inside Track LiNDA MALLON
Stop the Presses
i Like BReAkiNG Ne WS AS MUCH AS THe Nex T PeRSON (well, maybe more than the next person).
But it sure can make life challenging.
This issue of Contingencies features a package of stories related to long-term care in general and the Community Living
Assistance Services and Supports (CLASS) program in particular. Goosed by the aging of the U.S. population, the need
for long-term care has exploded in recent years—as has the financial pressure on Medicaid, which accounts for the largest
portion of total national spending on long-term care.
Included as part of the Affordable Care Act (ACA), passed by
Congress in 2010, CLASS was charged with providing voluntary
long-term care insurance for all comers, without regard to age
and degree of disability. Under the law, anyone who is employed
and earning enough to qualify for Social Security taxes would
be eligible to enroll in the government-administered program.
The assumption was that a government-sponsored long-term
care insurance program not only could protect Americans from
impoverishing themselves to pay for long-term care but also
take some of the pressure off the beleaguered Medicaid system.
It’s a noble concept. But many actuaries and policymakers
found the CLASS program, as it was enacted, to be a poor solution.
In a 2009 letter commenting on the Senate version of
CLASS, a joint work group of the Academy’s Federal Long-Term
Care Task Force and the Society of Actuaries’ Long-Term Care
Insurance Section Council questioned the program’s actuarial
soundness, warning that CLASS would experience significant
adverse selection. In his own report in 2010, Richard Foster,
chief actuary of the Centers for Medicare & Medicaid Services,
warned that older and more disabled people would burden the
plan from the start and price out healthier working people, creating a continuous negative cycle.
When I assigned veteran journalist Liz Smith the task of
writing about CLASS last spring, I knew that the long deadlines
required by a bimonthly magazine were going to be a hurdle.
Liz got her story to me in August, as promised, for November
publication. Having seen the CLASS program survive a close
call earlier in the summer when it was targeted by the Senate’s
“Gang of Six” as part of proposed spending cuts, Liz was careful
in her description of the program’s future prospects. Neither
of us, however, anticipated the actions of the Department of
Health and Human Services (HHS), which in mid-September
reduced staff in the office working on the implementation of
I got wind of HHS’ action fairly quickly (it never hurts to
keep up with sources, or with those who can connect you to
sources). Liz and I worked together to update and rewrite certain sections, turning it around in time to get the revised version
to the magazine’s graphic designers without major disruptions
to the production schedule.
Now I’m just holding my breath. Having caveated everything six ways from Sunday, there’s not a lot more that we
can do. As I write this I still can make minor last-minute
changes (for maybe another couple of days), but once the
magazine goes to the printer, those changes become costly
In classic movies about the newspaper biz, there’s
always the dramatic moment when the grizzled editor-in-chief bellows “Stop the presses” into the telephone
connecting him with the pressroom. There’s less drama in an electronic age when a story can be updated
with a few keystrokes. But for those of us who work
on print publications, the old rules still apply.
Once the ship has sailed, all you can do
iSTOCk PHOTO / DReAMSTiMe