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Senate passes healthcare bill

Contemporary Long-Term Care Weekly, December 31, 2009

The Senate voted shortly after 7 a.m. on Thursday, December 24, to pass a sweeping healthcare reform bill, taking one step closer to reinventing our nation’s ailing healthcare system. The bill, which is known as the Patient Protection and Affordable Care Act, passed with a 60-39 party-line vote.

The bill, if passed as is, would overhaul many aspects of the healthcare industry, including long-term care. One noteworthy long-term care provision included in both the Senate and House bills is the Community Living Assistance Services and Support (CLASS) Act, which was originally introduced by the late Senator Edward Kennedy. The CLASS Act would make long-term care insurance available to all Americans, who would be automatically enrolled with the choice to opt out. Individuals would begin paying a premium immediately and, after five years, those with functional limitations have the option of receiving a cash benefit of around $50 a day that can be used to offset the cost of long-term care services. The ability to immediately begin collecting premiums with a delay in paying benefits makes the plan extremely attractive from a budget standpoint, but opponents of the program are concerned about its cost down the road.

Other long-term care related provisions in the Senate bill would reduce the SNF market basket update and adjust for productivity, require SNFs to disclose information regarding ownership, accountability, and expenditures, and shrink the size of the Medicare Part D coverage gap for prescriptions, known as the doughnut hole.

The bill would also require most Americans to have health insurance, expand Medicaid coverage, and establish federal standards and rules for health insurance companies.

The Congressional Budget Office (CBO) estimates that the Senate bill would cost approximately $871 billion over ten years. However, the cost would be largely offset by taxes, fees, and savings from Medicare and Medicaid included in the bill. The CBO estimates that the Senate bill would reduce the deficit by $132 billion over ten years.

The road to passing the Senate healthcare reform bill has not been easy and the battle is far from over. The Senate and House still have to reconcile the differences between their two versions before drafting the final bill to be sent to the president.

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