[Congressional Record Volume 151, Number 143 (Wednesday, November 2, 2005)]
[Senate]
[Pages S12239-S12240]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KENNEDY (for himself and Mr. DeWine):
  S. 1951. A bill to amend the Public Health Service Act to help 
individuals with functional impairments and their families pay for 
services and supports that they need to maximize their functionality 
and independence and have choices about community participation, 
education, and employment, and for other purposes; to the Committee on 
Finance.
  Mr. KENNEDY. Mr. President, it's a privilege to join Senator DeWine 
in introducing this bipartisan legislation to build on the promise and 
possibilities of the Americans with Disabilities Act.
  Our bill, the Community Living Assistance Services and Supports Act--
the CLASS Act--will help large numbers of Americans who struggle 
everyday to live productive lives in their communities.
  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 concept is clear--everyone can contribute and everyone can win. 
We all benefit when no one is left behind.
  For only $30 a month, a person who pays into the program will receive 
either $50 or $100 a day, based on their ability to carry out basic 
daily activities.
  They themselves will decide how this assistance will be spent--on 
transportation so they can stay employed, or on a ramp to make their 
home more accessible, or to cover the cost of a personal care attendant 
or a family caregiver.
  It will help keep families together--instead of being torn apart by 
obstacles that discourage them from staying at home.
  The bill will strengthen job opportunities for people with 
disabilities at a time when 70 percent are unemployed. They have so 
much to contribute and the bill will help them do it.
  It will save on the mushrooming health care costs for Medicaid, the 
Nation's primary insurer of long-term care services, which also forces 
beneficiaries to give up their jobs and live in poverty before they 
become eligible for assistance.
  The CLASS Act is a hopeful new approach to restoring independence and 
choice for millions of these persons and enabling them to take greater 
control of their lives.
  It's time to respect the rights and dignity of all Americans, and I 
look forward to working with Senator DeWine and other colleagues to see 
this bill enacted into law.
  I ask unanimous consent that a summary of the CLASS Act legislation 
be printed in the Record.
  There being no objection, the summary was ordered to be printed in 
the Record, as follows:

  Summary of the DeWine-Kennedy CLASS Act of 2005--(Community Living 
                 Assistance Services and Supports Act)


                          Purpose of the Bill

       To help adults with severe functional impairments obtain 
     the services and supports they need to stay functional and 
     independent, while providing them with choices about 
     community participation, education and employment.


                               background

       Currently there are 10 million Americans in need of long 
     term services and supports, and the number is expected to 
     increase to near 15 million by 2020.
       Most private-sector disability or long-term care insurance 
     plans are constrained in the insurance protection they can 
     offer at an affordable price, and neither Supplemental 
     Security Insurance (SSI) nor Old, Age, Survivors, and 
     Disability Insurance (OASDI) programs have any benefit 
     differentials related to the extent and character of the 
     disability.
       Thus, most Americans who have or develop severe functional 
     impairments can only access coverage for the services 
     critical to their independence (such as housing 
     modifications, assistive technologies, transportation, and 
     personal assistance services), through Medicaid. Their 
     reliance on Medicaid for critical support services creates a 
     strong incentive for them to ``spend down'' assets and remain 
     poor and unemployed. With Medicaid paying 50 percent of the 
     costs of long term services, increased expenditures on long 
     term services are expected to add $44 billion annually to the 
     cost of Medicaid over the next decade.


                      Overview of the Legislation

       The CLASS Act will offer an alternative path. It will 
     create a new national insurance

[[Page S12240]]

     program to help adults who have or develop functional 
     impairments to remain independent, employed, and stay a part 
     of their community.
       Financed through voluntary payroll deductions of $30.00 per 
     month, without enrollment like Medicare Part B, this 
     legislation will help remove barriers to independence and 
     choice, e.g., housing modification, assistive technologies, 
     personal assistance services, transportation, that can be 
     overwhelmingly costly, by providing a cash benefit to those 
     individuals who are unable to perform 2 or more functional 
     activities of daily living.
       The large risk pool to be created by this program approach 
     will make added coverage much more affordable than it is 
     currently, thereby reducing the incentives for people with 
     severe impairments to ``spend down'' to Medicaid. It will 
     give individuals added choice and access to supports without 
     requiring them to become impoverished to qualify.
       The CLASS Act is an important step in the evolution of 
     public policy toward a new focus on helping individuals 
     overcome barriers to independence that they may confront due 
     to severe functional impairments. It is an important 
     extension of concepts embodied in the Individuals with 
     Disabilities Education Act (IDEA), the Americans with 
     Disabilities Act of 1990 (ADA), and Ticket to Work and Work 
     Incentives Improvement Act of 1999.


