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Fiscal Cliff Deal Includes Changes to Elderly Care

The so-called Fiscal Cliff Agreement that passed through Congress on New Year’s Day includes a compromise bill that may affect long-term care services. Nursing home abuse and neglect attorneys highlight this compromise bill, which repealed the CLASS Act and created a new federal commission to submit a proposal for financing and delivering long-term care needs.

To those paying attention, the repeal of the CLASS Act is long-awaited. The Obama Administration abandoned the Act not long after its 2010 creation and it had no champion in Congress. It was a faction of the health care reform law, and was initially intended to create a new, nation-wide, voluntary, long-term care insurance system. In reality, the CLASS Act’s premiums were too expensive for most and did not inspire employer participation.

The fiscal cliff bill, which is actually called the American Taxpayer Relief Act, may be critical to those receiving long-term support and their caregivers, and included 29 further provisions affecting Medicare, Medicaid and other healthcare programs. It traded the CLASS Act for the creation of a national long term care commission, which is expected to design and submit plans for the establishment, financing, and delivery of a comprehensive long-term services system, both for those currently in need of these services and those planning for future needs. The idea of such a commission was pushed for many years by West Virginia Senator Jay Rockefeller (D).

The commission will include 15 members, appointed by the White House as well as bi-partisan leaders of the House and Senate. Members are expected to reflect the interests of care recipients and their caregivers, long-term care insurance companies, state Medicaid administrators, and other care workers and providers.

According to Forbes, however, there are numerous elements of this commission that are extremely disconcerting. First is the extraordinarily limited time frame – panel members have to be chosen within a month, and a comprehensive proposal must be submitted within six months after that. Second, the commission will not be connected to any federal agency, which potentially avoids any bureaucratic politics, although it also means that the commission has no automatic supporters within federal entities. Lastly, and arguably most importantly, the bill does not require Congress to ever actually vote on the recommended changes. This is, apparently, an old political trick, which usually shelves commissions and their proposals, never to be seen or heard from again.

It is a lofty goal, to say the least, to expect a panel of 15 bi-partisan members to create a comprehensive long-term-health care system overhaul in just 6 months. The commission is expected to make recommendations and revisions to improve existing Medicare, Medicaid, and private insurance programs and the availability of long-term care in general. The commission will be working with the Medicare Payment Advisory Commission, among other groups. Currently, participation and adverse selection problems are the top issues plaguing voluntary long-term care insurance.

Nursing home abuse and neglect lawyers hope these fundamental problems will be realized, and that Congress will see to a vote on the commission’s proposal. We are keeping a critical eye on this issue, and will report more when the participating members are announced.

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