Reform of long-term health insurance needed for secure countryBy Rich Robinson | 03/11/2014 11:00pm
The AARP reports that 89 percent of Americans age 50 and above would rather live in their homes than give up control of their lives to a nursing home, but a significant percentage of them will not be able to do that. Some will not have families able to give them around-the-clock care, and so they will be sent to nursing home settings.
This is an inherently personal decision that all families should be able to make. Unfortunately, economic realities and current insurance coverage rules prevent that choice from happening for far too many of our nation’s elderly and disabled.
There are nearly 40 million people in the United States over the age of 65 – 12.9 percent of the population. A large number of them will not be prepared to pay long-term care costs if their health requires it. Many insurance plans do not cover long-term care costs.
In addition, more than 12 million citizens of all ages have “functional impairments” that require some level of personal assistance and other long-term support. The pressing need for national long-term care reform is becoming more and more urgent. All we have to do is look to our sunny neighbors to the south for an illustrative case study.
The failure of the federal government to step up and make a real difference in this area has allowed states like Florida to “warehouse” hundreds of disabled children in nursing homes intended for the elderly. In these nursing home settings, many children and young adults have little to no family or social interactions and basically wither on the vine.
It is also far more costly for families and government in the long run. Unum, an insurance company, estimates the average annual amount paid for home care to be $35,635 while private nursing home care costs $81,400.
The American taxpayer pays 62 percent of private nursing home costs for the 12 million Americans that require long-term care, more than $130 billion per year through the Medicaid program. This is outrageous and needs to be curtailed.
I propose a robust federal response to this growing human and fiscal crisis. First, Congress should revive the Community Living Assistance Services and Supports Act, while fixing its former solvency problems and adding other provisions that serve as a strong tool for America’s disabled community.
The CLASS Act was a major component of the Affordable Care Act championed by Senator Ted Kennedy. It was designed as a “self-funded and voluntary” program that put additional choices in the hands of health care consumers while helping lower Medicaid spending in the long term. The CLASS Act was not perfect, but it offered the biggest step forward toward a better long-term care system in America.
We should reform it and make it work with affordable premiums geared toward getting young people into the pool to sustain payouts for older individuals. No one should be turned away due to a pre-existing condition, and the work requirement should be lifted for those deemed unable to do so by existing federal programs. Family members should also be able to set up joint accounts for those unable to work. There should be no lifetime caps, and unused money should roll over to the next year in a personal savings account.
In addition to the new CLASS Act, there also needs to be additional federal oversight of state level “warehousing” policies with a tough enforcement provision.
These reforms can ensure a more secure America. Let’s make the tough decisions now before we have to make the impossible ones later.
Rich Robinson is a junior majoring in telecommunication and film. His column runs biweekly on Tuesdays.