                         Specifics of the bill

     Scope
       The CLASS Act will establish a national insurance program, 
     financed by voluntary premium payments to be collected 
     through payroll withholding and placed in a ``National 
     Independence Fund.'' The Department of Health and Human 
     Services will manage the Fund as a new insurance program, and 
     may enter into contractual agreements with those entities 
     that states direct to assume administrative/program 
     implementation roles.
     Enrollment in the Program
       Any individual who is at least 18 years old and actively 
     working will be automatically enrolled, unless they opt out, 
     and pay their premiums through payroll deduction or another 
     alternative method. Any non-working spouse may enroll in the 
     program and pay their premiums through an alternative payment 
     procedure.
     Triggering the Benefit
       To qualify for CLASS Act benefits, individuals must be at 
     least 18 years old and have contributed to the program during 
     at least 5 years. Eligibility for benefits will be determined 
     by state disability determination centers and will be limited 
     to: 1. individuals who are unable to perform two or more 
     activities of daily living (ADL) e.g. eating, bathing, 
     dressing, or 2. individuals who have an equivalent cognitive 
     disability that requires supervision or hands-on assistance 
     to perform those activities, e.g. traumatic brain injury, 
     Alzheimer's disease, multiple sclerosis, mental retardation.
     Benefits
       To account for differences in independence support needs, 
     there will be two cash benefit tiers.
       Tier 1 benefits $50/day, will be payable to eligible 
     individuals who are unable to perform 2 or more ADLs or have 
     the equivalent cognitive impairment.
       Tier 2 benefits $100/day, will be payable to individuals 
     who are unable to perform 4 or ore ADL's or have the 
     equivalent cognitive impairment.
       The monthly case benefit will be posted monthly to a debit 
     account or a ``Choice Account''. Individuals who do not use 
     the full monthly amount may roll it over from month to month, 
     but not year to year.
       However, once an individual becomes ineligible for CLASS 
     benefits (by improvement in functional status or death), 
     CLASS Act benefits will cease. Any residual balance of 
     available services remaining on the individual's account will 
     not be payable. If an eligible individual does choose to move 
     into an institutional facility, CLASS Act benefits will be 
     used to defray those associated expenses.
     Relationship of CLASS Act Insurance Program to Social 
         Security Disability Insurance
       Eligibility for CLASS Act benefits will be independent of 
     whether or not an individual is eligible for SSDI, so 
     participation in the CLASS Act insurance program will not 
     impair an individual's ability to remain qualified for SSDI.
     Relationship of CLASS Act Insurance Program to Social 
         Security Retirement Benefits
       Similarly, eligibility for CLASS Act benefits will be 
     independent of retirement benefits eligibility.
     Relationship to Medicaid
       If an individual is eligible for CLASS Act benefits, and 
     are also eligible for the long term care benefit under 
     Medicaid, CLASS Act benefits can be used to offset the costs 
     to Medicaid, thus producing Medicaid savings for the state.
     Relationship to Private Long Term Care Insurance
       The ``Class'' program benefit does not replace the need for 
     basic health insurance--it provides a mechanism to pay for 
     those non-medical expenses that allow a disabled person to 
     remain independent,
       The ``Class'' program benefit can be an addition to long 
     term care insurance. It provides a consistent, basic cash 
     benefit to glove with the insurance products that provide 
     more intense medical services over a shorter period of time.
  Mr. DeWINE. Mr. President, I am pleased to join Senator Kennedy today 
in introducing the Community Living Assistance Services and Supports 
Act--or the CLASS Act.
  Unfortunately, most Americans are not prepared for the costs of long-
term services and supports when they arise. High premiums have 
discouraged many Americans from purchasing long-term care insurance in 
the private market. Furthermore, underwriting practices have excluded 
individuals with existing disabilities from purchasing plans.
  Right now, 10 million people suffer from severe functional 
impairments and by 2020 that number will have increased to 15 million. 
Therefore, in the next 15 years, we will experience a 50 percent growth 
in the number of persons with severe functional impairments. Some of 
those people will be struck suddenly--through accidents or sudden 
illness. And the reality is that any one of us here today could face 
sudden impairment and disability. We won't see it coming until it 
happens, and most of us will not be prepared to provide for necessary, 
long-term care needs.
  Some people may end up with a degenerative disease, such as 
Parkinson's disease, which leads to increased impairments. They may 
know now what their needs will be, but are unable to purchase private 
insurance due to this pre-existing condition. Others will age and 
develop other physical or cognitive impairments, such as Alzheimer's 
disease.
  Although we know that age is inevitable, we are not properly 
preparing for this eventuality or the possibility of sudden accidents 
and many people are financially unable to purchase available insurance 
due to the high price. However, the fact remains that millions of 
Americans will need the services that the CLASS Act seeks to provide.
  The CLASS Act will help Americans to remain independent in their 
communities by creating a new long-term care insurance program. This 
program will be available to all working Americans above the age of 18. 
For only $30 per individual each month, and a minimum of 20 quarters of 
payments, the CLASS Act will help those who do not have adequate long-
term care insurance due to cost or current disability. This bill will 
allow people to choose the supports they need when and if they become 
severely impaired. It will help them remain independent. It will help 
them remain in their communities. It will help them remain with their 
families.
  This is a good bill. I thank Senator Kennedy for his work on this 
bill, and I encourage my colleagues to support it.
                                 ______