Larry Minnix is sitting at a large circular table eating lunch with a group of healthcare journalists. It's day two of the 2010 American Association of Homes and Services for the Aging Annual Meeting in Los Angeles, and while the convention center is decorated with banners advertising the organization's official name change to LeadingAge, the buzz during this show's only press briefing is focused squarely on tomorrow's midterm elections. At this point, everyone is talking about a Republican takeover of Congress with as much certainty as the sun rising over downtown L.A.
With the GOP's anticipated plan to choke off funding for health reform being discussed, one of the reporters addresses Minnix. “Should something like that play out, how will it affect your members?”
Minnix leans backward, his suit jacket unbuttoned, both hands moving with his speech. The president of LeadingAge talks of what would happen to Medicare, Medicaid, and HUD; he questions what congressperson would have the nerve to openly support slashing funds to services for the elderly and disabled. His words are spoken with poise and confidence, delivered in those well-known southern inflections, and he comes across as both a commanding presence and a familiar old soul.
Then, a slight pause, and he places both hands firmly on the table. “There will be some people who find out that rhetoric is a lot easier than reality.”
Rhetoric. Minnix has said the word now several times in a half hour conversation, and he'll say it a few more times before this meeting ends. Of course, he's referring to the partisan strife that fuels our political discourse. More importantly, it's a sharp criticism of the politicians he believes ride half-truths for their own benefit. And it rubs Minnix raw. That's because he sees what's coming; that the stake LeadingAge fought for most in reform, the Community Living Assistance Services and Support Act, simply known as CLASS, is going to be the target of such rhetoric when the legislative troops assemble for battle once more. * * *
Minnix is on the phone from his organization's Washington, D.C., office a few days after New Year's. The media is again swirling with talk of a fractured Congress-the members of which are to be sworn in today-along with the conventional strategies to repeal reform. “I have a very close friend of mine, an elected official back in Georgia, and we were talking about the current political climate and the rhetoric that floods the media every day,” Minnix recalls. “I asked him, ‘How does that happen-how can politicians get away with saying things that are not necessarily true, but they sound good or provocative or whatever?’ And he said, ‘Unfortunately, the first rule of any elected official is to get reelected. Some will say just about anything to get that to occur, and then they think they can do good later.’”
Such rhetoric trickles down to long-term care. The bitter fights over reform, which are primed to begin anew in the coming weeks, convinced some LeadingAge members that the organization betrayed their best interests by supporting the law. “I would have members call me and they would start saying, ‘You know, I'm angry. I can't believe AAHSA supported this, that, and the other.’”
Minnix would attempt to set them straight. “‘So you mean you don't support death panels?’” they responded-an example of the stories some believed. “Well no we don't support death panels, and in fact there isn't anything about death panels in there,” he says. “But how much rhetoric was spun around death panels? It's an imaginary construct. It shows you the power of language, even if it's not true.”
So then what of the CLASS Act, the cause he tirelessly champions? Much has been written about this voluntary long-term care insurance program, which Minnix argues could one day be the “salvation of Medicaid,” and most of it has been positive. Minnix concedes that congressmen and -women on both sides of the aisle supported CLASS back during the law's passage. Even Rep. Joe Barton (R-Texas), an outspoken opponent of health reform, “is a believer in CLASS,” Minnix says. But it still attracts that maligned rhetoric, recently being referred to as an entitlement program as well as other more insidious names.
“The term Ponzi scheme got thrown out there,” Minnix says. “The senator who used the term came back and clarified what he meant. In the way that the Congressional Budget Office looks at a 10-year revenue and expense cycle, there was $72 billion of premiums generated over expenditures because benefits [from CLASS] don't start getting paid out until later. But CLASS is perpetually solvent, or there are mechanisms in there to make it so, and no taxpayer money goes into it. What the senator then meant by the Ponzi scheme was that Congress might take the money later and do something else with it, as Congress has done with other programs. But we told them we can't control what a future Congress does, and we still have this growing need for long-term care coverage. Are you anticipating putting tens if not hundreds of billions of dollars into an expanded Medicaid program to cover that? No? Then we have to have another mechanism, and if Congress does something else with the money then shame on them.”