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NH recently passed Medicaid expansion. This was needed in order to provide coverage for the many people whose incomes were too low to qualify for subsidized coverage under the ACA.

However, for a segment of NH residents, there is a serious downside: anyone who has subsidized coverage now, because they make 100% of the Federal Poverty Level or more, will apparently lose that coverage July 1st unless they make more than 138% of FPL.

The subsidized coverage now in place in NH for those between 100% and 138% of FPL will be replaced by Medicaid. And for those who are 55 or older, that NH Medicaid enrollment comes with a set of laws and policies that set out to recover 100% of whatever Medicaid spends on your behalf, including monthly premiums, whose amount is not known.

We are only two and a half months away from this transition, and yet apparently very little is known about exactly how it will take place. I have not heard yet, for instance, whether people will be automatically enrolled, or have a chance to opt out.

The estate recovery aspect of the situation seems to have largely escaped notice until now. But now it really must be addressed, and first of all it must be addressed by having the facts widely understood and discussed.

I think we must consider the example recently brought to our attention in GreenMother's diary, of the government deciding that it can collect decades old overpayments, reportedly without much if any documentation, from the children of those who were (supposedly) overpaid. How is anyone going to know, possibly decades after the fact, that the bills being collected by Medicaid are accurate?

Should such bills even be collected at all? The whole idea of taking monthly premiums and spreading them out across the lowest income segment of a population, to be paid in the end only by those frugal enough to have any assets left at death, seems backwards. Especially when people who make a dollar more per year than some of these people will have well subsidized coverage with no estate recovery.

Given the amount of the expansion paid for by the federal government, and that CMS says they want to encourage states not to impose estate recovery for ACA enrollees not receiving long term care - why is CMS or some other entity of the federal government not able to put a stop to this?

As I have mentioned before, this policy will especially impact single people, as FPL per person in a married couple is considerably lower. As women often have lower incomes  than men, it will disproportionately affect women.  

And yes, this affects me personally. I am 57, co-own a house, and might have a MAGI less than 138% of FPL this year.

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Comment Preferences

  •  Tip Jar (18+ / 0-)

    If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

    by beverlywoods on Mon Apr 14, 2014 at 08:00:40 PM PDT

  •  The overpayments collection has been suspended (16+ / 0-)

    pending SSA review.  This was announced late today.  Of course, this doesn't mean it is ended.  We'll see what develops from the review.

    http://www.thestate.com/...

    The Social Security Administration is suspending a program in which thousands of people were having their tax refunds seized to recoup overpayments that happened more than a decade ago.

    Acting Social Security Commissioner Carolyn W. Colvin said Monday she has directed an immediate halt to the program while the agency does a review.

    "Go well through life"-Me (As far as I know)
    This message will self-destruct upon arrival in the NSA archives in Utah.

    by MTmofo on Mon Apr 14, 2014 at 08:09:52 PM PDT

    •  That's good news (8+ / 0-)

      I saw that update when I went to link to the diary.

      What this implies to me, however, is that this kind of thing can only be stopped by some good strong sunshine on what is going on. So anything you can do to help get the word out about estate recovery would be much appreciated!

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Mon Apr 14, 2014 at 08:11:50 PM PDT

      [ Parent ]

    •  Presumably, these provisions were written in (6+ / 0-)

      by Congress. So, it would be appropriate for people to contact their legislators and demand an explanation. If there are no complaints, we get no results. The President's signature attests to what can be done; what should be done is determined by our representatives assembled in Congress.

      http://hannah.smith-family.com

      by hannah on Mon Apr 14, 2014 at 08:16:49 PM PDT

      [ Parent ]

      •  yes, by all means contact legislators! (4+ / 0-)
        Recommended by:
        rl en france, hannah, Sylv, Calamity Jean

        And state legislators too, because while federal law says states must recover for long term care costs, collecting for premiums and every other expense is entirely optional. NH is among the states that decided to collect for everything. We even collect for mammograms received under the Breast Health program.

        If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

        by beverlywoods on Mon Apr 14, 2014 at 08:30:20 PM PDT

        [ Parent ]

    •  Great. (2+ / 0-)
      Recommended by:
      beverlywoods, Sylv

      So do I have to go through some impossibly lengthy appeals process to get my $238 back? Or will they just send it to me? Or, since my money was already taken, am I just screwed?

