The CLASS Act, a proposal to create a national long-term care insurance system, remains alive in the Senate health bill, but its fate remains far from certain.
On Friday, the Senate actually voted 51-47 to drop the plan from its health bill. But, thanks to Senate rules that required 60 votes to approve the change, CLASS remains in the measure. Most troubling, Senate Finance Committee Chairman Max Baucus and 10 other Democrats voted to kill CLASS. One, Sen. Ben Nelson (D-Neb) says he will oppose any health bill that includes the insurance plan.
Several senators oppose CLASS because, they say, it would become a long-term drain on the Treasury. In a November 25 report, the Congressional Budget Office laid out its concerns about the long-run budget consequences of CLASS. It is a complicated document, but, in brief, its says CLASS would build up huge surpluses in the short-run and then gradually spend both premiums and investment earnings in future years. This would be fine in a responsibly-run program.
But many fear is that there is little in CLASS that would stop future congresses from spending those reserves on other priorities rather than allowing them to build up as they should.
On Saturday, the Senate passed a non-binding resolution saying that CLASS premiums will be reserved to pay insurance claims and not spent on other government programs. This is exactly what should happen. But, sad to say, a sense of the Senate resolution promising fiscal responsibility is not worth the paper it is printed on.
I hope lawmakers can find a way to create a true reserve fund for CLASS premiums and investments. It would probably have to establish some sort of quasi-private entity outside of Treasury to do this. Otherwise, CLASS risks suffering the same fate as Social Security. That would be a disaster both for our parents and for those of us caring for our parents.
What I’m really intrigued by is what state initiatives occur to wrap around the CLASS Act and enhance personal savings.
Eric Schubert
VP, Ecumen
http://www.ecumen.org
Eric, as always, raises some interesting issues. I can imagine a whole set of state issues: How will Medicaid dovetail with basic federal LTC insurance? What would states do to ecnourage the purchase of private insurance to wrap around a public plan? How would the current Partnership prgram fit? But what other issues are out there?
And remember, health reform may also include some big changes in the home and community-based care program under Medicaid.