tH E R E ’ S A N O B S E R V A T I O N T H A T R I N G S T R U E for those of us who work within the Washington Belt way: It can take 10 to 15 years for a significant reform proposal to be developed, drafted, negotiated, revised, debated, and revised again before it ever has a chance of becoming policy. Creating public policy (for the most part) is about carefully honed compromises. It’s about learning from the successes and failures of others and crafting solutions that reflect those lessons in new and creative ways. It’s about working passionately and doggedly to convince people that a solution is the solution. And ultimately, it comes down to trial and error. While some people decried the speed with which the Patient Protection and Affordable Care Act of 2010 (ACA) was formed, debated, and passed, most policy experts believe that he most recent process for health care reform got its impetus in the early 1990s under then President Clinton. That experience—its achievements as well as its mistakes—undoubtedly affected the processes, negotiations, and compromises that led to the passage of the ACA. As they say, if one approach doesn’t work, try, try again. It looks like it’s time to start trying again when it comes to reforming the provision of long-term care in this country. When the late Sen. Edward kennedy (D-Mass.) introduced the Community Living As- sistance Services and Supports (CLASS) Act in 2009, it immediately became an integral (if somewhat controversial) part of the broader debate over health care reform. But the process for creating the CLASS program to improve long-term care service delivery and financing dates back to 2003 when Sen. kennedy’s staff first began on a bipartisan basis to draft long- term care legislation. The goal of the legislation was to provide a program that would make long-term care services affordable and accessible. The version of CLASS that was included in the ACA was voluntary, limited eligibility for the program to working adults, and required the program to be actuarially sound. It offered a minimum average cash benefit of $50 per day, auto enrollment aking the Long View on Long-term care reform 24 CONTINGENCIES JUL | AUG. 12 WWW.CONTINGENCIES.ORG
SHUTTERSTOCK / BONOTOM STUDIO INC.
By Heather Jerbi
With the
eclipse of the
CLASS Act,
it’s back to the
drawing board
to find another
way to address
the problem
of making
long-term care
health coverage
affordable and
accessible.