      Kind of guessing it's that last thing. :)

      But thanks for the news.

      •  I think since it's a temporary stay (1+ / 0-)
        Recommended by:
        Sylv

        they won't be issuing refunds or taking appeals just yet. But if and when there is a final decision made on this, if there is no refund, then asking for one and making a bit of a fuss might be worth it, even if you didn't succeed in getting your money back, in terms of preventing the next round?

        If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

        by beverlywoods on Tue Apr 15, 2014 at 05:11:48 AM PDT

        [ Parent ]

  •  This is just one more example of how (7+ / 0-)

    cheap New Hampshire is. Of course everything must be done in order to avoid imposing an income tax. It's infuriating. Plus, there are no estate taxes, so the wealthy are adequately protected.

    "A free society that will not help the many who are poor, cannot save the few who are rich." JFK, January, 1961

    by rontun on Mon Apr 14, 2014 at 08:19:05 PM PDT

    •  Isn't NH Ground Zero for a Libertarian Homeland? n (4+ / 0-)

      We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

      by Gooserock on Mon Apr 14, 2014 at 08:22:07 PM PDT

      [ Parent ]

    •  but this isn't really about cheap (1+ / 0-)
      Recommended by:
      Sylv

      The amounts of money recovered by Medicaid Estate Recovery compared to expenditures are a drop in the bucket: states vary, and I could not get much in the way of NH-specific figures,  but apprently the average may be about 0.13% which would be a princely $13 for every $10,000 spent. In other words, not a very effective funding mechanism.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Mon Apr 14, 2014 at 08:27:42 PM PDT

      [ Parent ]

      •  In other words, they're not really enforcing (0+ / 0-)

        that clause.

      •  But it is about being cheap. (2+ / 0-)
        Recommended by:
        beverlywoods, rl en france

        The state absolutely abhors the idea of spending a dollar on anyone and has no reservations at all about taking the last penny from the poorest citizen.

        Hell, its primary objective is to collect taxes from visitors and seasonal residents.  Even the discussion of allowing casino gambling is structured around the notion that folks from Massachusetts will flock to New Hampshire to gamble and fatten the state's coffers.

        Cigarette, alcohol and gasoline taxes are kept lower than those of surrounding states so that those states' residents will flock across the border to save a few dollars, adding revenue to New Hampshire.  

        Taxes that can't be collected from outsiders are levied primarily against working class residents in the form of outrageously high property taxes, which affects both homeowners and renters.

        Honestly, while I choose to live in New Hampshire, I have to admit that I've never seen stingier people anywhere else.

        "A free society that will not help the many who are poor, cannot save the few who are rich." JFK, January, 1961

        by rontun on Mon Apr 14, 2014 at 09:30:29 PM PDT

        [ Parent ]

        •  all this is true (2+ / 0-)
          Recommended by:
          rl en france, Calamity Jean

          But there are some things this state does that are so stingy they actually cost money. Like the failure to expand Medicaid to begin with, although this would demonstrably cost us money every day it was delayed: I kept asking people: how much money are you willing to PAY to deny your neighbors health coverage?

          The money quote from the other side was: "if they have coverage, they'll be able to go to our doctors!"

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Mon Apr 14, 2014 at 10:25:10 PM PDT

          [ Parent ]

    •  and for another example (1+ / 0-)
      Recommended by:
      rl en france

      try driving the roads in Carroll County the last few months. Some are truly frightening, and most have been in a condition destructive to the cars that drive on them.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Mon Apr 14, 2014 at 09:23:09 PM PDT

      [ Parent ]

  •  CMS has initiated investigation into this (8+ / 0-)

    and will be encouraging states not to implement asset recovery to Medicaid recipients under the ACA. They do not believe that ACA Medicaid recipients should be included in asset recovery. They are considering rule making if states insist.

    Not to mention that less than 1% of the eligible asset recovery cases have ever been enforced in the past.

