New healthcare fight is joined as administration's 2010 law implodes

Congressional Republicans on Monday called for the immediate repeal of a major component of the 2010 healthcare reform law as the issue blew up in the administration’s face.

The seemingly unworkable long-term care benefit contained in the health overhaul has been indefinitely shelved, quickly triggering a new offensive from GOP lawmakers that is expected to put congressional Democrats in a politically awkward position.

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The administration announced late Friday it did not see a way to make the long-term care CLASS Act, which was crafted by the late Sen. Edward Kennedy (D-Mass.), pay for itself. But perhaps even more damning is how the White House mishandled the controversy; consumer advocates accused the administration of being disingenuous and gutless.

Rep. Charles Boustany Jr. (R-La.), the House sponsor of legislation to repeal the program, told The Hill that he is “pushing” Republican leaders “personally” to bring up his bill shortly after the House returns from recess next week. The only Democrat who has co-sponsored Boustany’s legislation is Rep. Daniel Lipinski (Ill.), who voted against healthcare reform last year.

The bill’s Senate sponsor, Sen. John Thune (R-S.D.), also took to the floor to urge quick action.

“Hopefully we can kill this thing once and for all so it doesn’t become a drain on our children and grandchildren,” Thune said.

The growing drumbeat for repeal comes after the White House announced that it is against repeal and remains committed to making the program work.

“We do not support repeal,” said White House spokesman Nick Papas. “Repealing the CLASS Act isn’t necessary or productive. What we should be doing is working together to address the long-term care challenges we face in this country.”

It’s too late for that, Republicans say.

Boustany noted that a letter sent to Congress from Health and Human Services (HHS) Secretary Kathleen Sebelius concluded that she does “not see a viable path forward for CLASS implementation at this time.”

“It puts the Democrats in a very difficult position,” he told The Hill. “They have to decide whether they’re going to do the fiscally responsible thing and repeal the program or support something that is fiscally irresponsible.”

Some Democrats on Capitol Hill might vote against repeal because they want to keep CLASS alive and to support the White House. But others who are facing challenging reelection races — including Sens. Claire McCaskill (Mo.), Joe Manchin (W.Va.), Jon Tester (Mont.) and Ben Nelson (Neb.) — might not use political capital to save a costly program that might never be implemented. 

A key hurdle to repealing CLASS was cleared on Monday when the nonpartisan Congressional Budget Office (CBO) said that eradicating the program wouldn’t cost a penny. 

CBO had scored the long-term care program for people with disabilities as raising $86 billion, or 40 percent of the health law’s $210 billion in deficit reduction over 10 years. 

In a blog post, CBO Director Douglas Elmendorf clarified that last week’s announcement from the administration means those savings are now moot. 

 “Following longstanding procedures,” Elmendorf wrote, “CBO takes new administrative actions into account when analyzing legislation being considered by the Congress — even if it has not published new baseline projections. Beginning immediately, therefore, legislation to repeal the CLASS provisions in current law would be estimated as having no budgetary impact.”

New baseline budget projections due out in January, Elmendorf wrote, “will assume that the program will not be implemented (unless there are changes in law or other actions by the administration that would supersede Friday’s announcement).”

The administration’s move on CLASS has caused plenty of consternation among the program’s advocates.

AARP, a key ally during the healthcare reform fight, released a statement saying the seniors lobby is “disappointed that the secretary has prematurely stated she does not see a path forward to properly implement CLASS.”

Other advocates don’t know what to believe, ripping the administration’s communications strategy. 

Several said an administration official reached out over the weekend to tell them that ubiquitous media reports about the program’s demise were flat-out wrong. 

The administration’s message was received with skepticism by the nonprofit Advance CLASS coalition that is tasked with building private-sector support for the program.

“I feel like somebody just called me about how to do really good pet care after they shot my dog,” said Advance CLASS CEO Larry Minnix.

Advance CLASS Executive Director Connie Garner, a former top health aide to Kennedy, said advocates have been getting “what feels like disingenuous feedback for a while” from the administration.

Asked if she believed officials who now say Friday’s announcement was misinterpreted, she paused. 

“We’re happy if … they think we didn’t hear correctly or whatever they want to say,” Garner said. “We need to hear from the White House that they’re going to move forward on working on this program.”

The White House’s lack of clarity and attacks on the media have only fanned the flames, keeping the CLASS story in the news for weeks. 

Bob Yee, the former CLASS Act actuary who created a firestorm last month when he told colleagues in a widely circulated email that the CLASS Act Office was closing, said he felt vindicated by Friday’s announcement. 

The administration at the time dismissed Yee’s announcement as a false “rumor.”

“I don’t know why they sort of scrambled and said they weren’t shutting down,” he said. “In fact, as is proven now, they’re not working on [CLASS].” 

Yee added that he shared several options with HHS before he was laid off. He said the program could be made to work.

Others agree.

“When I look at their decisions,” said Georgetown health policy expert Judy Feder, “it seems to me they have the analysis that says they can continue. They have the authorities. What they seem to be lacking is the guts.”