Medicaid, which funds more long-term care supports and services than any other payer--$115 billion in 2008--is about to crash. Like a head-on train wreck, we can see it coming. The question is: What are we going to do about it? The Kaiser Family Foundation, in an extensive new survey of all 50 state Medicaid programs, tells the grim story. Medicaid is [...]
In a Washington Times column yesterday, two Heritage Foundation researchers argued that the Community Living Assistance Services and Supports (CLASS) Act is a trillion dollar government bailout waiting to happen. The CLASS Act is a national voluntary long-term care insurance program that was included in the new health care law. And to listen to the authors, you'd think CLASS will [...]
Kudos to President Obama for making a "recess appointment" of Don Berwick to run the Centers for Medicare and Medicaid Services (CMS). Berwick may be the ideal choice for the job. He is the right candidate at exactly the right time. The new health law makes possible broad reforms in the way we deliver health and long-term care. But it by no [...]
Nice to see President Obama and Health and Human Services Secretary Kathleen Sebelius beginning to talk about the CLASS Act--the voluntary national long-term care insurance program that is included in the new health law. But unfortunately, even at a town hall yesterday at a senior center, CLASS was little more than an afterthought for the Administration. Sebelius discussed the new program only in response [...]
For months, physicians have been refusing to take new Medicare patients, and some are now even dropping long-time patients. The problem: Congress's inability to resolve a now 13-year-long argument over how much Medicare should pay docs. The whole mess started in 1997, when the government concluded that Medicare was overpaying many doctors. The reality was that some physicians probably were being paid too much while others were [...]
Earlier this week, I participated in a panel with Connie Garner, the Senate staffer who was a key architect of the CLASS Act, the national long-term care insurance program that is included in the new health reform law. Garner challenged the audience, which included several private long-term care insurance company execs, to work with her to help turn CLASS into workable [...]
President Obama has signed health reform, including the CLASS Act, into law. Now, his administration needs to turn a law into an insurance product people will buy. It won't be easy. No other country has tried to create a voluntary public long-term care insurance program, which is what CLASS is. The challenge will be to design a policy that provides a respectable benefit at an [...]
The health reform bill passed by Congress last night includes big changes in the way we pay for long-term care, both at home and in nursing facilities. The reforms will give the elderly and disabled far more flexibility in the way they get care and, at the same time, begin turning long-term care from largely a welfare program to an insurance system. The biggest change [...]
A typical couple would have to save nearly $200,000 to pay for their out-of-pocket medical costs from the time they are 65 until they die, according to an important new study by the Center for Retirement Research at Boston College. Add in nursing home costs, and they are likely to need $260,000. But that's only part of the story. About 5 percent of 65-year-old couples will [...]
The compromise health reform plan proposed today by President Obama includes many of the key long-term care provisions that were included in the earlier House and Senate bills. The CLASS Act--the national long-term care insurance program--along with federal incentives to encourage states to expand their home and community based care programs under Medicaid, and improved care coordination for those receiving both Medicare and Medicaid [...]