Connie Garner, the top Senate staffer on long-term care issues, said today that she is certain the CLASS Act, which would create a new national long-term care insurance program, will be included in the final health bill being considered by Congress. “I don’t have any question CLASS will survive,” Garner told a long-term care conference sponsored by the journal Health Affairs.

A senior insurance industry official told me today that he agrees with Garner’s assessment. He said the industry is shifting its attention to tweaking the bill rather than trying to kill it and will begin to work with the Obama Admnistration on the design of CLASS policies. 

Garner, a veteran Hill staffer and no pollyanna when it comes to legislative predictions, said there were still many unresolved issues as House, Senate, and White House negotiators write a final version of CLASS. Among the issues: how to prevent people from enrolling in the program for the five year minimum, then dropping out for many years before re-enrolling again late in life.

She said her biggest concern now is making sure the Adminsitration will have the flexibility it needs to design insurance policies under CLASS while maintaining the basic framework of the new program. “We have to be careful to watch the structure doesn’t change,” Garner said.

For her, that means keeping the program’s cash benefit and protecting Medicaid for those who need it. As the bill has moved through Congress, it has gradually become less specific about the exact design of the insurance policies. It now leaves many questions–including the premiums and specific benefits–to the Secretary of Health and Human Services.

Garner acknowledged concerns that too few healthy people will enroll in CLASS insurance and that premiums will be too high for many. But she said she believed the program would attract many buyers: “Our gamble is that we’ll have a big enough risk pool.”

And, as she has often said in the past, she insisted private insurers would have the opportunity to sell their own policies to wrap around the CLASS benefit, which is expected to be modest. “It is not meant to crowd out private long-term care insurance,” she said.