By Larry Minnix and Connie Garner
A 65-year-old with high cholesterol and a 30-year-old accountant with an affinity for extreme sports may not appear to have much in common. But imagine if our elderly friend suffered a stroke, while the athlete had a surfing accident and wound up paralyzed.
Both could continue leading productive lives. But they and their families would need assistance that they couldn’t have predicted — perhaps someone to cook for them or drive them to work.
Enter a new federal program called the CLASS Act, which will help elderly stroke victims, young adults living with disabilities, and others with similar conditions pay for the personal care they need.
Short for Community Living Assistance Services and Supports, CLASS will fill a gaping hole in our system of caring for the elderly and disabled.
Insurance does not cover many of the most daunting expenses faced by the elderly and those with disabilities — like transportation to and from work, meal delivery, or a home care aide to help with bathing and dressing.
CLASS changes that, by providing cash benefits to those who participate.
Imagine how a daily cash benefit could lighten the burden on an 80-year-old wife caring for her dementia-stricken husband. She could hire an aide for a few hours to take care of her spouse while she went to church or shopped for groceries.
Or consider a young person who is paralyzed who wants to work but needs help getting dressed in the morning. He could use CLASS to hire a caregiver to come each morning and thereby avoid unemployment, isolation, and unnecessary dependence on government programs.
The program is voluntary. Working people can choose to participate in CLASS. If so, the premiums are deducted from their paychecks. After they’ve paid into the system for five years, they become eligible for benefits.
CLASS permits individuals who might otherwise end up in nursing homes to continue living independently in their communities — to the benefit of their psyches and their finances. Or, if they need assisted living or nursing home care, they can use their benefit to help pay for the setting of their choosing.
Indeed, many older adults and people with disabilities have few options aside from checking into a nursing home, which Medicare does not cover. Long-term care insurance is a good option for a few, but many Americans can’t cover the cost or don’t qualify because of pre-existing conditions. And several major insurers may soon stop offering it altogether.
That forces people who can’t pay for nursing care out of pocket to spend themselves into poverty and apply for Medicaid, the joint federal-state health insurance program for the poor.
Medicaid covers nursing home care — but not all home-based care, in most cases, even if it’s more cost-effective.
CLASS helps fix this. Americans will no longer have to impoverish themselves to receive long-term care through Medicaid. Instead, they’ll be able to purchase affordable long-term-care insurance that empowers them to choose the type of care that suits their unique needs.
And by reducing the country’s reliance on Medicaid to pay for long-term care, CLASS will deliver relief to state governments, many of which are struggling under the weight of their Medicaid obligations.
Medicaid already spends more than $100 billion — one-third of its total budget — on long-term services and supports. Such spending is expected to double within 15 years — and triple within 35 years.
CLASS could help curb those rising expenses and limit Medicaid’s role in the long-term care business so that it can focus its resources more directly on the poor.
The nonpartisan Congressional Budget Office concluded as much, writing that CLASS “would generate about $2 billion in savings . . . in the Medicaid program.”
Employers should also welcome the program. CLASS will allow them to offer a valuable benefit to their employees at no cost to the employer. All they have to do is let their employees sign up.
As workers opt in, employers are likely to enjoy rising productivity and lower medical costs. One survey found that half of small businesses say they have been negatively affected by employees dealing with long-term care issues. Many workers are no doubt exhausted and less productive as a result of family caretaking obligations.
Employees caring for an older relative are also more likely to report health problems such as depression, diabetes, hypertension, or heart disease. These issues cost employers an estimated $13.4 billion annually in additional healthcare costs.
The CLASS Act will help Americans, help employers and will save tax dollars in so doing. Lawmakers should support its speedy implementation.
Constance Garner, Ph.D., is the executive director and Larry Minnix is the chairman of Advance CLASS, a national advocacy organization dedicated to the implementation of a strong and vital long-term services and supports program. Ms. Garner is a former staffer of the Senate Health, Education, Labor and Pensions (HELP) Committee, and Mr. Minnix is the president & CEO of the American Association of Homes and Services for the Aging.
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