CLASS Act, Voluntary Long-Term Care Insurance Program of Affordable Care Act, is Called-Off

On October 14, 2011, the Obama Administration announced that the voluntary long-term care insurance program of the Affordable Care Act, the “CLASS Act,” is not viable for implementation. The announcement came from Kathleen Sebelius, Secretary of the United States Department of Health and Human Services, in the form of a letter to the Speaker of the House of Representatives. In this letter, Ms. Sebelius describes the thorough research done on the financial and structural solvency of the CLASS Act if implemented. The bottom line: the CLASS voluntary long-term care insurance program will not work because the cost will be too high for individuals who need care.

What is Long-Term Care?

Let’s take a look at what long-term care is before getting into why we need long-term care insurance. Long-term care (LTC) covers a broad range of services and supports for individuals requiring medical and/or social care over an extended period of time. 

• This includes activities of daily living (ADLs) like feeding and bathing; and instrumental activities of daily living (IADLs) like grocery shopping and doing laundry. 
• Long-term supports and services (LTSS) can be delivered in two main areas: institutions (like nursing facilities) or the home and community based setting (Assisted Living, Supportive Living, private apartment or home).

To learn more about how Illinois LTC measures compared to other states, read my blog post about a recently published study on LTC across the country.

What does this announcement mean to people with long-term care needs?

The CLASS Act offered a way for the United States to start addressing the long-term care needs of millions of Americans.  Persons with disabilities and older persons are the largest populations with LTC needs.  For more information on what the CLASS proposed to do, read Illinois’ Health Matters Blog Post by Lisa Ekman on the CLASS Act.

According to the National Clearinghouse for Long-Term Care Information, over 20 million people had LTC needs in 2008, with more than half of these people being over age 65. According to Politico Pro, only 7 million of these individuals have the private insurance to cover their LTC needs.

With the advance of medical technology and the aging of our population, people are living longer and with chronic conditions that require LTC. Here are some statistics:

• The number of adults 65 years and older will more than double from 40 million today to over 85 million by 2050. See Census Bureau data here and here.   
• An estimated 130 million Americans live with at least one chronic disease, and at least 65 million older adults experience multiple chronic conditions[1]. 
• 25% of older adult Medicare beneficiaries have more than four chronic conditions and are responsible for at least 80% of Medicare spending[1].

Now that the CLASS Act has been called off, the American public should be asking: “What is our country going to do for people who need long-term care?” Right now, we simply do not have a LTC system that can handle the number of people who need LTC. Medicare only pays a small portion of long-term services and supports; Medicaid requires people to spend down their savings in order to access LTC. And both Medicare and Medicaid are constantly under attack at a federal level for budget cuts. Meanwhile, the millions who require LTC will continue to have LTC needs, many of which will go unmet.

What Can You Do?

If:

• You are a person with a disability or an older adult who requires long-term care, OR 
• You know someone who requires LTC, OR  
• You support the program for those who have LTC needs

Then:

Share your story, and call your Senators and other elected officials! Simply call their offices and tell them that you support, and would like the Senator to also support, Medicare and Medicaid because these programs help you address America’s (perhaps your) LTC needs. More specifically, you can tell them that you do not want any cuts to benefits or changes to eligibility for these programs.

For your reference:

• Senator Dick Durbin’s Illinois office phone number is: (217) 492-5089 
• Senator Mark Kirk’s Illinois’ office phone number is: (217) 492-4062

Your voice and your stories are important and are a way to tell our elected Congressmen WHY we need LTC programs, and WHY we need to protect Medicare and Medicaid.  
 
Questions? Comments? Please let me know, I look forward to hearing from you and continuing the conversation.

For additional resources on how the Affordable Care Act addressing LTC, please download the Health Care Reform Impact in Illinois, Long-Term Care Reform Provisions Brief.

Kristen Pavle
Associate Director
Center for Long-Term Care Reform
Health & Medicine Policy Research Group
312.372.4292 x 27

[1] Boult, C., Karm, L., & Groves, C. (2008) Improving chronic care: The “Guided Care” model. The Permanente Journal. 12 (1), 50-54.