House Votes to Repeal Long-Term Care Insurance Program
Mental Health Weekly February 6, 2012
Mental health advocates and disability groups vowed to protect the Community Living Assistance Service and Support (CLASS) Act, a long-term care insurance program enacted under the Affordable Care Act (ACA), despite a vote last week by the U.S. House of Representatives to repeal the program. The CLASS Act would help people pay for longterm services and supports vital to helping them live independently in their homes and communities.
The CLASS Act enhance community-based service options for individuals with a mental health and/or substance use condition. Medicaid state plan changes and demonstration grants will expand these services for individuals who have long-term care needs (e.g., dual-eligibles, high-risk Medicare beneficiaries), according to the Substance Abuse and Mental Health Services Administration (SAMSHA).
The CLASS program also establishes a self-funded long-term care insurance program paid for by voluntary premiums and not taxpayer funds. Working Americans who enroll in the program would pay premiums, just as for health insurance. In the event that participating individuals develop a disability with functional limitations, as is common with aging, they would be able to receive a daily cash benefit to help offset the costs of home health aides and other services and supports, according to a statement released by the Judge David L. Bazelon Center.
It was expected the House would pass the CLASS Act repeal bill (HR 1173 “Fiscal Responsibility and Retirement Security Act of 2011”), said Laurel Stine, director of federal relations for the Bazelon Center. “The House did so on a vote of 267-159, with 28 Democrats joining all voting Republicans in support,” Stine told MHW. “This is in line with Republicans’ efforts to dismantle the Affordable Care Act and in line with the House Republican efforts last advocacy groups, had encouraged members to oppose the House effort to repeal the program.
A companion bill to repeal the CLASS Act has been introduced in the Senate by Sen. John Thune (RS. D.), said Stine. “However, the demise of the CLASS Act in the Senate is not guaranteed. The magic filibuster proof number is 60.”
Stine added, “The Bazelon Center is opposed to the repeal of the Class Act and will advocate to block a repeal in the Senate.” Generally, advocates that oppose repeal of the CLASS Act want lawmakers to engage in real discussions on the long-term care crisis and to make the program financially
viable, said Stine. “The growing population of Americans that will need or who currently are in need of long-term care services and supports should be able to plan for and have access to necessary services and supports in their own homes or communities without impoverishing themselves,” she said.
Disability groups weigh in
The American Association of People with Disabilities (AAPD), a leading cross-disability group, along with the Bazelon Center and other advocacy groups, had encouraged members to oppose the House effort to repeal the program.
“The AAPD is very disappointed and we’re going to fight now to make sure this doesn’t happen in the Senate,” Mark Perriello, president and CEO of the AAPD, told MHW. Perriello added, “We’re hoping President Obama will come out fairly strong [on this issue] and would veto any legislation to repeal the CLASS Act. Twenty-one million people have chronic conditions that cause them to need long-term services and supports. People want to work and contribute to society.”
Perriello said the fear is that more people without the supports will have to rely on Medicaid. “Lawmakers have to do more,” he said. “They’re forcing people into Medicaid; that’s not a solution at all. Medicaid right now is the number one place people go to for long-term services and supports.”
“The CLASS Act is an important step forward to address the aging population and the inevitable caregiving crisis that we will face,” Fernando Torres-Gil, director of the UCLA Center for Policy Research, told MHW. The program would assist a growing aging population but also the thousands of veterans returning from Iraq and Afghanistan who may have disabilities, he said.
People are living longer and there are an increasing number of people with cognitive, mental, intellectual and physical disabilities in need of this comprehensive system of home- and community-based care, Perriello said.
“The CBO [Congressional Budget Office] projected the CLASS Act will reduce the deficit by a substantial amount,” he said. The program also brings together the senior and disability communities into a coalition of sorts, said Torres-Gil. “Our hope is that the coalition will remain [intact]; we will fight to protect this program.” •