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View Diary: Cantor: Medicaid and Medicare beneficiaries 'don't need' safety net (221 comments)

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  •  Re reductions in Medicaid (0+ / 0-)

    As I understand it one of the largest services that Medicaid pays for is long-term care. (At least that's the case in my rural upstate NY county.)

    You might think that this is long-term care for people who had life-long, marginal resources, or late-life financial challenges, and I'm sure that is a significant component.

    But there are also some  families who choose to use aggressive (but legal) strategies to remove assets ahead of time to make sure that their elders will quickly become eligible for Medicaid, while still protecting wealth transfers between generations.  The rules have tightened over the recent decade, but it's still happening.

    A large component of estate planning services are all about managing to protect assets, while maintaining Medicaid eligibility.

    I'm not making judgements about the ethics or efficacy of this strategy, just pointing out that families who use this option maybe pretty surprised when Medicaid cuts begin to bite them.  Since its unlikely people who go to such great (and expensive) efforts to protect assets, while still creating Medicaid eligibility,  think of themselves as the indigent poor.

    The proponents who are counting on the voicelessness of the truly needy, may instead find themselves in the sights of lawyered-up, generation-skipping, trust creators.

    Oops!

    •  In Canada, they can have (4+ / 0-)

      subsidized nursing care without liquidating their assets. $1500 a month.  If you can't afford $1500 a month, means testing kicks in.

      Nursing care is just too expensive for anyone middle or working class to afford, and risk should be spread across the population. I don't blame people for shifting assets - most who do don't probably have as much as you'd think, and just want to make sure they aren't completely indigent, as there are many costs and quality of life issues that medicaid won't cover.  

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