Senate Health Committee Chair Ted Kennedy (D-MA) will include a major restructuring of long-term care services in his version of health reform, due out in late May. But getting those changes through Congress “is like pushing a rock uphill,” says Connie Garner, Kennedy’s top staffer on aging and disabilities issues. 

Garner spoke yesterday at a terrific conference sponsored by Health Affairs and the Scan Foundation. Lots of new research and new ideas on how to better deliver care. But Garner’s candid assessment of the prospects for long-term care reform was a highlight of the day-long program.

She said that Kennedy was deeply commited to including reforms of both financing and delivery of long-term services in an omnibus health bill. Financing reforms will be based on Kennedy’s CLASS Act, a plan to provide universal government long-term care insurance. The coverage of up to $100-a-day for life would be funded through a payroll deduction. People would be automatically enrolled, but could opt-out if they chose.

So far, the Obama Administration has been unwilling to support such a plan. In addition, Senate Finance Committee Chairman Max Baucus (D-MT) has been reluctant to include long-term care in his health reform plan. Later this summer, the Baucus and Kennedy bills will have to be stitched together. Later, the House will write its own version.

Prospects for reform are even dicier because advocacy groups and providers disagree among themselves on the details. While there is widespread agreement that some form of public insurance should be included, there is no consensus on what it should look like. Some in the for-profit nursing home business, for example, favor delaying long-term reform until after health care is enacted. Non-profits, by contrast, are pushing hard to include reform now. 

For those of us focused on caring for our parents, it is going to be an interesting few months.