Long-Term Care Patients and the Affordable Health Care Act

In an effort to lower national health care costs and make health services available to more people, the federal government enacted new programs under the Patient Protection and Affordable Care Act of 2010. One of the programs underway involves extending federally-funded long-term care benefits beyond those offered through Medicare's health insurance program. The official start of the program begins in 2013.

The CLASS Act

• The Patient Protection and Affordable Care Act of 2010 incorporates another act -- known as the Community Living Assistance Services and Support (CLASS) Act -- to help address the needs of long-term patients who prefer to be cared for at home. Through the CLASS Act, patients have access to insurance coverage that helps pay some of the costs associated with home care services. The CLASS Act program is designed to work as a consumer-financed insurance plan where premiums are paid through payroll deductions made during an individual's time in the workforce.

Eligibility

• In order to become eligible for long-term home care benefits under the Patient Protection and Affordable Care and CLASS Acts, a worker must contribute to the program for five years and be an active workforce participant for three of the five years. According to the National Center for Policy Analysis, eligible long-term care patients must meet certain qualification requirements in terms of physical limitations, which must persist for at least 90 days. In terms of physical limitations, a person must be unable to perform two daily living activities on their own in order to qualify for benefits under the program. Daily living activities include essential tasks such as cooking, bathing or using the bathroom.

Long-Term Care Benefits

• Eligible long-term care patients receive a minimum of $50 a day in cash benefits depending on the types of home care services needed. According to the National Center for Policy Analysis, actual benefit amounts are figured according to a sliding scale that's based on the number of years a person has worked and the amount of payroll contributions made into the program. While Medicare insurance does cover medically-necessary, home care services, the CLASS Act provides coverages that include non-medically related services, such as daily living care. Long-term care benefits are also inflation-sensitive, so benefit amounts will increase according to inflation rates.

Considerations

• As far as health care services go, the benefits available through the Affordable Care Act provide long-term care patients with alternative options aside from nursing home and hospice care. As a self-funded program, monies taken in during the early years will actually go towards government operations, with the Federal Treasury replacing any used funds, according to the National Center for Policy Analysis. As the program progresses, the U.S. Congressional Budget Office estimates the program will pay out more in benefits than it takes in by its 20th year. In effect, funding deficits may result in additional taxes or an increase in the national debt.