The long-term care insurance program created by the Affordable Care Act will be reshaped to address concerns about solvency.


The Affordable Care Act of 2010 established the Community Living Assistance Services and Supports (CLASS) Plan, a voluntary, publicly administered insurance program. It is designed to help people should they become disabled and need long-term services and support, including home care, adult day care, or a stay in a nursing home.

In exchange for paying premiums during their healthy, working years, people would get a daily cash benefit to help defray the costs of these forms of assistance.

By law, CLASS must be self-sustaining through premiums and without the infusion of federal tax dollars. As currently structured, however, the program does not appear to be financially viable. Many policy makers have called for its repeal.

The Obama administration has acknowledged the program’s shortcomings and is developing modifications that it says will ensure the program will remain solvent and self-financing for at least 75 years, as the law requires.

This Health Policy Brief examines the issues surrounding CLASS and options that policy makers may consider as they seek to make the program sustainable, and was published online on May 12, 2011 in Health Affairs.