Establishing national responsibility for affordable health insurance was a monumental and much debated achievement. But deep within the health-reform legislation it passed last March, Congress also did something else extraordinary with hardly any fanfare: It enacted a new federal long-term-care insurance program called the Community Living Assistance Services and Supports Act.

As a public program directly run by the government, CLASS resembles Social Security and Medicare, yet it differs in critical ways that pose significant challenges for implementation. CLASS is a voluntary program that will need to enroll a broad portion of the population in order to spread its costs as widely as possible. The start-up will therefore demand wide publicity.