Long-Term Care On Life Support As House GOP Passes Repeal Of CLASS Act

February 1, 2012 2:06 p.m.

“Where is your heart?” cried Rep. Bill Pascrell (D-NJ). “Have you no heart?”

Despite the congressman’s plaintive objections during Wednesday’s House debate, his Republican colleagues passed a bill 267-159 to repeal the ill-fated CLASS Act. The Community Living Assistance Services and Supports program, championed by the late Ted Kennedy, aimed to provide a long-term care insurance program. Wednesday’s party-line vote deepens a partisan stalemate over how to fill that major hole in the U.S. health care system, as the legislation now goes to the Senate where it’s expected to perish.

The impasse in a nutshell: The Obama administration conceded last October that it saw no viable path to implement CLASS within its statute, citing financial solvency problems. But the President and his Democratic allies oppose repealing the program and would rather repair it. Republicans, who decry CLASS as costly, unworkable and predicated on a budget gimmick, have no intention of letting that happen. They’re insisting on outright repeal and say Congress must start from scratch on the long-term care problem — although they haven’t yet offered an alternative.“We need to address the growing cost of long-term care services. We will now begin that process,” said Rep. Phil Gingrey (R-GA), sponsor of the repeal bill. “But first we must take this section out of the health care bill known as CLASS. We must take it off the books.”

On the House floor, Democrats accused the GOP of running away from the problem itself and seeking to score political points by attacking the Affordable Care Act. They argued that repealing CLASS would be a step backward for the nation’s long-term care problem.

“We should mend the CLASS Act, not end it,” said Rep. Frank Pallone (D-NJ). He called out Republicans for “taking a stance against CLASS without proposing any solutions for long-term care in America.”

CLASS was designed as a voluntary long-term care insurance program wherein working adults who enroll and pay premiums for 5 years can subsequently enjoy regular cash benefits to pay for non-medical community living or institutional services, if they suffer from impairments ranging from Alzheimer’s disease to less life-threatening medical conditions. The benefit would vary based on the level of the beneficiary’s disabilities.

About ten million Americans are in need of long-term care, according to estimates, and that number is expected to rise to 15 million in 2020. The main alternative to CLASS for these services is Medicaid, which means repeal will more rapidly grow the burden on the low-income safety net program, a fact that multiple Democrats pointed out Wednesday during the debate.

CLASS’s political back-story is uncomfortable for Democrats. Congressional Republicans months ago uncovered evidence that even before the Affordable Care Act was enacted, Obama administration officials were aware that CLASS, as written, was problematic. “Seems like a recipe for disaster to me,” wrote one official in an email. Meanwhile, Sen. Kent Conrad (D-ND) publicly — and famously — called CLASS a “Ponzi scheme of the first order.”

Gingrey became annoyed with Democrats for offering amendments aimed at neutering his bill. “Admit your failure. Get over it,” he told them. “Vote to repeal this failed CLASS Act, and live to fight another day.”

After the Obama administration said CLASS would not be implemented in its current form, the Congressional Budget Office announced that repealing it would have no budgetary impact.

The poison pill that ultimately sank CLASS into its present coma was placed by former Sen. Judd Gregg (R-NH) — an amendment that required the program to be certified as fully self-financed for 75 years before it went into effect. Gregg told The Washington Post‘s Sarah Kliff after CLASS fell that he got what he wanted.

So what’s next for long-term care legislation this year? Not much. CLASS repeal isn’t likely to go far in the Senate, nor are the two sides poised to strike an agreement to amend the program.

For the time being election politics will guide the issue. The GOP has gone all in on repealing the health care law, and slicing off the CLASS Act gives them a tangible victory they can take to their constituents. President Obama and Democrats have already faced criticism from seniors groups like the influential AARP for halting its implementation, and don’t want to upset them any further by letting Republicans kill it.

Image from stefanlunardi/ Shutterstock

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