The Basics

As I mentioned in my last blog entry, the health care reform bill signed by President Obama includes something called Community Living Assistance Services and Supports (CLASS).  CLASS is a voluntary, self-funded insurance program for long-term care services.  People who are working will be able to pay into a fund that will provide ongoing cash benefits should they lose their ability to perform multiple activities of daily living.  A person who receives these benefits gets to decide which nonmedical services and supports he or she needs to maintain independence at home or in another residential setting.

Why do we need CLASS?

We’re not getting any younger.  Long-term supports and services are expensive and most of us don’t have insurance to cover them.  Medicare and most private insurance only pay for a short period of long-term care.  Those who need long-term care often must spend all of their assets until they are eligible for Medicaid (that is, until they are officially poor). 

Today, about five million Americans under age 65 who live in the community have long-term care needs.  More than 70,000 workers with severe disabilities need daily assistance to maintain their jobs.  About 65 percent of people over 65 will need some amount of long-term care services in their homes.  There are now one-and-a-half million Americans in nursing homes, and about nine million seniors who need assistance with activities of daily living.  These numbers are all on the rise.

How does CLASS work?

Anyone who is working can choose to enroll or opt out.  Those who participate pay a monthly premium.  You must pay premiums for five years and work for three years in order to qualify for benefits.  If you come to need help with activities of daily living you will be assessed and, if eligible, begin receiving benefits.  The amount of the benefits depends on your level of need.  CLASS anticipates that the average case benefit will be about $75 per day.  Counseling, coordination and advocacy services to assure receipt of high-quality support services will also be available.

Does CLASS respect disability rights?

Absolutely. CLASS is designed to support choice and independence. Participation is voluntary. Benefits may be used as the person sees fit to support and maintain community living (home modifications, assistive technology, accessible transportation, homemaker services, respite care, personal assistance services, home care aides, nursing support, etc). They may even be used to help a person with disabilities stay on the job. For those with greater needs, benefits can also be used to offset the costs of assisted living and nursing home care.

How can the government afford this program?

All CLASS benefits and administrative costs come from premiums, not taxpayer money. To assure this, the law requires that premiums be set at a level that actuaries certify as self-sustaining. In addition, CLASS will save public money by reducing Medicaid costs. Allowing people to hire their own help and make their own choices lowers the need for expensive, publicly-funded nursing home beds.

So? (And what about that Keep Rockin' reference in the title?)

As a member of the Baby Boom generation, Biden's language does not shock me.  Nor (as is likely true of many Boomers) have I fully embraced fact that old age approacheth.  I've never bought long-term care insurance because it's expensive, it has terms and limitations that are hard to evaluate, and -- to be honest -- I simply don't like thinking about it. 

But now, like Joe Biden, I am excited.  With a touch of this CLASS, my fellow Boomers and I could have the chance to keep on "rockin' in the free world."