Kennedy's disability plan could snag health bill

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By Jennifer Haberkorn

An insurance plan championed by Sen. Edward M. Kennedy that would help elderly or disabled people avoid nursing homes ironically adds yet another sticking point to the comprehensive health care reform plans for which the Massachusetts Democrat fought through much of his career.

The Community Living Services and Support (CLASS) Act is designed to help those who need assistance with basic daily tasks pay for in-home assistance. But moderate Democrats and Republicans worry about the plan's impact on the deficit and the potential for saddling the federal government with the responsibility of another insurance program.

Sen. Kent Conrad, North Dakota Democrat and chairman of the Budget Committee, has called the act a Ponzi scheme.

Under the proposal in the House-passed version of the overhaul, the CLASS Act fund would collect monthly premiums, estimated to be $65 in 2011, from the wages of all working Americans, unless they elect to opt out - a technique used to help drive participation.

Once they pay premiums for five years, participants would be eligible for cash benefits to help them buy in-home care, if they can no longer care for themselves. Participants would qualify if they could no longer do two of life's basic tasks on their own, such as eating, showering and dressing.

Mr. Kennedy first proposed the act years ago and later included it in the comprehensive reform bill that his Senate health committee passed a month before he died in August.

"We must pass the CLASS Act and create a long-term care infrastructure in this country that will support every American's choice to live at home and be part of their community," he said in November 2006. "Every older or disabled American has this right, and it's our job in Congress to provide them with the support they need to make this a reality."

But budget hawks warn that cost estimates for the program by the Congressional Budget Office (CBO), Congress' nonpartisan budget-keeper, don't look far enough into the future, when they expect benefit requests will far outweigh revenue.

"While the goals of the CLASS Act are laudable - finding a way to provide long-term care insurance to individuals - the effects of including this legislation in the merged Senate bill would not be fiscally responsible for several reasons," several senators wrote late last month in a letter to Senate Majority Leader Harry Reid, Nevada Democrat, asking him to keep the act out of the bill he sends to the Senate floor.

"Nearly all the savings result from the fact that the initial payout of benefits wouldn't begin until 2016, even though the program begins collecting premiums in 2011," wrote the group, which includes Mr. Conrad and Democratic Sens. Mary L. Landrieu of Louisiana, Evan Bayh of Indiana, Blanche Lincoln of Arkansas, Ben Nelson of Nebraska and Mark Warner of Virginia, as well as Connecticut independent Joe Lieberman.