Long-Term Services and Supports:
In Health Reform
The health reform law that President Obama signed includes several provisions that will help expand access to appropriate and affordable long-term services. These include incentives for states to expand home- and community-based services in Medicaid, a new voluntary long-term services insurance program that will be available to all working Americans, and other programs that will extend existing grants or demonstrations, increase care coordination, and increase the long-term care workforce.
Recent Developments
The American Tax Relief Act of 2012 (the legislation that came out of the fiscal cliff deal), signed into law on January 2, 2013, repealed the Community Living Assistance Services and Supports (CLASS) Act, a voluntary, national long-term care insurance program created by the Affordable Care Act and established a Commission on Long-Term Care. Implementation of the CLASS Act was suspended on October 12, 2011, in response to an actuarial and legal analysis of the program conducted by HHS. The Commission is responsible conducting a comprehensive evaluation of current access to long-term care, examining workforce issues, and developing a comprehensive plan to establish, implement, and finance a coordinated long-term services and supports delivery system. The Commission will be comprised of 15 members, appointed within 30 days of the enactment of the Tax Relief Act.
Latest from Families USA:
The Health Care Law: Good News for Caregivers discusses how the health care law will help build the long-term care workforce, encourage states to expand home- and community-based services in Medicaid, improve resources for caregivers, and expand protections for people in long-term care facilities. | The Affordable Care Act: Provisions that Will Help Caregivers (March 2011)
Protecting Seniors and People with Disabilities: Why It Is Important to Preserve the Maintenance of Effort Requirement in the Affordable Care Act discusses how stripping the maintenance of effort requirement from the ACA will have negative consequences for the many people who depend on Medicaid by allowing states to change eligibility requirements. (February 2011) | State Reports
Better Safety and Quality for Seniors and People with Disabilities discusses the Elder Justice Act, the Patient Safety and Abuse Prevention Act, and the Nursing Home Transparency and Improvement Act, three sections in the Affordable Care Act that will bring historic improvements to the quality and safety of long-term care and result in the most comprehensive federal effort ever to fight elder abuse. (October 2010)
Help for Those Who Need Long-Term Care describes how the Affordable Care Act will help more people stay in their homes or the community (rather than an institution) and why this help is needed. (September 2010)
Health Reform Provisions that Expand Access to Home- and Community-Based Services (HCBS) briefly outlines key provisions, including the State Balancing Incentive Payments Program, the Community First Choice Option, and Changes to the Medicaid 1915(i) option. (September 2010)
Long-Term Services: Health Reform Provisions summarizes the key provisions of the new health reform law that affect long-term services, including a new home care program, a new voluntary long-term care insurance program, and changes to existing programs that expand eligibility and make other improvements. l pdf version (May 2010)
Helping People with Long-Term Health Care Needs: Improving Access to Home- and Community-Based Services in Medicaid discusses how health reform gives states incentives to strengthen home- and community-based services in Medicaid. (October 2009, Updated April 2010)
Helping People with Long-Term Health Care Needs: An Insurance Program to Help People Afford Long-Term Services and Supports discusses the Community Living Assistance for Services and Supports (CLASS) program, a new, voluntary, public long-term services insurance program that is part of health reform. (October 2009, Updated April 2010)
A Summary of the New Health Reform Law describes the major changes in health coverage that health reform will bring, including Medicaid and CHIP coverage, the affordability provisions, the exchanges, individual and employer responsibility requirements, improvements in private market coverage, and changes to Medicare and long-term services. (April 2010)
From the Alliance for Health Reform:
Long-Term Services and Supports: A Rebalancing Act is a briefing that answers the following questions: Are there sufficient home- and community-based programs in all states to address the aging population? How can incentives in the Affordable Care Act be used to develop new approaches to long-term services? And how effective are existing federal initiatives to promote care in home- and community-based settings? A podcast, transcript, and webcast are available. (October 2011)
From the Congressional Research Service:
Community Living Assistance Services and Supports (CLASS) Provisions in the Patient Protection and Affordable Care Act (PPACA) is a detailed review of the CLASS Program, including a projected implementation schedule. (June 4, 2010)
From the Kaiser Family Foundation:
Implementation Timeline is an online, interactive tool that explains how and when provisions of the health reform law will be implemented over the next several years. The provisions covered in the timeline span all areas of the health care system, including the Children’s Health Insurance Program (CHIP), Medicaid, Medicare, minority health, the private insurance market, and long-term supports and services. (December 2010)
Medicaid Long-Term Services and Supports: Key Changes in the Health Reform Law outlines several provisions, such as the expansion of the home- and community-based services state plan option, the community first choice option, and the CLASS program. Implementation of these provisions presents a new opportunity for states to expand access to home- and community-based services in Medicaid. (June 2010)
Health Care Reform and the CLASS Act describes the major components of the CLASS program, including eligibility, benefits, financing, and its interaction with Medicaid. Going forward, it will be important to monitor the affordability of premiums, the adequacy of benefits, and participation rates, as these factors will determine the solvency of the program. (April 2010)
From the National Academy for State Health Policy:
Long-Term Services and Supports and Chronic Care Coordination: Policy Advances Enacted by the Patient Protection and Affordable Care Act provides an overview of the policy changes organized into five categories: national insurance for long-term services and supports (LTSS), Medicaid options and incentives to expand LTSS, chronic care coordination, nursing home reforms, and other LTSS provisions. (April 2010)
