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Obama’s long-term care plan in doubt

By Ricardo Alonso-Zaldivar
Associated Press / October 18, 2011

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WASHINGTON - The White House sent mixed messages yesterday on the future of a financially troubled long-term care program in President Obama’s health overhaul law, as supporters and foes heaped criticism on the administration.

At stake is the CLASS Act, a major new program intended to provide affordable long-term care insurance. Last Friday, Health and Human Services Secretary Kathleen Sebelius said the administration would not proceed with the plan because she has been unable to find a way to make the program financially solvent.

Yesterday, the nonpartisan Congressional Budget Office issued a ruling that cleared the way for repealing the act, but the administration rejected that step - and created considerable confusion. Backers and opponents said the White House is trying to have it both ways.

“I feel like somebody just called me about how to do really good pet care after they shot my dog,’’ said Larry Minnix, president of LeadingAge, a trade group representing nonprofit nursing homes, which are strong supporters of CLASS.

Paying for long-term care for a frail, elderly family member is a major financial dilemma for America’s middle class. Medicare only covers short-term nursing home stays, for patients in rehab. And to become eligible for Medicaid, people have to spend most of their assets, akin to impoverishing themselves. The Community Living Assistance Services and Supports program was supposed to help provide an answer.

A longstanding priority of the late senator Edward M. Kennedy, it was supposed to function as a self-sustaining voluntary insurance plan, open to working adults regardless of age or health.

Workers would pay an affordable monthly premium during their careers and could collect a modest daily cash benefit of at least $50 if they became disabled later in life. The money could go for services at home or to help with nursing home bills.

But a central design flaw dogged CLASS. Unless large numbers of healthy people willingly sign up during their working years, soaring premiums driven by the needs of disabled beneficiaries would destabilize it, eventually requiring a taxpayer bailout.

After months of insisting that that could be fixed, Sebelius acknowledged Friday that she didn’t see how. “Despite our best analytical efforts, I do not see a viable path forward for CLASS implementation at this time,’’ she said in a letter to congressional leaders.

Officials said they discovered they could not make CLASS both affordable and solvent while keeping it a voluntary program open to virtually all workers, as the law required. The law also mandated that the administration certify CLASS would remain financially solvent for 75 years before it could be put into place.

In its ruling, the budget office said repealing CLASS would have no impact on the deficit. Absent a viable program, the government would not see savings of more than $80 billion from premiums that would have been collected in the early years, before CLASS started paying benefits on a large scale.

That ruling removed a major obstacle for repeal, and congressional Republicans vowed to press ahead. The administration balked.

“We do not support repeal,’’ White House spokesman Nick Papas said yesterday. “Repealing the CLASS Act isn’t necessary or productive. What we should be doing is working together to address the long-term care challenges we face in this country.’’

He declined to answer whether the president would veto a repeal bill.