The title creates a new voluntary nationwide long term services and supports insurance program for persons with disabilities and seniors with chronic illness. Long term services and supports are the primary unmet health care needs for these populations.
Key goals of the legislation
- Supporting America’s workers and future retirees with a new financing alternative for long term services and supports.
- Promoting individual choice and independence through self-determination.
Premiums
- Premiums are paid by voluntary payroll deductions through employers with an opt-out option by employees.
- Premium levels would be set by the Secretary to be actuarially sound for the long term.Preliminary studies suggest this would on average be around $85-$100 per month.
- Those below poverty will pay no more than $5 per month.
- Younger participants will pay less than older participants.
Qualification for benefits
- Individuals must have contributed monthly premiums for at least five years and have been working during three of those years.
- Individuals unable to perform a specified number (either 2 or 3, as determined by the Secretary) of Activities of Daily Living (ADLs) or have the equivalent cognitive impairment can receive benefits.
Benefits
- Beneficiaries receive a cash benefit based on degree of disability or impairment averaging no less than $50 per day.
- Used to maintain independence at home or in a community residential setting of choice
Relationship with Medicaid and Long-Term Care Insurance
- Would help many individuals avoid going on Medicaid.
- Would provide new opportunities for private long-term care insurance carriers to sell wrap around products and/or their current offerings allow private long term care insurance carriers to offer wrap around insurance to individuals.
Solvency
- CBO concluded CLASS does not cost government a penny over the 10-year period.
- Consistently maintains a positive balance.
- Saves Medicaid $2.5B in the first 10 years alone.
- Legislation mandates HHS secretary to address any changes that need to be made to ensure solvency.