By Jason Millman | August 19, 2012 - Excerpted from Politico Pro
Months after the Obama administration said it shut down efforts to implement the fiscally unstable CLASS Act, federal officials have participated in closely guarded, multi-stakeholder conversations about ways to finance long-term care.
In the aftermath of the Obama administration's decision to shut down the troubled health care reform program, policy experts have quietly huddled to ponder policy prescriptions for boosting long-term care coverage. Those discussions, which have explored possible fixes to the CLASS Act, have been attended by federal officials, as well as long-term care advocates, insurance company representatives, actuaries and policy experts, according to participants.
"It's impossible to not talk about CLASS," said Howard Gleckman, an Urban Institute fellow who's been involved in the discussions. "It's the elephant in the room in this thing."
After widespread, bipartisan doubts about the CLASS Act's sustainability, HHS Secretary Kathleen Sebelius announced a halt to the program last October. The administration said it couldn't find a legal way to make the voluntary program solvent for 75 years, as the Affordable Care Act requires, though the actuary hired by the administration to study the program disagreed with the decision.
Gleckman — who confirmed that federal officials participated in the meetings and blogged about their first get together in March — said there's a realization that a coverage mandate for CLASS would likely be politically impossible. But he said there have been discussions about incentivizing enrollment in ways that would "come close enough to mimicking a mandate."
"I think there's a genuine issue about whether or not CLASS could be repaired or whether it's necessary to move on from CLASS and look for other solutions," said Gleckman, who called the CLASS Act "the right idea but badly designed."
Participants wouldn't discuss which federal officials have attended the meetings. HHS did not respond to a request for comment by deadline.
Connie Garner, the former aide to Sen. Ten Kennedy who developed the CLASS Act, has also been part of the group discussions. She said members have talked about the CLASS Act, but the group is focused on finding broad consensus on how to improve long-term care coverage options.
"The issue is not going to go away," Garner said. "CLASS is just one way to think about it. There are other ways, and we're trying to look at all the scenarios that are out there and look at other models."
The group has met twice and plans to meet again this fall, according to Gleckman. The meetings are organized by Steve Schoonveld, who leads the American Academy of Actuaries Long-Term Care Committee.
Schoonveld declined to say whether federal officials have joined in the discussions. Other group members POLITICO spoke with also declined to say who's participating, citing directions from Schoonveld.
Schoonveld said early discussions have centered on principles for developing efficient systems for financing long-term care. Having actuaries present, he said, provides a fiscal check on ideas.
"We're talking about long-term care financing," he said. "It's various sources. It's self-funding, it's Medicaid, it's CLASS Act-like programs, private long-term care insurance and combination products out there," he said.
The group aims to have some concrete proposals ready by early next year.
"Some are going to be definitely new and exciting and not rehashing the ideas from the past," he said.
Multiple efforts have also emerged on the Hill to encourage long-term care coverage as the private market continues to dwindle. Sen. Herb Kohl (D-Wis.), who's retiring after this year, has been trying to gain support for a bill. Rep. Charles Boustany (R-La.), who authored the House bill repealing the CLASS Act, and Rep. Richard Neal (D-Mass.) have talked about possible bipartisan approaches.