Here in North Dakota, at least, people over 65 are excluded from Medicaid Expansion solely on the basis of their age, whether they have Medicare or not. There are thousands of people here, and in every state, who will not receive Medicare, and it is such a disaster for them that I have to say we would be better off without Medicaid Expansion at all than having it with such terrible effects on these good people. Every health care professional I have spoken with, every social worker, and the only legislator (a Democratic former state legislator) agrees that the situation is terrible, yet nothing is being done or even said about it. AARP is doing nothing. If progressives don't speak out for the elderly (and not so elderly - 65 is not that old any more), who will?
People under 65 receive free health insurance regardless of their assets. They could have a million dollars in the bank and still receive it. They receive it with incomes up to $15,000, even though anyone with an income above the povertly level can buy insurance affordably in the marketplace. For people under 65, Medicaid Expansion is not only good, it is better than it needs to be.
But for those over 65, it is virtually a death sentence. People over 65 are disqualified unless their assets are less than $3,000, which in today's world is almost nothing. However, they are still required to buy health insurance. If their incomes are below the poverty line and they can't use the marketplace, they have to pay full price, which is often more than their incomes. The alternative is to have no insurance and pay a fine that is a serious hardship for people with $6,000 or $8,000 incomes - and what will they do if they get sick?
It is simple justice to include people over 65 on exactly the same basis as younger people. They need their assets, not only as much, but far more, because it is not possible to live as cheaply at age 80 as at age 64. Things that are luxuries or conveniences at age 64 become necessities at 80. And people over 65 have less time to save for those expenses - not all of which, by any means, are medical.
Most people without Medicare have paid money to Social Security, but because they do not have 40 quarters, their money goes to fund the retirement benefits of those who have more. Owners of small businesses who have earned a frugal living, people with poor health or disabilities, people who spent many years as selfless caregivers to others, and a disproportionate number of women - all are victims of this policy, which now threatens the security they have sacrificed and saved for over their lifetimes.
Something must be done, and I believe it should be done before we promote Medicaid Expansion in states that do not have it. As it stands now, it is too harmful to innocent, older people, and especially to women and the poor. We need to circulate petitions, put initiatives on our state ballots, write letters to editors, lean on organizations we belong to and insist that they speak out. Personally, I have belonged to the Democratic Party since high school, but refuse to participate in party politics again until this terrible situation is resolved.
Sat Aug 15, 2015 at 8:55 AM PT: YES, people under 65 DO receive Medicaid Expansion in North Dakota without counting their assets. And YES, seniors ARE excluded from Medicaid Expansion unless their assets are $3,000 or less, including stocks and bonds, not including land. That is just about enough to buy an old but reliable car.
Updated facts (i got the original facts from someone at the Health Dept.): seniors do NOT have to spend their incomes on premiums. They can remain uncovered (YEA!???), which costs nothing for people with incomes under the income threshold and $95 for people between the tax threshold and the poverty line.
Yep, it IS true. People under the poverty line can't use the marketplace and get a subsidy, but they have to pay $95 to go without insurance. How unjust is that? But if they are under 65, they gt Medicaid Expansion, so it's worth it. If they are 65 or older, they get NOTHING.
We need political ACTION on this issue, NOT inaction. But pushing a system this flawed into more states without changing it is inaction. Let us spread Medicaid Expansion as far as we can, but let us fix it first.