CBO expects delay in new healthcare program

The Obama administration will likely fall a year behind schedule in implementing a controversial piece of healthcare reform, according to the Congressional Budget Office (CBO).

The budget update that CBO released Wednesday assumes a one-year delay in the law’s new insurance program for long-term care. The program — Community Living Assistance Services and Supports, or CLASS — has faced serious skepticism ever since its inclusion in the healthcare overhaul.

Under the healthcare law, CLASS is slated to begin collecting premiums next year. But CBO said Wednesday that "based on the pace of implementation actions thus far," it doesn’t expect the program to start taking in money until 2013. As recently as March, the budget office was still projecting that CLASS premiums would begin rolling in next year.

The CLASS program collects premiums for several years before it begins paying out benefits, but stakeholders have still raised questions about whether it will ultimately be able to sustain itself. 

Republicans have been particularly critical of the CLASS program, which helped offset the cost of the healthcare law because it only collects money for most of the 10-year window that CBO uses to score legislation. They see it as an accounting gimmick, but aides have also acknowledged that the same on-paper savings would make it difficult to repeal.

Officials in the Health and Human Services Department have acknowledged concerns about the CLASS program and said they’re considering changes to ensure its solvency. Administration on Aging Secretary Kathy Greenlee told a House committee earlier this year that HHS won’t implement CLASS unless the department is sure the program will be self-sustaining.

But even some of HHS’s proposals to fix the CLASS program have raised eyebrows. State lawmakers recently questioned whether HHS might have to raise premiums to the point that relatively healthy people don’t want to participate.

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