With the Obama adinistration forced to give up on the Community Living Assistance Service and Supports (CLASS) program created in the Affordable Care Act, the choruses of "I told you so" from Obamacare opponents have begun.
To be fair, it should be acknowledged that there were many in Congress who were against this program from the outset. They did not believe that a government-sponsored, self-sustaining, long-term care insurance program was going to work and did not wish to see money wasted in attempting to form what they believed would ultimately be a failed effort. There are also those who believe that the only reason the program was included in Obamacare, given their presumption that the administration knew it could not work, was that it would allow the pro-healthcare forces to load up their deficit reduction forecasts by some $80 billion as a result of pretending that the government would be collecting premiums from the long-term healthcare policies sold to consumers signing up for the program. These were premiums for policies the opponents did not believe would ever be sold.
These arguments, which have seeds of truth in varying degrees with respect to CLASS, will no-doubt turn out to be useful for politicians who want to pursue the false claim that the failure of this one program reveals the inevitable failure of Obamacare. Of course, suggesting this is entirely disingenuous, as the inability to make CLASS work in no way speaks to other elements of the law that are presently working out pretty well and those which remain to be proven as successes or failures.
It's all good stuff for short term GOP political talking points but very bad news for anyone who takes a long-term view of the public's needs and for those who actually would like to respond and prepare for what we know is a pending crisis. The idea behind CLASS was for the government to create a long-term health care policy that would provide certain benefits to Americans at the time when they find themselves in need of nursing home care or in-home medical services. Concerned that the government would end up subsidizing such a program, both Democrats and Republicans in Congress forced a provision into the law which required that the program prove that it could sustain itself for 70 years without the benefit of government subsidies.
What the Department of Health and Human Services discovered in attempting to pull the program together was that younger Americans were simply not likely to participate. The concept of thinking about one's long-term health care needs, particularly in difficult economic times, was just too remote for younger consumers. Understandably, young immortals simply cannot see the value of spending the money to buy protection for something that may or may not come to pass well into the future, particularly at a time when they are struggling to keep up financially.
The inability to attract the young into the insurance pool left only those with reason to anticipate the need for long-term care in the near future as the likely customers of the program. Clearly, this is not the most desirable customer, particularly when the insurance pool cannot be balanced out by younger participants who are unlikely to call upon their benefits for many years. This reality pretty much guaranteed that either the program would go broke, sooner rather than later, or the premium costs would have to be so high that pretty much nobody could afford to purchase the product. Either way, the idea turned into a non-starter.
While those who are out to destroy healthcare reform—or out to destroy Obama using healthcare reform as a weapon to do so—will celebrate the situation, they really shouldn't.
Indeed, in exchange for scoring some near-term political points, Congressional Republicans, and some Democrats, are exposing their own parents—and possibly their children, should a disability become a part of their life—to a very serious problem. While members of Congress are able to purchase a federally sponsored long-term care policy for themselves and their spouses, their parents and children are not beneficiaries. And given that 70% of all Americans over 65 will require long-term medical care at some point in their lives, there are a lot of congressional parents who are going to face this serious problem in the not too distant future when they are forced to struggle to pay for needed care like the rest of us.
What's more, had the very idea of a self-sustaining (no government subsidies), long-term care insurance program been offered up by anyone other than Obama, we could expect the Republicans to be all for it, just like they were once all for the idea of mandated health insurance—until the current administration supported the idea.
As things currently stand, the wealthy are able to handle their long-term health care needs either by purchasing the insurance policies covering care of this nature in the private market or simply paying the bills when the time comes that they require this extra medical attention. The poor are also in fairly decent shape on long-term care as Medicaid provides this benefit to its beneficiaries.
However, Medicare does not provide long-term care benefits. And that means that it is the middle-class who find themselves in a big problem when it comes to paying for the nursing or in-home care that can become necessary in old age or when someone finds that they are incapacitated at a younger age.
So what happens? Those who have too much money to qualify for Medicaid but not enough to handle these costs on their own for the long haul, end up spending what they have until they no longer have enough. At that point, they turn to Medicaid and, because they now qualify having spent everything on paying their own nursing home or in-home care bills, the government, through the Medicaid program, ends up paying the tab.
Thus, the failure of CLASS is bad for government spending and bad for the majority of Americans who will, someday, need long-term health care services.
So, who won? Certainly not the great American middle-class taxpayer.
Most of us will still face a very serious problem when it comes to paying for the long-term care so many of us will inevitably need. And while the GOP and Fox Newsies will crow that they have struck a blow against Obamacare, as usual these people will be ignoring the fac that the day is coming when they, too, will be hurt as a result of the failure of this program.
I hope some of those who will celebrate this failure have some ideas to offer. Like it or not, we are all going to be in the same boat when it comes to figuring out how to get the care we need when we get old, and Fox News and the Tea Party won't be of much help then.