House Votes to Kill LTCI Provision of Affordable Care Act

February 01, 2012 at 03:44 PM
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The U.S. House of Representatives voted 267 to 159 today to repeal the CLASS Program, a component of the Patient Protection and Affordable Care Act.

Not one Republicans voted to keep CLASS, and 23 Democrats crossed party lines to vote for H.R. 1173, the "Fiscal Responsibility and Retirement Security Act of 2011." 

The bill's chances in the Senate, which is controlled by Democrats, are far less certain. 

H.R. 1173, sponsored by Rep. Charles Boustany, R-La., would repeal CLASS, aka, the Community Living Assistance Services and Supports program—a government-run voluntary long-term care (LTC) program that scored by the Congressional Budget Office as cutting the deficit by more than $80-plus billion over a 10-year period.  

Lawmakers included the CLASS program in the act to honor the late Sen. Edward Kennedy, D-Mass., who had worked for decades to try to improve the U.S. LTC safety net. But critics in the LTC insurance community argued from the beginning that the combination of voluntary participation and loose underwriting rules would make the program unsustainable.

The CLASS program was due to begin enrollment in October 2012, however, U.S. Department of Health and Human Services Secretary Kathleen Sebelius seemingly halted its implementation in an letter to Congress sent in October 2011 after determining they could not meet the statutory requirement that the program be actuarially sound over 75 years.  At that point it was said that the actuaries had left the building, figuratively and literally.

The decisive House repeal brought immediate reaction from the agent and producer lobby as well as from consumer groups.

The parameters of the program were such that only "those who were already in need of benefits would likely be attracted to apply, causing premiums to rise to the point where healthy individuals would be discouraged from enrolling thereby creating the classic adverse selection scenario," the Big I said. This lobbying group and others said the act would lead to a death spiral that would drive the program into insolvency.  

"Today's action by the House was an important step toward full repeal of this ill-advised program and we urge the Senate to follow suit," says Charles Symington, Big "I" senior vice president of government affairs.

 "From its inception, this program set a dangerous precedent for massive government intervention in the private market. Now that the Administration has been forced to abandon it, the good public policy course of action is to repeal this program so it cannot be revived at some later time."

 "Once again, the Republicans are punishing the American people in an attempt to hurt President Obama politically, even if that means repealing the only health reform provision that could someday help seniors and people with disabilities live independently and stay out of nursing homes," stated Ethan Rome, executive director of Health Care for America Now (HCAN).

However, members of the House Ways and Means Committee agreed two weeks ago at a markup on H.R. 1173 that they have to do something else about long-term care.

 Some Republicans then talked about their own parents' experiences with LTC and said they care deeply about developing an alternative to the CLASS program. 

Boustany, a medical doctor, said that he had treated hundreds of patients who needed LTC and that he had had to help get LTC for two of his own family members.

One solution to reforming the system would be to change the laws governing private LTCI, Boustany said.

"It's simple math: while two-thirds of the population is likely to need long-term care, few seniors can independently afford the staggering private cost of nursing homes and assisted-living facilities. Half of retirees have less than $55,000 in assets, and nursing homes charge about $75,000 each year," Rome pointed out. 

Nearly one-third of Medicaid spending goes to long-term care. 

House Energy and Commerce Committee Chairman Fred Upton, R-MI, urged the Senate to follow the House's action and repeal the measure.

"I believe we have to start over on long-term care reform—an issue that will affect millions of Americans as they or a loved one need care. But first, we must erase a program that we know will not work; a program that was never structured to work, and that we could never afford," Upton stated.

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