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The CLASS Act: A Promising Approach for Long-Term Care

By Kathryn Roberts, President and CEO of Ecumen

Late last year, authorities slapped felony charges on a farmer who lived with his wife near Bagley, Minnesota.
His alleged crime — and his desire — was to keep his wife at home. She sat in the easy chair, he on the davenport, and when she wandered as many people with Alzheimer’s do, a chain attached to her wiggled and called him to her aid. Authorities faulted his ingenuity, arrested him, and sent his wife to a nursing home before finally dropping charges.

At least he had a plan. Most of us are uninsured and unprepared to care for loved ones who suffer from Alzheimer’s or who need long-term services and supports for other reasons. Businesses have no solutions for the lost productivity of employees juggling their jobs and the demands of caregiving. Today, approximately half of caregivers for families also hold full-time jobs. They often have to reduce or eliminate personal savings during this ultimate multitasking.

We need to approach this major problem differently. One proposal moving us in the right direction is the Community Living Assistance Services and Supports (CLASS) Act, which is part of both the Senate’s and the House’s version of the healthcare bill.

Many people think that if they or a loved one gets Alzheimer’s or is disabled and needs long-term services and supports, Medicare will pay. It doesn’t.

Typically, a person must spend down his or her assets into poverty, and then Medicaid, called Medical Assistance in Minnesota, kicks in. And generally, people’s primary choice for Medicaid-paid shelter and care is an institutional, government-funded nursing home.

Through the CLASS Act, Americans 18 and over would pay premiums through voluntary payroll deductions, building a national risk pool, without penalties for preexisting conditions. After a vesting period of five years, a person needing help with daily activities would receive an average cash benefit of $75 and would be able to choose the services he or she wants. Disability doesn’t segregate by age; neither does the
CLASS Act.

The CLASS Act isn’t a cure-all, but it would provide benefits where most have none, and it would slow down an individual’s movement to Medicaid while it empowers more people to avoid Medicaid altogether.

An average of $75 as a daily benefit doesn’t sound like a lot, but it could help a husband get necessary respite care, paying for a half day of in-home services for his wife with Alzheimer’s. Families also could use the monies for a variety of other services that make life better.

More than 200 national organizations support it, including the Alzheimer’s Association, AARP, American Association of Homes and Services for the Aging, Easter Seals, and the Paralyzed Veterans of America.

The CLASS Act also would enhance private long-term-care insurance, which because of costs or preexisting conditions, leaves too many people uncovered. After 30 years in the marketplace, just 7% of adults nationally own such insurance. Some say that the CLASS Act will confuse consumers, providing false hope that they’re covered. In reality, the act will increase the public’s awareness of the need to have coverage for long-term services and supports. This awareness can lead to new private insurance policies, similar to Medi-Gap, that allow people to extend their CLASS benefits.

The act also would open up opportunities for states, such as Minnesota:

  • To innovate and build upon the CLASS Act with other strategies that can improve Minnesotans’ financial security
  • To improve the state’s financial status by lowering Medicaid’s expenditures
  • To strengthen the safety net for those in need
  • To provide people with expanded alternatives to institutional nursing homes.

The Senate’s Finance Bill says: “Nearly two decades have passed since Congress seriously considered long-term-care reform. The United States Bipartisan Commission on Comprehensive Health Care, also known as the Pepper Commission, released its Call for Action blueprint for health reform in 1990. In the 20 years since . . .Congress has never acted on the report.”

The future is here. And it needs a way to pay for services that empower us.

Ecumen is a nonprofit that provides senior housing and services statewide. It envisions a world in which aging is viewed and understood in radically different ways.

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