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Concord Coalition Warns That New Entitlement Is Not a Valid Health Care Reform Offset
Date:10/7/2009

ow of $57 billion through 2019.(1) On paper, this sum would count as an offset against other provisions of health care reform. However, this money is not a savings. It represents premiums that would be needed to pay benefits once the five-year vesting period ends.

Once benefit payments begin in 2016 the annual cash surplus would rapidly dwindle. The CBO cautioned that, "Beyond the 10-year window, the effects of the program could be quite different and CBO expects that the HHS Secretary would need to reduce benefit payments and increase premiums to maintain the program's solvency."(2)

CBO further observed, "If premiums and benefits were set in subsequent years so as to draw down some of that accumulated [trust fund] balance, the program's outlays after 2019 would exceed its premium income."(3)

In other words, it would become a net drain on the budget.

"It would be the height of budget gimmickry to use a new health care entitlement to 'offset' new spending on health care subsidies. This kind of short-term thinking and sleight of hand is what got us into the fiscal hole we're in. Creating yet another federal trust fund with phantom pre-funding is not the way to get us out of that hole," Bixby said.

Two versions of the CLASS Act are contained in pending health care legislation. The House version, included in the Energy and Commerce Committee's health care bill, authorizes creation of the program and leaves it up to the Secretary of Health and Human Services (HHS) to set premium and benefit levels. The Senate version, included in the Health, Education, Labor, and Pensions Committee's bill (Section 191 of S. 1679) requires a minimum average daily benefit of $50. It would guarantee coverage without exclusion for pre-existing conditions and allow enrollees to opt in and out of the program. Benefits would begin after a five-year vesting period.

Both bills require the program be actuarially sound. Yet, desp
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SOURCE The Concord Coalition
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