It Appears that A program to help people with illness and disabilities to stay in their homes is too costly

Republican lawmakers, who have vowed to repeal the health care law, cite the administration’s acknowledgment as yet another reason to do so. But the health and human services secretary, Kathleen Sebelius, says the law gives her plenty of authority to make the necessary changes to the program without Congressional action.

To make the program viable, Ms. Sebelius said, she is considering changes in the eligibility criteria, including employment and earnings requirements, to ensure that only active workers may enroll. She also said she favored adjusting premiums to rise with inflation.

Senator Tom Harkin, Democrat of Iowa and chairman of the Senate health committee, encouraged the administration to make any changes that might be required to keep the program fiscally sound, so “no one with a disability will be forced to live in an institution.”

Under the current law, the program will allow workers 18 and older to buy insurance from the government to cover the costs of long-term care. After paying premiums for at least five years, they are then eligible for benefits if they become unable to perform basic activities of daily living because of chronic illness or crippling injury. The program is meant for people with severe disabilities who want to live in the community, though benefits can also be used to help pay for nursing home care or assisted living.