    •  not sure what you are trying to link to (1+ / 0-)
      Recommended by:
      Sylv

      but if it was this diary of mine, CMS so far isn't talking like they think they have the authority to make such a rule.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Mon Apr 14, 2014 at 08:36:02 PM PDT

      [ Parent ]

      •  Incorrect link. Not even sure how that got there, (5+ / 0-)
        Recommended by:
        Cedwyn, ybruti, Nance, Sylv, guyeda

        since I never copied your link.

        Here is the correct link: Implementing Health Reform: Medicaid Asset Rules And The Affordable Care Act

        And CMS acknowledges that the state has the authority, and states that it will consider changing the rules if the states don't cooperate.

        •  they "encourage" states to cooperate (2+ / 0-)
          Recommended by:
          ybruti, Sylv
          “CMS intends to thoroughly explore options and to use any available authorities to eliminate recovery of Medicaid benefits consisting of items or services other than long term care and related services in the case of individuals who are determined eligible for Medicaid benefits using the MAGI methodology.”  Moreover, CMS encourages states not to pursue estate recoveries against Medicaid expansion populations and notes that there are special rules limiting recoveries against American Indians and Alaskan natives.
          but that doesn't mean they have any actual authority, necessarily; they will "explore options" and "use any available authorities" - but if the authority were really readily avilable, they would have just used it, don't you think?

          Anyway, I'm all for CMS doing something, but this letter of theirs suggests looking for change elsewhere, and that's what I'm doing.

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Mon Apr 14, 2014 at 08:52:53 PM PDT

          [ Parent ]

    •  and re this part of your comment: (0+ / 0-)
      Not to mention that less than 1% of the eligible asset recovery cases have ever been enforced in the past.
      When I spoke with the NH Medicaid Estate Recovery office, the situations they detailed to me in which they do not recover were mainly those in which the estate was less than $500.

      I don't know where you got the 1% figure. Is is possible you are thinking of that because less than 1% of Medicaid's costs being offset by the recovery efforts?

      Anyway, if you have any documentation of that 1% figure, and especially of the circumstances that lead to it if it is able to be documented (are 99% of the estates in question less than $500?) - I would like to see it.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Mon Apr 14, 2014 at 09:20:13 PM PDT

      [ Parent ]

  •  By the way, no one with 100-138% of FPL (2+ / 0-)
    Recommended by:
    Nance, Sylv

    got subsidized coverage. In states that hadn't expanded Medicaid, there was no coverage available for those folks unless they paid full price.

    However, for a segment of NH residents, there is a serious downside: anyone who has subsidized coverage now, because they make 100% of the Federal Poverty Level or more, will apparently lose that coverage July 1st unless they make more than 138% of FPL.

    The subsidized coverage now in place in NH for those between 100% and 138% of FPL will be replaced by Medicaid.

    •  that's completely untrue (0+ / 0-)

      as I can attest from personal experience. I have subsidized marketplace-enrolled coverage right now.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Mon Apr 14, 2014 at 08:32:05 PM PDT

      [ Parent ]

      •  Per your comment: (0+ / 0-)
        And yes, this affects me personally. I am 57, co-own a house, and might have a MAGI less than 138% of FPL this year.
        Might have. You don't know? You must have had at least 138% now to get subsidies, because they do not exist.
        Options depend on your state, your income, and other factors
        If you live in a state that hasn't expanded Medicaid you may not qualify for either Medicaid or reduced costs on a private insurance plan. It will depend on where your income falls.
        You're a bit of a one note wonder on this Asset Recovery issue. You've been told before that there are restrictions on a state collecting. And if you co-own a house, it won't be taken.
        •  why are you posting with such certainty (1+ / 0-)
          Recommended by:
          fauve

          about things about which you evidently do not know? Wherever you got your information, it is wrong.

          I went in the insurance exchange and stated an income for 2014 of considerably less than 138% FPL. I got subsidized coverage, because we didn't have expanded Medicaid.

          And I am one of plenty of people who don't have a crystal ball to know exactly where their income will come out in a given year.

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Mon Apr 14, 2014 at 08:45:23 PM PDT

          [ Parent ]

          •  Probably because we both misspoke. (1+ / 0-)
            Recommended by:
            Sylv

            The Medicaid eligibility level is 133%, not 138%. So if you're anywhere between 133%-138%, you would be eligible. Between 100-133% you are not.

