The first Health Wonk Review of 2013 is up at Wright on Health, and it’s an excellent edition – great artwork too! I will admit that I haven’t followed all of the details of the fiscal cliff leadup and eventual deal very closely, so I wasn’t aware until I read this post in the HWR that the ACA provision for long term care (Community Living Assistance Services and Supports, aka “CLASS”) was officially killed as part of the fiscal cliff negotiations. It isn’t really surprising, given that it’s been more than a year since CLASS was suspended amid growing concerns that it just wasn’t going to be financially viable. Even when CLASS was first discussed (albeit briefly) in the news when the ACA was in its early days, the most common criticism was that there was no way it was going to work from a money standpoint. So all in all, the decision to do away with it is not surprising and doesn’t really change much of anything. But it’s still a bit sad and alarming. As the baby boomers age, our country is looking at rapidly increasing long term care expenditures over the next several decades. Most people don’t have private long term care insurance, and a lot of people are under the misconception that Medicare will cover their long term care needs. I would say that it’s reasonable to assume that we could be heading towards a looming problem with long term care expenses, similar to what the country has been dealing with in terms of health care costs over the past decade or so.
CLASS wasn’t going to be financially viable, and the first try just didn’t work. But that doesn’t mean we can just forget about it and move on. One way or another, long term care costs have to be addressed relatively soon. My prediction is that a new bill will be crafted in the next couple of years to create a solution similar to CLASS but hopefully with a more solid financial groundwork. But I think lawmakers might wait until 2014 – after the ACA has been more fully implemented and health insurance coverage is more widespread than it is today – to take action.