NCOA supports CLASS Act health reform proposal

National Council on AgingOct 31 2009

At a briefing by the Leadership Council of Aging Organizations today in Washington, DC, James Firman, President of the National Council on Aging (NCOA), applauded the House for making the CLASS Act (Community Living Assistance Services and Supports) part of its Affordable Health Care for America Act and urged the Senate to include the CLASS Act and other important long-term care provisions in its final package as well.

Firman called long-term care, "the primary unmet health need for seniors."

"Without strong provisions addressing long-term care," he said, "health care reform will not be truly comprehensive and meaningful. Our current system forces people into institutions inappropriately, requires many middle class families to spend-down into poverty before receiving the help they need, and doesn't support family caregivers adequately."

Firman said NCOA supports the CLASS Act, and noted, "We are in good company." More than 130 national organizations have signed on to support the provision. And a survey in late June by Lake Research Partners found that almost eight out of ten Americans (79%) say they would be more likely to support a health reform proposal that includes improved coverage for home and community-based long-term care services.

A fiscally sound proposal, the CLASS Act promotes independence by helping seniors and people with disabilities pay for care in their own homes rather than going prematurely into a nursing home to obtain care covered by Medicaid. The Act promotes consumer choice, because recipients can use the cash benefits as they see fit, controlling what services they get, how, and from whom.

Other important provisions in the House bill increase funding for family caregiver support programs and strengthen programs for direct care workers. There are also important provisions in the Senate Finance Committee legislation, but not in the House bill that advance home and community-based services. The Community First Choice provisions would enable more Medicaid beneficiaries to remain in their communities by providing a state plan option for community-based attendant supports and services to individuals with disabilities.

The Finance bill also includes language from the Home and Community Balanced Incentives Act, which would similarly provide ways to increase access to home and community-based services through a targeted increase in the federal Medicaid match for states that adopt best practices shown to have increased institutional diversion. Furthermore, the bill includes important protection against spousal impoverishment in Medicaid programs by requiring states to apply the same rules currently applied to spouses of Medicaid nursing home residents. The Elder Justice Act, also part of the Finance offering, represents the first national response to the growing epidemic of elder abuse. NCOA hopes that these important provisions are included in the merged Senate bill, and ultimately the final health care package.

In this debate, women are especially at risk. With longer life expectancies, higher rates of disability and chronic health problems, and lower incomes on average than men, millions of women cannot afford long term care and would benefit from the CLASS Act and other long term care provisions.

These policies also support families by helping people with disabilities continue to work, and employers by reducing absenteeism among the fast-growing pool of employees caring for a disabled family member. It can also relieve some of the pressure on employers to contribute to the cost of long-term care insurance.