            •  wrong again. (0+ / 0-)

              there's a 5% cushion. The 133 and 138 derive from the 5% cushion.

              I and plenty of others who gave income figures of not much over 100% of FPL have subsidized coverage right now.

              I could expain this, but I'd like to invite you to go do some research and find out why we were able to do this, instead of hanging around peppering my diary with inaccurate comments. Would you be willing to do that?

              If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

              by beverlywoods on Mon Apr 14, 2014 at 09:01:37 PM PDT

              [ Parent ]

              •  So there was no (0+ / 0-)

                Medicaid gap in NH?

                •  there was the "coverage chasm" (1+ / 0-)
                  Recommended by:
                  fauve

                  (and still is, until July 1st, I think) - if you made less than 100% of FPL, no coverage of any kind for you until Medicaid expansion is implemented.

                  OK, for the curious, here is how it works: owing to two different possibilities having been written into the ACA law that were never reconciled, subsidies apply down to 100% of FPL, which was one of the original ideas about where Medicaid would take over.

                  But there is also a provision that if you qualify for Medicaid, you can't have a subsidy.

                  So in states with no Medicaid expansion, the subsidies go down to 100%. But when the exansion comes into play, it covers people up to 138%, and their subsidies (if they had them) disappear and are replaced by Medicaid.

                  If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

                  by beverlywoods on Tue Apr 15, 2014 at 05:21:07 AM PDT

                  [ Parent ]

        •  and about this: (1+ / 0-)
          Recommended by:
          fauve
          And if you co-own a house, it won't be taken.
          If by this you meant that you believe that jointly owned property is not subject to recovery, that is not true either. See for instance:
          ..elder-law/avoid-medicaid-recovery-in-ohio-adding-joint-tenant-property/
          It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so.

          Mark Twain

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Mon Apr 14, 2014 at 10:15:51 PM PDT

          [ Parent ]

  •  Do you know what AARP's position is on this? (7+ / 0-)

    They start hounding people to join as soon as they hit 50. If they could be convinced to play the ALEC role and get model legislation out to the states this could be fixed in some states and put the uncooperative ones in sharp relief. And it could be a goodwill builder for those of us who will soon enough be in the position of choosing a Medigap provider (cough-AARP/UHC-cough). Definitionally, this issue isn't about the truly destitute but for low-income/some-assets people who will likely be able to spend some of those assets when Medicare rolls around. I'd think it would be a non-trivial chunk of their potential market, though I'm not sure.

    I know Washington took steps to solve it but I haven't looked at the law to see whether it would serve as a model. But it wouldn't be that hard to craft a statute clearly limiting estate recovery to what the federal law requires and eliminating this particular problem.

    •  last I heard WA issued a regulation (1+ / 0-)
      Recommended by:
      Sylv

      through their HHS department, not a law.

      I think this was after that couple got married so they wouldn't be subject to estate recovery.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Mon Apr 14, 2014 at 08:40:07 PM PDT

      [ Parent ]

      •  So, what's AARP's position on such (1+ / 0-)
        Recommended by:
        Sylv

        regulations? That may be how it's done everywhere.

        •  as far as I can tell AARP has not said yet (0+ / 0-)

          all the info on this from AARP that I was able to find is from before the last year or so. If you can find out anything I'd love to hear about it.

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Mon Apr 14, 2014 at 08:54:50 PM PDT

          [ Parent ]

          •  WA State Changed Their Rules, Also AARP Is (4+ / 0-)
            Recommended by:
            ybruti, beverlywoods, peptabysmal, Sylv

            "watching" the issue.

            Washington state, which changed its policy to rule out estate recovery for services received under Medicaid medical coverage, does not expect to lose much money from making the change, said Manning Pellanda, assistant director of Washington State Health Care Authority. The state for the most part only went after costs related to the long-term care due the legal costs of pursuing estate recovery, she said.
            and also:
            Elaine Ryan, AARP's vice president of state advocacy and strategy integration, told the news organization FactCheck.org that AARP is watching the issue and hasn't decided yet whether to lobby states to roll back their estate recovery programs. “This is all so new … and we're still looking at what makes sense,” she said.
            http://www.modernhealthcare.com/...

