Uninsured and Disabled? The New Healthcare Law May Help
Many people who apply for social security disability benefits have no health insurance, and many of these people need long term care. More than 10 million Americans need long-term care and over 60% of them are 65 or older. Long-term care, which includes receiving help with bathing, dressing, eating, using the toilet, and getting in and out of bed, is a necessity for anyone – old or young – who becomes disabled. Unfortunately, few people are prepared to cover the cost of long-term care. On March 23, 2010, the President signed the Patient Protection and Affordable Care Act, establishing a national, voluntary insurance program for purchasing community living services and supports. This program, which is known as the Community Living Assistance Services and Supports program (CLASS), is designed to offset the cost of long-term care services for aging populations and people with disabilities. Individuals are enrolled in the program automatically but have the choice to opt out. Monthly premiums are automatically deducted from workers' accounts. How Much Are the Monthly Deductions? Enrollees will have an average of $150 to $240 deducted from their paychecks each month. The amount of the deduction is based on the enrollee's age and salary. Who Is Eligible for Benefits? Adults who have multiple functional limitations or cognitive impairments are eligible for benefits if they have paid the monthly premiums for at least five years and have been employed for at least three of those five years. The CLASS act does not require the screening of patients for health problems, so even those who do not qualify for private health insurance programs may enroll. What Are the Benefits? Enrollees in the CLASS program receive a cash benefit averaging no less than $50 per day that can be used to offset the cost of long-term care services. The amount of the cash benefit is based on the degree of the impairment or disability. The cash benefit can be used to purchase non-medical services and supports. It can also be used towards payments for institutional care. Although the CLASS program is not designed to cover the entire cost of long-term care, it lifts much of the burden. Beneficiaries can choose the kind of care that best suits their needs, whether that means adaptations to their home, assistance from a home care aide, or participation in an adult day program. Supporters of the CLASS program claim that it will help people with disabilities stay in their homes instead of enter nursing homes. What Are Critics Saying about the CLASS Act? Critics say that people who have existing health problems will sign up for the CLASS program in droves, paying such low premiums that the program would eventually collapse. They argue that the program will not have enough money in it to cover problems several years down the line. Both critics and supporters of the program agree that there have to be enough healthy people in the program in order for it to work because otherwise, the premiums would become so expensive that the program would not be an attractive option for anyone. Eventually, the premiums will have to be based on the number of people enrolled in the program if it is to sustain itself.