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Revamp for CLASS Act program: Sebelius

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WASHINGTON—A series of “tough” changes are coming for a major new public insurance program.

The Community Living Assistance Services and Supports Act program, which is a long-term-care insurance program authorized by the health care reform law that will provide cash benefits to qualified beneficiaries, will need changes to ensure its “fiscal sustainability,” said Health and Human Services Secretary Kathleen Sebelius.

“It would be irresponsible to ignore the concerns about the CLASS program's long-term sustainability in its current form,” said Ms. Sebelius at a Monday discussion on long-term care at the Washington office of the Kaiser Family Foundation, a health reform advocacy group.

The changes to the program she described—expected through regulations—included indexing premiums to projected benefits; offering a range of payments instead of a single $50 daily payment indexed to inflation; changing earnings and employment qualifications; and ending “loopholes” that allow beneficiaries to receive payments even if they only sporadically pay premiums.

Republican critics blasted the long-term disability program during Congress' consideration of the health care overhaul as a new unfunded entitlement. The Congressional Budget Office estimated “tens of billions of dollars” in future deficit costs every decade beyond beneficiaries' premium payments. President Barack Obama's deficit commission in December also recommended repealing or overhauling the program because of its cost.

The program will begin accepting premium payments in 2012 and paying out benefits in 2017.

Rich Daly is a reporter for Modern Healthcare, a sister publication of Business Insurance.