Op-Ed: Giving Help When it's Most Needed

Op-Ed

Program would help millions pay for long-term care

Born and raised in Norwalk, Sara Baker was living in Arizona the day her phone rang. Her mother, only 57 years old, had suffered a massive stroke, leaving her unable to speak and her right side completely paralyzed.

"There I was," Sara says, "in a state of complete and total lunacy -- getting on a plane with one suitcase" to go home to her ailing mother. "Guess what? I never went back." Her mom's insurance covered two months of therapy at a rehab hospital. Sara visited every day. But after 60 days, her mom was discharged; the insurance company determined that she had made enough "progress." And, like 200 million American adults, Sara Baker's mother didn't have insurance protection in place to handle the long-term costs associated with her illness.

So Sara Baker did what many other Americans have done in her situation. She spent down her modest savings. She went into debt. She went months without working to take care of her mom, helping her with basic tasks like bathing and eating, administering medicine and taking her blood pressure, even renovating the house to make it wheelchair-accessible.

It's a story familiar to more and more families. Ten million Americans are in need of long-term services and support, a number that will increase by nearly half in the next decade.

The average cost of this care is nearly $18,000 a year -- and neither Medicare nor most private insurance plans cover it for the long term.

Sara says that if she hadn't been able to put her own life aside to assist her mom, she would have been forced to either bring in outside help (at even greater cost), or watch her mother's assets be depleted until she could be put into a Medicaid-funded nursing home.

There's a better way. The health care reform we're working on in Congress includes a provision called the Community Living Assistance Services and Supports (CLASS) Act.

The CLASS Act, written by my dear friend Sen. Ted Kennedy before his passing earlier this year, is a national, voluntary insurance program that will help people with functional impairments access the services and supports they need to go about their daily lives. I was honored to see it through the Senate Health Care Committee and hope to get it into the final legislation.

The program would be available to any working American. Participants would pay a modest monthly premium into a "Life Independence Account." They would then become eligible for benefits if they are unable to perform two or more daily activities like getting dressed or bathing, or if they have a cognitive disability that requires hands-on assistance or supervision to perform those activities.

The amount of the benefit would depend on the degree of disability -- but it would be no less than $50 per day. It could be used to pay for a shower chair or wheelchair ramp, or for a part-time caregiver so that a Sara Baker could keep her job, or for a number of other supports and services depending on the individual's need.

That benefit would be there for the recipient as long as they need it; there would be no lifetime or aggregate limits. And, importantly, CLASS benefits would not affect anyone's eligibility for Medicaid, Medicare, Social Security, survivors benefits or any other kind of disability benefits.

Administered on a not-for-profit basis by the Secretary of Health and Human Services, the program would be extremely cost-effective.

In fact, according to the Congressional Budget Office, the CLASS Act would save -- yes, save -- money, reducing the deficit by more than $70 billion over 10 years and producing Medicaid savings for both states and the federal government.

But, more importantly, it would save millions of Americans who need long-term care from having to either spend their life savings, rely on unpaid care provided by family members who would have to give up their own lives, or even live in poverty in order to qualify for Medicaid.

Long-term supports and services allow millions of Americans to maintain their dignity and independence, making it possible for them to live in -- and be vibrant members of -- their communities despite serious functional impairments.

The CLASS Act is a simple, cost-effective and practical step we can take to make this care more available and affordable to these Americans. And it will help to alleviate the burden that falls, sometimes suddenly and without warning, on people like Sara Baker when a loved one requires long-term care.

In the midst of the contentious debate over other aspects of health care reform, this common-sense, bipartisan legislation deserves our attention and support, and I am proud to carry it forward.

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