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The poor who are lucky enough to inherit a house aren't off the hook either. They can lose the family home, in fact it's more likely because they are so busy thinking they got a free insurance and won't take the time to educate themselves on the details. The devil is in the details.
Obamacare and medicaid expansion states.... Obamacare herds the poor into Medicaid which requires them to forfeit homes and other assets they might have to the state to cover the cost of their medical care. I believe it is 55 yo.
The ACA, however, does three things that potentially will subject more people between the ages of 55 and 65 and their assets to the Medicaid recovery program
The Affordable Care Act did nothing to change existing federal law. It did, however, expand the number of people who are eligible for Medicaid, so there will be more people on Medicaid between the ages of 55 and 65, and, therefore, potentially more estates on the hook for Medicaid expenses after the beneficiary dies.
the individual mandate provision of the ACA will “force” people into Medicaid and then “strip” them of their assets after they die. “Since this despicable plot was exposed by the Seattle Times, a number of states have vowed to change estate recovery rules as revised by ObamaCare
That is why it's good to know what is going on "and what's in the law" before it's passed. Too late now.
The ACA, however, does three things that potentially will subject more people between the ages of 55 and 65 and their assets to the Medicaid recovery program
The Affordable Care Act did nothing to change existing federal law. It did, however, expand the number of people who are eligible for Medicaid, so there will be more people on Medicaid between the ages of 55 and 65, and, therefore, potentially more estates on the hook for Medicaid expenses after the beneficiary dies.
the individual mandate provision of the ACA will “force” people into Medicaid and then “strip” them of their assets after they die. “Since this despicable plot was exposed by the Seattle Times, a number of states have vowed to change estate recovery rules as revised by ObamaCare
That is why it's good to know what is going on "and what's in the law" before it's passed. Too late now.
I guess I'm not following this particular issue.
Prior to the ACA - Medicaid already had recovery laws, and as expenses for medicaid have soared - states have become much more aggressive about pursuing recovery against estates. (all prior to ACA).
Post ACA - some states have expanded medicaid, allowing some individual to get assistance they would not otherwise have had access to (including presumably LTC in a SNF). The estates of those who have utilized medicaid for extensiver services are now subject to the pre-existing recovery laws.
I don't see how any of that is controversial? Unless you're suggesting that asset recovery laws (for all medicaid recipients, not just previously middle class) should be abandonded? But if so, where will the additional tax revenue come from to help pay for care?
I would be happy if there were universal LTC available, regardless of wealth/income. But again - it would have to be paid for and no one in this country wants to pay more in taxes for social benefits.
As with other issues....I think most people who are praising expansion of Medicaid (under ACA), have no idea about the recovery laws.
-- 1) if they're presumably poor and on Medicaid -- what's left of their 'estate' to recover?
-- 2) because of increased costs due to the increased numbers on Medicaid, states will be even MORE likely to go after people who do have "a little something."
I'm not talking about recovery being right or wrong....my point is the lack of awareness about whatever the rules and consequences are.
As with other issues....I think most people who are praising expansion of Medicaid (under ACA), have no idea about the recovery laws.
-- 1) if they're presumably poor and on Medicaid -- what's left of their 'estate' to recover?
-- 2) because of increased costs due to the increased numbers on Medicaid, states will be even MORE likely to go after people who do have "a little something."
I'm not talking about recovery being right or wrong....my point is the lack of awareness about whatever the rules and consequences are.
(Knowledge is power, so it's said anyway)
What it comes down to is all but the rich will quickly become destitute if they require significant (LTC-type) assistance in old age.
For the already-destitute, this is not earth shattering, they've lived in poverty for years. For people who *THOUGHT* they had some financial cushion, they quickly find that at private pay costs of $6K a month (and higher!!) that they will quickly be destitute - at which time they can receive medicaid assistance, but the price of that is loss of any additional assets (car/home) eventually (upon their death, or the death of their surviving spouse).
Its a crappy system, no doubt. But its the system the American public is willing to pay for. Because any time you talk about more social services, the American public starts screaming about taxes. So? Catch 22.
