The C.L.A.S.S. Act (Community Living Assistance Services and Support. To transform the way people pay for long-term care. Participants would receive daily benefits. They could use this money for home care adult day programs, or assisted living or nursing homes.

It creates a national insurance trust that people can voluntarily participate in. It's a publicly sponsored insurance plan. You have to pay premiums that will be average around $65 a month for five years before you can draw benefits. It will be self-funding.

While Medicaid already pays for some of the same services, you have to be really sick and really poor to qualify. The plan allows you to have no more than $2,000 in assets plus your house, which they will put a lien on when you die for reimbursement of your care. This plan has been proposed as a way of easing the burdens of middle class families.

The bill was introduced this summer by Senators Edward Kennedy and Tom Harkin and Representatives John Dingell and Frank Pallone.

In the Press Release on the bill they said that there are currently 10 million Americans in need of long-term care services. It quotes Sen. Kennedy, "Too many Americans are perfectly capable of living a life in the community, but are denied the supports they need. They languish in needless circumstances with no choice about how or where to obtain these services.Too often, they have to give up the American Dream – the dignity of a job, a home, and a family – so they can qualify for Medicaid, the only program that will support them. The bill we propose is a long overdue effort to offer greater dignity, greater hope, and greater opportunity. It makes a simple pact with all Americans – ‘If you work hard and contribute, society will take care of you when you fall on hard times.’”

The right price for home health care

Editorial in yesterday's NY Times

Health care reformers have long advocated providing more care to patients in their own homes or communities instead of hospitals and nursing homes.

"So it is disturbing to learn that charges have risen well above reasonable levels in one segment of the home health care market — short-term care provided to Medicare beneficiaries after, or sometimes instead of, hospitalization. The problem is compounded by fraud."

The overpayment problem is exacerbated by fraud and manipulation. These included overstating a beneficiary’s condition to get an improperly high reimbursement, billing for patients who were not homebound, and making unnecessary visits.

Some of the worst abuses were in Texas and Florida.