Long-term care proposal raises cost, sustainability concerns

"Embedded in sweeping health legislation passed by the House and being debated on the Senate floor is a major new federal insurance program," called the Community Living Assistance Services and Supports Act, or Class Act, The New York Times reports.

The program, which is to be financed with premiums paid through voluntary payroll deductions, would provide cash benefits to people with cognitive impairments or those who could not perform two or three of the "activities of daily living," such as eating, bathing or dressing. "Advocates for older Americans and people with disabilities see the program as a long-overdue effort to address needs that will explode as baby boomers age. It is meant for people with severe disabilities who want to live in the community, though the benefits could also be used to help pay for nursing home care or assisted living. But critics say that the program is unsustainable and that it could ultimately create serious fiscal problems for the government" (Pear, 12/13).

The National Journal reports that the program may be in jeopardy: "Senate Majority Leader Harry Reid, D-Nev., last week cleared the first -- but not the last -- major hurdle to creating a government-run long-term-care insurance program along the lines of what Sen. Edward Kennedy championed until his death in August. Although Reid was able to defeat a Republican attempt on December 4 to strip the proposal from the health care reform bill, the vote was close, and 11 Democrats plus Sen. Joe Lieberman, ID-Conn., who caucuses with the party, sided with Republicans. ..."

"Many older people who require long-term care end up on Medicaid, the federal-state health care program for the poor. Medicaid pays about 40 percent of the cost of long-term care in the United States, which in 2006 totaled $178 billion. Federal and state budgets are being strained by the expenditures" (Serafini, 12/12).