A crisis looms concerning long-term care for individuals with disabilities. Very soon large numbers of baby boomers will begin to develop arthritis, Alzheimer’s and other conditions requiring them to seek assistance with basic daily tasks.
A potential first step towards addressing this problem—CLASS (Community Living Assistance Services and Supports)—is unlikely to be implemented. Established as part of the Affordable Health Care Act, CLASS was intended to be a voluntary insurance plan providing funds for community-based support services. It could also have been used to help pay nursing home expenses.
Last month, though, the U.S. Department of Health and Human Services announced that it would suspend efforts to implement the program because it could not identify means of making it economically viable. Supporters have demanded that the program be revived, while detractors have called for its formal repeal. Given the current political and economic climate, its future looks dim.
Although far from offering a complete solution to the nation’s long-term care dilemma, it would have provided a reasonable level of insurance, enabling many people to continue living at home longer and offering an important alternative to Medicaid.
Today, the top reason that my clients enter nursing homes is that they cannot afford to pay for in-home supports. Their unattractive alternative is to spend down assets in order to qualify for Medicaid, which will cover nursing home costs. The irony is that while community-based services are a far less costly option, there are few public funds available to pay for them.
In the past, family members have often been unpaid caregivers for aging parents, but some studies estimate that up to 25 percent of baby boomers are childless. Add to that the geographic and career mobility that have characterized recent decades and it’s clear that traditional caregiver options will not be available to many seniors in the future.
The U.S. needs to develop a viable long-term care policy. CLASS had the potential to be a partial solution to a huge national problem. Hopefully Congress will find some way to revive CLASS as an economically feasible program or develop an alternative.