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No one wants nursing home care.  For many middle-income Americans, the Kennedy plan could be just enough to allow them to stay at home or to afford assisted living care.  Medicare generally covers home care only for a short period following hospitalization, and few people can afford long-term care insurance.

Life Care Planning, Estate Protection, Disability,
VA & Medicaid Assistance Lawyers

ObamaCare and Long-Term Care Insurance

President Barack Obama has given his support to a proposal for new national long-term care insurance program that would offer extremely limited yet basic help for the elderly and disabled. The President's support is a huge step in the right direction and could be key to making long-term care coverage a part of the final health reform legislation.

 

Proposed by Sen. Edward M. Kennedy (D-MA) as part of his health care reform bill, the plan would set up a new, voluntary social insurance program to help people insure against the high costs of long-term care. Americans would pay a premium of roughly $65 per month, although the Congressional Budget Office has said the premium could end up being as much as $110 a month -- still far less than the typical monthly cost of private long-term care insurance.  After participants had contributed for at least five years, they would be eligible for a benefit of not less than $50 a day to cover long-term care costs.

 

All working Americans would automatically be enrolled in Kennedy's plan, known as the Community Living Assistance Services and Supports (CLASS) Act, but they could choose to opt out. Students and the poor would pay only $5 a month.

 

While the $50 daily benefit is extremely modest compared to the average cost of nursing home care (that can be as much as $150 per day or more in southern Illinois), it could be used instead to pay for a range of services that would help people remain in their homes.

 

Supporters of the CLASS act say the insurance program could help ease some of the pressure on Medicaid by helping the elderly and disabled stay in their homes. Nationally, Medicaid pays most of the nation's nursing home bills; this is particularly true in southern Illinois.

 

"You can't really reform health care without addressing long-term care," said Larry Minnix, CEO of the American Association of Homes and Services for the Aging (which represents non-profit care providers).

 

In a letter to Kennedy, Health and Human Services Secretary Kathleen Sebelius said that President Obama considers the long-term care program an "innovative" idea that should be "part of health reform." She went on to say "Enactment of this important legislation would expand resources available to individuals and families to purchase long-term services and supports to enable them to remain in their own homes in the community."

 

No one wants nursing home care.  For many middle-income Americans, the Kennedy plan could be just enough to allow them to stay at home or to afford assisted living care.  Medicare generally covers home care only for a short period following hospitalization, and few people can afford long-term care insurance. (In 2006, private insurance - including Medicare supplemental policies as well as long-term care insurance - covered only 9 percent of the $180 billion spent on long-term care, according to the Kaiser Family Foundation.)

 

This means, that if people want to stay home, for the most part they must pay out-of-pocket.  Medicaid programs have been expanded to include home health care coverage in many states.  But consumers must wade through a patchwork of programs and qualify for Medicaid coverage, which has different rules in every state.  Most states, like Illinois, have long waiting lists and do not provide adequate funding.  Consequently, many elderly or disabled individuals end up in nursing homes at government expense when all they actually need is help around the house or home nurse visits.

 

Sen. Kennedy's proposal for a broad-based insurance plan for long-term care will help address the huge challenges millions of seniors and their families face every day. In addition, it should be politically palatable because it does not replace the long-term care insurance market; seniors who can afford the monthly premiums and want insurance to pay for all of their care will still prefer to purchase long-term care insurance.

 

            Richard Habiger is an elder care attorney, who focuses on asset protection, Medicaid and VA benefits, Alzheimer's and life care planning  -  all in collaboration with a multi-disciplinary staff that includes attorneys, social workers, nurses and benefits specialists.  You may contact him at 618-549-4529 or Richard@HabigerElderLaw.com.

 

 


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1808 Clark Street, Carterville, Illinois 62918
Phone: 618-985-4529
Toll Free: 800-336-4529

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1808 Clark Street
Carterville, Illinois 62918
Phone: (618) 985-4529