Kaiser Health News: The Community Living Assistance Services and Supports (CLASS) Act program, a provision of the health reform law, "establishes a voluntary, long-term care program that will provide cash to enrollees who suffer at least two limitations in daily activities, such as eating, bathing and dressing. … There are about 10 million Americans who need long-term care services, including 4 million under age 65."
"Under the terms of the health law, the CLASS program has to pay for itself through premiums and cannot be subsidized by the government. Keeping the program solvent, CBO said, hinges on enrollment of healthy individuals" (Meyer, 4/15).
Stateline.org: "It is well known that nearly all seniors and adults with disabilities want to remain in their homes as long as possible, and it's vastly cheaper for states to provide the help – meals, bathing and dressing, and other home services – that allows them to do so rather than resort to institutionalization."
But "here's the problem: Medicaid -- which pays nearly 50 percent of all nursing home bills in the country and 40 percent of all long-term care -- is biased in favor of institutional care. When seniors qualify financially and are deemed to need care, Medicaid funding for a nursing home bed is guaranteed. But for those who want to remain at home, funding is only a possibility and a national shortage of home health providers often means long delays." The new law gives states incentive to reduce the costs of long-term care (Vestal, 4/15).