Concern is mounting about the worksite market impact of a proposed government-run plan to provide in-home, long-term care (LTC) assistance to the elderly and disabled that survived a flurry of amendments to both the House and Senate health care reform bills.

The Community Living Assistance Services and Supports (CLASS) Act, which is in the hands of congressional leaders who now must reconcile their differences, would allow employees to sign up for a payroll deduction program whose monthly premiums would range between $160 and $240 unless they decline coverage.

Age-based fees that would be assessed for program participants, who must be employed, are expected to finance the plan. A five-year waiting period would be imposed before people could collect any benefits, though there would be no pre-existing conditions.

Critics who project low participation fret that the measure would create a new federal entitlement program whose benefits surpass revenues. They also cite a study by the Centers for Medicare & Medicaid Services suggesting that it no longer would be self-sustaining beyond 2025.

Proponents counter that a benefit of up to $75 a day would help working Americans pay for the cost of LTC and avoid having to receive care from a nursing home or assisted-living facility. They also note that the Congressional Budget Office forecasts cheaper premiums and fiscal solvency over a 75-year period.

Jesse Slome, executive director of the American Association for Long-Term Care Insurance, cautions that such legislation would create chaos in the marketplace, as well as expand the HR and benefit professional’s workload given the plan’s opt-out nature.

“An enormous educational and awareness effort will need to be undertaken to avoid frustration among employees who unwittingly will have their paychecks reduced,” he says. “Employers currently offering voluntary long-term care insurance plans will need to find ways to integrate the two offerings, or choose between one and the other.”

Still, some advocacy groups representing senior citizens and the disabled believe the CLASS Act lives up to its name. Larry Minnix, CEO of the American Association of Homes and Services for the Aging, described the plan in a recent press account as “one of the few transformational things in the health care bill” that would afford people “the opportunity to begin to plan for an eventuality everybody will face.”