This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.


And I'm Robert Siegel.

More than 45 million Americans have no health insurance. Even for those of us who do have health insurance, almost none of us has coverage to pay for a nursing home or for the services we would need to live at home as we age. Now the Obama administration has added its endorsement to a new and potentially expensive program that would change that.

NPR's Joseph Shapiro explains.

JOSEPH SHAPIRO: Here's a great name for a piece of legislation: the CLASS Act. That is a bill that would let workers choose to have government deduct money from their paychecks, maybe 65 to $100 a month, and put it in a savings account. When they get old or disabled and need care, they could use that money.

Senator CHRISTOPHER DODD (Democrat, Connecticut): Our current system forces seniors and Americans with disabilities, who need additional help caring for themselves, prematurely into institutions because help is unaffordable.

SHAPIRO: That's Senator Chris Dodd as his Senate committee marked up a version of the bill today as part of health care overhaul. But just days ago, the conventional wisdom in Washington was that long-term care was too expensive. That changed when a Congressional Budget Office analysis said the program would actually save money, because if people delayed going into a nursing home or got homecare that kept them out of the hospital, there would be a net savings for government. Now Health and Human Services Secretary Kathleen Sebelius has sent a letter to Senator Ted Kennedy with an endorsement.

Larry Minnix runs the American Association of Homes and Services for the Aging, that's the trade group for not-for-profit providers of care to the elderly and disabled. He says the letter from the Obama administration is a big step.

Mr. LARRY MINNIX (American Association of Homes and Services for the Aging): Because it recognizes for the first time that insuring for the need for long-term services and supports is a vital part of health care reform. Seventy percent of American families will face some kind of disabling situation, and we're not insured for it.

SHAPIRO: But Republicans said adding long-term care would create a costly new program for years to come. Senator Mike Enzi questioned the CBO's analysis, a $58 billion in savings over 10 years. He says the real cost would come later.

Senator MIKE ENZI (Republican, Wyoming): Only in Washington could someone develop a policy that costs the taxpayers $2 trillion and call that a savings and then use it to pay for more federal spending.

SHAPIRO: Also angry are some groups that represent people with disabilities. They say not enough is done for poor people who can't afford to have the money deducted from their weekly paychecks or who, because of their illness or disability, may not be able to work at all.

Joseph Shapiro, NPR News.

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