House Democrats' unity tested over CLASS Act repeal vote

House Democrats face their first test of unity over a key provision of their healthcare reform law next week when legislation to repeal the long-term care CLASS Act comes up for a vote.

Republicans are trying to capitalize on the program's demise after the Obama administration announced last month that it could not find a way to make it work. The House will get that ball rolling on Tuesday when the Energy and Commerce health subcommittee marks up repeal legislation.

A Republican effort to kill the program failed in the Senate last week after Sen. Jay Rockefeller (D-W.Va.) blocked a request by Sen. John Thune (R-S.D.) for unanimous consent to move to a vote on repeal.

ADVERTISEMENT
Democrats face a potential lose-lose situation: vote for repeal and implicitly acknowledge that their health law contained a fatally flawed program; vote against, and open up to criticism that they're in denial.

"It puts the Democrats in a very difficult position," Rep. Charles Boustany (R-La.), the bill's sponsor, told The Hill recently. "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."

The White House is formally opposed to repeal. Health and Human Services Secretary Kathleen Sebelius has said that the department cannot find a way forward "at this time," and Congress' nonpartisan budget scorekeeper has eliminated projected savings from the program as a result.

Advocates for the elderly and people with disabilities have so far focused their lobbying efforts on the administration, but a number of groups will be sending Energy and Commerce members a letter on Monday urging them not to kill the program. 

Former Ted Kennedy (D-Mass.) aide Constance Garner, one of the architects of the law who's now leading efforts to build private-sector support for it, said the program creates a structure that can be tweaked but should not be eliminated.

"What we'd like to see is that it not be repealed," Garner said, "and for a period of time that (the administration) continue to go forward with the work that they were required to do (under the law)."

Proponents of the program say long-term care in the United States is gravely deficient, with only about 8 percent of Americans buying long-term care insurance. Many seniors instead end up relying on the cash-strapped Medicaid program for low-income Americans when they become disabled.

The Community Living Assistance Services and Supports program called for the creation of a daily cash benefit for people with disabilities to help them continue living at home. Beneficiaries would have had to pay monthly premiums for five years to qualify but structuring the program in a way that didn't attract a preponderance of people most likely to need it quickly was always going to be difficult.

Garner said most Democratic lawmakers and their staffers remain committed to the program, even as many bemoan the way the administration has handled things.

The repeal bill is expected to sail through the Energy and Commerce panel Tuesday and hit the floor shortly thereafter. Only 11 Democrats sit on the panel, versus 16 Republicans.

Its top Democrat, Rep. Frank Pallone (D-N.J.), sponsored the CLASS Act in the House and remains a strong champion. And a spokeswoman for Rep. Lois Capps (D-Calif.) told The Hill she'd be voting against repeal too.

Panel member Jim Matheson (D-Utah), however, announced last month that he'd vote for repeal. Matheson voted against the healthcare reform law in 2010 and against the Republican bill to repeal it in January.

More in Healthcare

Health officials turn over 19,000 ObamaCare documents

Read more »