Review the Patient Protection and Affordable Care Act (CLASS)

The Patient Protection and Affordable Care Act, signed into law by President Barack Obama will enable Americans to better budget and plan for senior care and have an insurance program to pay for the costs.

Today, senior with no personal assets to pay for senior care must spend-down to poverty level to qualify for Medicaid health insurance, which will only pay for long-term care in a Medicaid nursing home.  Review this new law below to understand how the Community Living Assistance Services and Supports will assist seniors to pay for care in their own homes or in assisted living communities.  Nursing home care can cost as much as $350 per day and in-home senior care costs from $16 - $26 per hour.  You may find the daily prices of nursing homes nationwide in Caregiverlist's Nursing Home Star-Rating Directory.

Community Living Assistance Services and Supports (CLASS)

The Persistent Long-term Care Gap

• Long-term supports and services are not affordable or accessible for millions of Americans
• An estimated 65% of those who are 65 in the year 2011 will spend some time at home in need of long-term care services, at an average cost of $18,000 per year, according to the Department of Health and Human Services.
• 5 million people under age 65 living in the community have long-term care needs and over 70,000 workers with severe disabilities need daily assistance to maintain their jobs and their independence.
• 1 1/2 million people are in nursing homes today.  Roughly 9 million elderly Americans will need help with activities of daily living (ADL's) during the current year, and by 2030 that number will increase to 14 million.
• Many people who need long-term care services and supports rely on unpaid family and friends to provide that care, but ultimately are forced to impoverish themselves to qualify for medicaid, which remains the primary payer for these services.

How the CLASS (Community Living Assistance Services and Supports) Program Works

• The CLASS Act will provide a lifetime cash benefit that offers people with disabilities some protection against the costs of paying for long-term care services and supports, and helps them remain in their homes and communities.
• CLASS is a voluntary, self-funded, insurance program with enrollment for people who are currently employed.  Affordable premiums will be paid through payroll deductions if an individual's employer decides to participate in the program.  Participation by workers is entirely VOLUNTARY.
• Self-employed people or those whose employers do not offer the benefit will also be able to join the CLASS program through a government payment mechanism.
• Individuals qualify to receive benefits when they need help with certain activities of daily living, have paid premiums for 5 years, and have worked at least 3 of those 5 years.
• Beneficiaries receive a lifetime cash benefit based on the degree of impairment, which is expected to average roughly $75 a day or more than $27,000 per year.
• Benefits can be used to maintain independence at home or in the community, and should be sufficient to cover typical costs of home care services or adult day care.
• Benefits also can be used to offset the costs of assistive living and nursing home care.

How the Improved Version of the CLASS Act Protects Taxpayers

• All CLASS Act benefits are paid by voluntary participants, not taxpayers.
• CLASS actually will save taxpayer dollars by reducing Medicaid costs.
• CLASS premiums must be set at a level sufficient to guarantee actuarial soundness.
• The current CLASS Act includes significant improvements over earlier versions, such as tighter eligibility standards, a new reserve requirement, and an absolute prohibition on the use of taxpayer dollars to pay benefits.
• The Congressional Budget Office determined that the improved program is actuarially sound.

The CLASS Act would begin on January 1, 2014.  The new healthcare law also has a component for preventive care to be included in new health insurance policies.  As many senior illnesses are caused by lack of exercise and unhealthy diets, this measure was added in an effort to promote healthier lifestyles which would result in healthier seniors.  Hospitals and nursing homes spend significant dollars on investing in both equipment and personnel and insurance in order to properly transfer overweight patients and residents.