Oponents say CLASS remained a part of the Affordable Care Act because the Congressional Budget Office (CBO) estimated in a November
2009 report to Sen. Tom Harkin (D-iowa) that
the Senate’s version of the legislation would
save the government more than $72 billion.
Lawmakers spared it only because it offset
increased Medicaid spending. Supporters say
it was mostly a matter of good timing.
The CBO has from the start said CLASS
would save the government money, but also
keeps changing its forecast. it first quoted
a savings estimate of $72.5 billion, in
a November 2009 letter to Sen.
Tom Harkin, for a 10-year pe-
riod ending in 2019. The
agency in February 2011
said it recalculated the
estimate to $86 billion
based on new infor-
mation. it trimmed
the estimate a
it to $83 bil-
lion after HHS
announced it would implement CLASS in 2013
instead of 2012. in its most recent report on
the issue, released in August, the CBO said it
had reduced its $83 billion savings estimate
but didn’t specify a new number.
Throughout the summer and early fall of 2011, influential
groups continued to advocate for government-run long-term
care insurance, including AARP and LeadingAge, an association of nonprofit groups that provide services to the elderly.
AARP earlier this year had created an online promotional
video that sells the program as if it were underway, even advertising its potential to pay for home modifications for disabled
But resistance continued to stiffen, as well. In early September, a Republican group opposing CLASS said Democrats knew
that the idea was a non-starter before passage of the health
care overhaul, but pressed ahead with it anyway. The Republicans’ report highlighted emails sent by administration and
HHS senior officials, one of which characterized the CLASS
Act as “a recipe for disaster.” Other emails warned that projections underestimated administrative expenses and bloated
savings. The report also cited communications from Foster and
an HHS official detailing the flaws in the projection’s underlying assumptions.
As of late September when this was written, the government’s long-term care insurance program appeared, after 18
months of turmoil, to be dead on arrival.
LIZ SMITH is a freelance journalist who has written for the
New York Times, Reuters, and Bloomberg, as well as other media
outlets. She was also a corporate governance analyst for several
years at Moody’s investors Service.