Nursing home benefit likely in health plan Displaced insurers may get job aid


WASHINGTON -- President Clinton will likely expand his health reform plan to include a new insurance program to help protect the elderly from being bankrupted by nursing home expenses, White House health policy adviser Ira Magaziner disclosed yesterday.

The benefit, to be called "Medicare Part C," was sought by several groups that represent the elderly.

The option would be financed entirely through insurance premiums paid by Medicare beneficiaries, not federal funds.

"We're likely to put that in," Mr. Magaziner said in an interview. Inability to pay the cost of nursing home care is one of the major worries of the elderly.

The nursing home insurance would complement Mr. Clinton's proposed long-term care program, which is designed to help pay for care in the home and the community.

Mr. Magaziner also revealed that Mr. Clinton would propose a program to subsidize retraining for workers expected to lose their jobs as the insurance industry shrinks because of health reform.

Though Mr. Magaziner predicted "significant dislocation" in the insurance industry, he estimated that Mr. Clinton's health reform plan would create 700,000 jobs over the next several years as the need for nurses and home care workers increases.

Administration officials also said that Mr. Clinton may not make all the final decisions on his plan by the time of his speech to Congress on Wednesday night.

Instead, Mr. Clinton may wait to resolve outstanding issues until he sends health reform legislation to Capitol Hill later in the fall.

"The legislation will have all the blanks filled in, and the legislation will appear a few weeks after the president's speech," said White House spokesman Kevin Anderson.

Mr. Clinton's health reform plan would guarantee coverage for all through a system of regional health alliances, and ratchet down costs by capping insurance premiums.

Senior health reform planner Judy Feder said Mr. Clinton has made no final decision on how much to raise cigarette taxes, or whether to increase the levy on alcoholic beverages. Also unresolved is whether to impose a fee on large employers to help finance the plan.

Mr. Magaziner said scores of details in the plan are undergoing revision as the administration receives comment from hundreds of interests affected by health reform.

Among the changes: mental health coverage is being refined to ensure that those who most need help are better served when the benefits become effective in 1996.

Dan Schulder of the National Council of Senior Citizens said Mr. Magaziner agreed to include the Medicare Part C nursing home benefit at a session last week with representatives from several organizations that serve the elderly.

Mr. Magaziner would not discuss details, but Mr. Schulder said the program would work as follows:

* People would have the option of buying nursing home insurance within a given period of time as they become eligible for Medicare at 65.

* After paying premiums for five years, beneficiaries would be entitled to $30,000 for nursing home expenses, the average cost of a year of care.

* People participating in the program would also be allowed to protect an additional $30,000 of their assets when applying for nursing home benefits through the Medicaid program.

Currently, Medicare has a Part A for hospitalization and a Part B for physician services.


If you have questions about President Clinton's complicated health care reform program and what impact it would have on you, we'd like to hear them. Call Sundial, the Baltimore Sun's telephone information service, at (410) 783-1800 (268-7736 in Anne Arundel County). After you hear the greeting, punch in the four-digit code 4425 on your touch-tone phone.

Responses may appear in future coverage of the president's program.

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