Don't want to die impoverished? Become Rich. Otherwise, acknowledge its a possibility and make sure your kids (if you have any) aren't counting on your estate for any sort of inheirtance, because there may not be any.
Don't want to die impoverished? Become Rich. Otherwise, acknowledge its a possibility and make sure your kids (if you have any) aren't counting on your estate for any sort of inheirtance, because there may not be any.
Or use the same rules the rich use to protect what they have.
The middle class even more so than the wealthy need to do that.
If Trump, Gates and Buffet don't protect their money from Medicaid recovery, their heirs will still have plenty.
If a person who only has a paid off home and a 500K 401k, or a 200K IRA doesn't protect that his/her heirs won't have any second generation inheritance.
That's what helps generations do better than the one before....inheritance. You think Donald Trump started out with nothing? Gates built his wealth before his parents died and I bet he (or his kids) STILL inherited something. Even a 10 or 20K inheritance can help get the kids or grandkids started with a leg up.
Prior to the ACA - Medicaid already had recovery laws, and as expenses for medicaid have soared - states have become much more aggressive about pursuing recovery against estates. (all prior to ACA).
Post ACA - some states have expanded medicaid, allowing some individual to get assistance they would not otherwise have had access to (including presumably LTC in a SNF). The estates of those who have utilized medicaid for extensiver services are now subject to the pre-existing recovery laws.
I don't see how any of that is controversial? Unless you're suggesting that asset recovery laws (for all medicaid recipients, not just previously middle class) should be abandonded? But if so, where will the additional tax revenue come from to help pay for care?
I would be happy if there were universal LTC available, regardless of wealth/income. But again - it would have to be paid for and no one in this country wants to pay more in taxes for social benefits.
I"m not saying that it's controversial at all but people should understand what's in the law.
This is "exactly why" there should have been a lot of debating so people understood what they are supporting.
Let everything good and bad come out. Buying into hype is never smart. I bring this up and Obamacare supporters automatically ASSUME I got a problem or will divert away. It's always easier to fool people that are uneducated to such matters, especially when people think they'll get something free. Politicians use this tactic all the time.
Its a crappy system, no doubt. But its the system the American public is willing to pay for. Because any time you talk about more social services, the American public starts screaming about taxes. So? Catch 22.
Don't want to die impoverished? Become Rich. Otherwise, acknowledge its a possibility and make sure your kids (if you have any) aren't counting on your estate for any sort of inheirtance, because there may not be any.
It's not the inheritance, it's when you as an elderly person drains your kids bank account because they failed to plan, it's when you (not you) expect your kids to take care of all your needs, forget that you have responsibilities, let it all blow up, because you as an elderly person did not plan for your elder years.
Years ago, my grandmother who traveled all over, never worked outside the home said to me "what do you do with your time?"
However, its the best crappy system we currently have.
If you don't expand medicaid - you still have poor people, and they still need services - except now they have NO WAY to pay for them. LTC housing isn't going to do it for free.
So, while I think medicaid recovery sucks, I think its better than letting someone die of neglect in their apartment or home because they are incapable of caring for themselves.
Of course, I also think that people who don't want to be institutionalized should be allowed to say "no" and if that means they do die somewhat prematurely, so be it.
I agree that LTC policies are great to have, and for the boomers (and the 40-somethings) its great to be proactive ... but there's still no guarantees. Just because you buy a policy doesn't mean they'll be in business when you need to utilize it.
So, short of "universal" LTC for those who require it (and want it!) - there's no good answer.
And - no one in this country would support universal LTC. Well, some would, but not enough to get through this hostile political enviroment.
Which leaves us back at - be rich. (I guess I really need to start playing the lottery more.)
Of course, I also think that people who don't want to be institutionalized should be allowed to say "no" and if that means they do die somewhat prematurely, so be it.
Of course they should be able to say no but that's the point of this thread, people who have always been poor will get government to help to pay for home health care. The middle class will have to foot the entire bill if they go home, they paid in but again get a lot less out comparative to the poor.
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