CLASS Act (part of health care bill) means new $100-200 payroll tax each month?

[Robor]

Pretty soon the only way you are going to be able to stay in charge of your own life is to be self employed where you can control just how much income the Feds think you make.

Didn't you get the memo? Obama and his evil henchmen are going to kill all small businesses.

 

[Fern]

I can think of a very good reason why not to add it it Medicare: because the Medicare pay-in is mandatory and this pay-in is voluntary. What if not everyone wants to pay for insurance for home assisted living?

- wolf

Medicare/Medicaid already pays for people to live in assisted care facilities. It seems the point here is that it doesn't pay for people to get assisted care in their own homes.

Presumably, some people would prefer to stay in their own homes instead of being forced to move to a facility. So the question is why not change Medicare/Medicaid to allow for that?

ATM, the only rational reason would seem to be cost. But, having done the accounting/taxes for assisted care facilities, it's not clear to me that providing that care in someone's home is more expensive.

I've checked an ademic paper ( http://www.ahcancal.org/ncal/resources/Documents/MedicaidAssistedLivingReport.pdf ) and states' rates, as one might expect, are all over the place. Some exceed the $75, and by a good margin. I would think these variations are to be expected, and at least partially attributable to the various the cost-of-living found in different locales.

Seems to me existing Medicare/Medicaid money can be used for this purpose (paying for in-home care instead of forcing people to relocate to a care facility).

I'm starting to get the impression that a chunk of this bill is designed to force standardization of medicaid among the states. That begs the question "why".

Fern

 

[woolfe9999]

Medicare/Medicaid already pays for people to live in assisted care facilities. It seems the point here is that it doesn't pay for people to get assisted care in their own homes.

Presumably, some people would prefer to stay in their own homes instead of being forced to move to a facility. So the question is why not change Medicare/Medicaid to allow for that?

ATM, the only rational reason would seem to be cost. But, having done the accounting/taxes for assisted care facilities, it's not clear to me that providing that care in someone's home is more expensive.

I've checked an ademic paper ( http://www.ahcancal.org/ncal/resources/Documents/MedicaidAssistedLivingReport.pdf ) and states' rates, as one might expect, are all over the place. Some exceed the $75, and by a good margin. I would think these variations are to be expected, and at least partially attributable to the various the cost-of-living found in different locales.

Seems to me existing Medicare/Medicaid money can be used for this purpose (paying for in-home care instead of forcing people to relocate to a care facility).

I'm starting to get the impression that a chunk of this bill is designed to force standardization of medicaid among the states. That begs the question "why".

Fern

Individual nursing care, particularly if it is 24 hour care, is generally far more expensive than in-patient facilities. More than likely the $75 per day (which is an estimate of a variable figure) is not intended to cover the entire cost, which Medicare/Medicaid does do for in-patient. Accordingly, if you added this in to Medicare and set it to cover everything, lots of people would opt for personalized in home care and it would up the cost of the system.

This program appears to be aimed at appealling mainly to middle to upper middle class people. People don't usually plan ahead for stuff like this, and lower income people won't want to pay the premiums. For higher income people, this is an insurance policy that will defray the cost of at-home care, which relatively speaking, is kind of a luxory compared to in-patient care. As such, it isn't something that should be covered under a mandatory program.

- wolf

 

[Fern]

Individual nursing care, particularly if it is 24 hour care, is generally far more expensive than in-patient facilities. More than likely the $75 per day (which is an estimate of a variable figure) is not intended to cover the entire cost, which Medicare/Medicaid does do for in-patient. Accordingly, if you added this in to Medicare and set it to cover everything, lots of people would opt for personalized in home care and it would up the cost of the system.

This program appears to be aimed at appealling mainly to middle to upper middle class people. People don't usually plan ahead for stuff like this, and lower income people won't want to pay the premiums. For higher income people, this is an insurance policy that will defray the cost of at-home care, which relatively speaking, is kind of a luxory compared to in-patient care. As such, it isn't something that should be covered under a mandatory program.

- wolf

This is not nursing care in the 'technical sense' - like an RN. This program is for "assistance in eating, bathing or dressing in their old age" according to the article.

I'll drop it here saying this stuff is rather technical and arcane. I've helped assisted care facilities with their license applications renewals etc, I'm no expert but have come to understand a bit. E.g., depending on you size (measured by # of beds in the facility) and state, there are different requirements for staff, including their licensing (or lack thereof), the number of hrs of their presence required, and the tasks they are required to perform etc.

Yes, a nurse (RN) would be terribly expensive, but RN's do not do such tasks as bathing and dressing. Those tasks, here in NC, are performed by the lowest level unlicensed workers. Handing out prescription medication? Yeah, that's the RN.

Fern

 

[Ozoned]

We had to pass the bill to find out what is in it...

 

[Patranus]

It isn't a "tax" if the deductions are voluntary.

- wolf

I take it you default to being opted in instead of being opted out.

 

[OutHouse]

We had to pass the bill to find out what is in it...

quoted for truth.

 

[paperfist]

I hope I don't have to match employee funds for this or everyone's getting fired!

 

[joeboggs]

Medicare/Medicaid already pays for people to live in assisted care facilities.

Medicaid only pays for assisted living if you divest yourself of all assets and sign your house over to the government so you can qualify by getting below the poverty line. If you have any assets at all you are ineligible for Medicaid LTC benefits.

The CLASS deal sounds like a gov't run LTC program except it's considerably more expensive than a private plan and likely has much lower benefits. Yay gov't!