The CLASS Act, the plan to create a national voluntary long-term care insurance program, is now included in both the House and Senate versions of health reform. So that means it will pass this year, right?

Not so fast. There once was a time when provisions included in both the House and Senate versions of a bill were almost certain to become law. But these days, everything is up for grabs, and key elements of overall health reform, including CLASS, won’t be decided until the final version of the bill is written behind closed doors–probably early next year.

The fate of CLASS will be decided by about a half-dozen Democratic senators. Several–including Kent Conrad of North Dakota, Ben Nelson of Nebraska, and Mark Warner of Virginia–oppose the measure, in part because of their concerns about its budgetary cost and in part because they are representing the interests of some big private insurers in their states. The other key lawmaker will be Senate Finance Committee Chairman Max Baucus (D-Mont), who has been cool to the idea throughout the health debate.

Sources say that opponents will propose dropping CLASS for this year’s health bill and, instead, request the Adminsitration study the nation’s long-term care financing needs and propose a set of reforms in a year. The key for supporters of CLASS is to find a senator who will demand the provision remain in the bill as the price for voting in favor of overall reform.

CLASS is now in the hands of the backroom dealmakers. My guess is that it has a 50/50 chance of surviving.