WASHINGTON BUREAU — The head of a long term care insurance trade group says industry participants should act quickly to explain the weaknesses of a proposed federal LTC program.
The private LTC insurance industry already can provide better coverage for a lower cost, says Jesse Slome, executive director of the American Association for Long-Term Care Insurance, Westlake Village, Calif.
On the Internet, “millions of people will read that President Obama supports a federal LTC plan and will say ‘I’ll wait,’” Slome says.
But “this is no time for the industry to be silent,” Slome says. “This is a time for the industry to speak out because we have over 8 million policyholders and several hundred thousand people who buy insurance every year and tens of thousands of insurance agents who also want to know what the future means for them.”
Sen. Edward Kennedy, D-Mass., has put the Community Living Assistance Services and Supports Act, or CLASS Act, proposal in Section 191 of the Affordable Health Choices Act, the Kennedy-Dodd health bill draft.
The CLASS Act proposal would create an optional LTC program that would pay a minimum benefit of $50 per day. To qualify for benefits, an enrollee would have to pay premiums for at least 5 years. A successful claimant would have to be unable to perform “at least 2 or 3 activities of daily living,” drafters say. Workers who wanted to avoid paying the premiums could opt out of the program.
The average premium would be limited to $65 per month in 2011 and indexed for inflation in later years.
The initial $65 premium is actually a $780-per-year premium, Slome says.
“By contrast,” he says, “we just issued our annual prime index, which shows that a 55-year-old would pay $723 a year for a $100 a day benefit.”
That is an average, he says, for an individual who is married, who has a spouse who buys the same contract, and who qualifies for the good health discount.
“So, in essence a large majority of consumers can get far more protection for comparable cost, and the Congressional Budget Office tell us that the federal plan is likely to be underpriced,” Slome says.
The CLASS program would be “a legislators’ dream, because you have taxpayer income for 5 years with zero expenses,” Slome says. “What legislator wouldn’t favor a plan that has the potential to bring in billions of dollars of income with zero risk of expenses guaranteed for a 5-year window?”
The problem, he says, “is that after 5 years, the claims are going to begin, and if [the program] attracts people who have a likelihood of health conditions, the claims will start immediately and will escalate exponentially. So that what they are doing is creating an entitlement plan that will never be adequately funded and will burden future generations with an enormous tax liability.”