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...option, this once obscure provision has already made waves on the Senate floor. To supporters, it's the fulfillment of a long-deferred dream of Senator Ted Kennedy, a chance to improve the current options available to the elderly and disabled who need care (Medicare does not cover long-term nursing-home stays, and Medicare funding for home health care would be cut under health reform); to critics, it's a fiscally unsound budget gimmick, "a classic definition of a Ponzi scheme," as Republican Senator John Thune of South Dakota described it late last week. (See 10 players in health...
Home care is much cheaper 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...
...standpoint, certain details of the CLASS Act have made it an easy target for critics. Examining the merits of these criticisms provides a window to understanding both the complexity of health care reform and why it's so ripe for mischaracterization. For instance, to prevent people from purchasing long-term-care coverage when they are already in need, the CLASS Act requires that enrollees be employed and pay into the system for five years before becoming eligible to collect benefits. But because the CBO evaluates the costs of legislation - like the Senate reform bill - based on 10-year periods...
...opponents are just as guilty of fiscal shenanigans. It's true, as Thune pointed out, that the CBO says the CLASS Act will increase budget deficits in the long term, but that's only because of the peculiar way the deficit is calculated. Premiums collected would be invested in federal securities, and when the interest earned is transferred back to the CLASS Act trust fund, the transaction would be recorded as an increase in the deficit. The Senate bill also requires that the CLASS Act trust fund be solvent over a 75-year period, and the bill would give...
...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...