Cokie and Steven Roberts
We are the lucky ones. Not only are we blessed with two mothers in their 90s — we are doubly blessed with mothers whose resources cover their care. That's not the norm in America, where the aging population's need for long-term care imposes harsh economic as well as emotional stress on many families. A provision of the health-care bill aims to offer some relief to those families, and we're all for it.
The Community Living Assistance Services and Supports Act, called CLASS, was one of Teddy Kennedy's pet proposals in recent years. It's a simple idea. Workers would voluntarily pay into a fund for at least five years and then be able to draw from it if they become disabled by age or illness. A daily stipend tied to the degree of disability, to be set by the secretary of Health and Human Services but probably starting at about $75, would go for whatever was needed — someone helping out at home, transportation to senior daycare, installation of handicap-friendly devices — allowing many individuals to remain in their communities and out of costly nursing homes.
For people who aren't as lucky as we are, that's often the only choice. Their parents or a disabled relative might need assistance in eating, bathing, dressing or moving from a chair to the bathroom. A small stipend can make all the difference. It can mean an elderly person gets to stay at home with some assistance getting dressed and fed. It can mean family caretakers get to keep their jobs if someone can cover for them at home in the hours they are away from a live-in parent.
As it is now, in order to receive care, many disabled and elderly people are forced to divest themselves of all their assets so they can qualify for government assistance through the Medicaid program. And in many places, that means moving to a nursing home. We taxpayers are footing the bill for those nursing homes, which usually run about $200 a day. Under the long-term-care plan now before the Congress, the people who receive the care pay for it. Premiums would be automatically deducted from paychecks unless a worker makes a positive determination to opt out of the program. And the law as drafted by the Senate specifically states, "No taxpayer funds shall be used for payment of benefits." The program is designed to pay for itself through premiums and interest on the trust fund generated by those premiums, which can't be touched for five years.
In the first 10 years of the program, the Congressional Budget Office expects the CLASS provisions to add about $72 billion to the federal coffers — a huge chunk of change tempting to lawmakers who would use it to draw down the deficit. That's a legitimate fear, given the congressional track record on other trust funds. And a Sense of the Senate amendment insisting that the CLASS fund should not be used for anything other than long-term care doesn't do much to quell the skeptics who believe the program will eventually grow into a massive budget-buster.
And those skeptics abound, some of them spurred on by the insurance companies that sell long-term-care policies. Despite language passed by the Senate that requires CLASS to stay sound over a 75-year period, critics insist that the program is bound to go broke when the number of people who need long-term care, now about 10 million, more than doubles with the retirement of the baby boomers. Premiums will go so high in order to keep up with benefits, they argue, that no one will buy them so taxpayers will have to subsidize them.
There are lots of reasons to believe that won't happen. But even if it did, it would be no worse for taxpayers than what's happening right now. We are paying about $100 billion a year for long-term care through Medicaid, and that number is going to go geometrically higher if no other provision is made for people who need help. How can forcing people into poverty so the government can pay for them be better than setting up a program where workers pay for themselves? How can pushing people into nursing homes be better than letting them stay in their houses? As a caller to a public radio program on the CLASS plan asked, "Why not try something where I can exercise my own responsibility for my future?"
Why not, indeed? Then his children, too, could be among the lucky ones.
Steve Roberts' new book, "From Every End of This Earth" (HarperCollins), was published this fall. Steve and Cokie Roberts can be contacted by e-mail at email@example.com.