistance Services and Supports (CLASS) Act - would be funded by premiums and would pay enrollees $50 or more per day if they became too disabled to perform normal daily activities like eating and bathing. Employers who chose to participate would sign up their employees, who would then have the ability to opt out. The cash benefits could be applied to nursing-home care, but in an effort to encourage enrollees to stay in their own homes, payouts could cover such things as wheelchair ramps and wages for home health care aides...
...than nursing-home care, which averages about $200 per day. Yet millions of Americans who need long-term care but can't afford to pay for it have to "spend down" all their assets, become poor enough to qualify for Medicaid and then move to nursing homes, which the program covers. (Medicaid coverage for home health services varies from state to state.) This does not come cheap for the government, which pays about 60% of all long-term-care costs in the U.S.; only about 5% of Americans currently have private long-term-care insurance. "Medicaid is invaluable," says Judy...
...work financially. In October, seven Democrats wrote to Senate majority leader Harry Reid urging him to exclude the CLASS Act - already included in the passed House health reform bill - from the Senate's legislation, saying they had "grave concerns that [the CLASS Act would] create a new federal entitlement program with large, long-term spending increases that far exceed revenues." The chief actuary for the federal Centers for Medicare and Medicaid Services wrote that the CLASS Act provisions in the House bill "face a significant risk of failure...
...major change is in eligibility. The original CLASS Act would have allowed nonworking Americans to enroll in the long-term-care plan if their spouse worked, which could have led to "adverse selection," attracting people to the program who were too disabled to hold a job and therefore sure to file claims. Of course, excluding these people also means that spouses who stay at home just to care for their children (or for other reasons) are excluded from eligibility. The House bill also did not include the 75-year solvency requirement. (See "The Year in Health...
There is still plenty of room for improvement, according to the AAA. The CLASS Act doesn't include sufficient funding to market the program, meaning participation will be low - the CBO says 5% of the population would sign up, the CMS actuary says 2.5%, and AAA says 6%. Such low participation would not allow risk to be spread out enough to keep premiums affordable; in that case, the program could end up in an "insurance death spiral," in which premiums are so high, only those who know they'll need coverage sign up, driving up premiums even further until they...