Long-Term Care Faces Tough Time in Congress

THE JOURNAL RECORD, March 16, 1994 | Go to article overview

Long-Term Care Faces Tough Time in Congress


WASHINGTON _ For John C. Rother, the chief lobbyist for the American Association of Retired People (AARP), President Clinton's call for a new program to help finance long-term health care was the fulfillment of a dream.

"We were overjoyed that the president had included a bold, constructive and historic start," Rother said of his reaction to Clinton's decision to include long-term care in the health care reform plan he proposed last year.

Tess Canja, an AARP board member, added that long-term care was the organization's "No. 1 priority." She said: "We were overjoyed with the president's proposal."

But as Congress last week began writing a health care bill, Rother said long-term care now faces an uncertain fate.

"It's silly to predict the outcome," he said, pointing out the "tug of war between the concern of many in the Congress to keep the scope of the bill down versus the political imperatives at home" to come up with a solution to the problem of long-term care costs.

Sen. Phil Gramm, R-Texas, who opposes Clinton's plan, says the problem with a long-term care program is "the same problem as with every new benefit. How do you pay for it? Not just now, but forever? The cost always grows."

Rep. Ron Wyden, D-Ore., a liberal who favors a long-term care program, concedes that even some of his liberal colleagues see it as "a foot-in-the-door to massive government involvement in long-term care."

Clinton's proposal calls for a federal-state program to help people with severe disabilities by paying for assistance with the normal activities of daily living, such as getting in and out of bed, eating, using the toilet, bathing and getting dressed.

Typically, long-term care is rendered outside of hospitals, usually in nursing homes, individual homes or adult care centers. Providers include registered and practical nurses, physical therapists and home health aides.

At present, the cost of private insurance coverage for long-term care is so steep that fewer than one million people _ less than 3 percent of the elderly population nationwide _ are covered under such insurance, according to the Health Insurance Association of America.

This means that the costs of long-term care are usually paid from the individual's savings or by Medicaid and Medicare, the government programs aiding the elderly and indigent.

Medicare recipients must pay their own nursing home bills until they deplete their assets. Once they have only $2,000 left, they become eligible for Medicaid coverage.

Medicaid pays the entire cost of long-term care for low-income elderly and disabled people.

The story of Orien Reid of Philadelphia illustrates how a family's economy can be devastated by the costs of long-term care.

Reid placed his mother, an Alzheimer's victim and a widow, in a nursing home. …

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