            "I think that gay marriage is something that should be between a man and a woman.” - Arnold Schwarzenegger 2003

            by kerplunk on Mon Apr 14, 2014 at 09:26:42 PM PDT

            [ Parent ]

  •  I have a question. Since this is through private (2+ / 0-)
    Recommended by:
    Sylv, guyeda

    insurers, how would the state collect for expenses paid? The insurance companies will be paying.

    Also, as it stands now, New Hampshire estate recovery is only for Old Age Assistance, Aid to the Needy Blind, and Aid to the Permanently and Totally Disabled.

    http://www.dhhs.nh.gov/...

    I know that probably means nothing as far as the future, but it hasn't changed yet.

    •  it won't be with private insurers yet (2+ / 0-)
      Recommended by:
      fauve, Sylv

      because that apparently will take time to set up. Also we only have "private insurer" right now: there is only one company on the exchange: Anthem.

      Re what we recover for in NH, you did not read far enough:

      Estate Recoveries Unit
      The Estate Recoveries Unit (ERU) recovers funds from individuals and/or their estate following their death who have received Old Age Assistance (OAA), Aid to the Needy Blind (ANB), or Aid to the Permanently and Totally Disabled (APTD) cash assistance and/or from individuals who have received OAA, ANB, Medicaid for Employed Adults with Disabilities (MEAD), or APTD medical assistance (Medicaid).
      As I have noted before: NH is among the states that attempts to recover for everything Medicaid spends. See my previous diaries, which have links to the the AARP chart, etc.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Tue Apr 15, 2014 at 04:15:12 AM PDT

      [ Parent ]

      •  APTD is Aid to the Permanently and Totally (1+ / 0-)
        Recommended by:
        Cedwyn

        Disabled. Yes, it's Medicaid, but it's specific.

        •  keep reading on the same page (0+ / 0-)

          on the link you sent. You will see that it says

          Estate Claims

          In this context, an "estate" is all of the property (such as cash, savings, stocks, land, etc.) owned by a person at the time of their death. For the purpose of recovery of medical assistance, your "estate" includes both assets that pass through probate and assets that pass outside the probate process. This includes assets held in joint tenancy, tenancy in common, life estates and living trusts. However, the Department will not seek recovery after your death from life estates and joint tenancies with rights of survivorship created on or before July 1, 2005.

          When a probate estate is opened for someone who received cash and/or medical assistance, the State may file a claim against the estate for repayment of the assistance received. The State will file a claim against your estate for the:

              Cash assistance you received, if the total assistance is more than $100; and/or
              Medical assistance you received after age 55, if you are unmarried or widowed at the time of your death and do not have any minor or disabled children. (NOTE - There is no recovery for Medical Assistance received prior to age 55.

          Probate law provides that creditors, such as the State, must be paid before any directions in a will are followed. If any assets remain after paying all debts against the estate, the court will follow the directions of the will and allow assets to be given to your heirs. The State will collect on the funds that are available in your estate even if there is not enough to pay the claim in full.

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Tue Apr 15, 2014 at 10:58:08 AM PDT

          [ Parent ]

          •  and by the way I confirmed this (0+ / 0-)

            in a phone call with NH DHHS: Any and all medical coverage received after age 55, including any received by people part of the expansion, is what they are currently expecting to collect for.

            If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

            by beverlywoods on Tue Apr 15, 2014 at 11:12:09 AM PDT

            [ Parent ]

          •  It's still limited to the services outlined in the (0+ / 0-)

            first paragraph. I read through the whole thing several times before I made my initial comment, so I'm not just throwing things out randomly.

            I agree that the subject, in general, is of concern. At this point, however, as stated, the estate recovery is limited to those services that are enumerated. If those services were to someone who was over 55, then that medical assistance is recoverable.

            •  No it is not limited to those services (0+ / 0-)

              Please do some research, and/or read the document more carefully, and or call NH DHHS yourself and ask them.

              Or go to p. 62 of this PDF compiled by AARP some years back, and see that "Services Recoverable" include doctor visits, prescriptions, etc. etc. etc. and "All Other Items Under State Plan."

              And then I am really wondering: why is it so hard for you to believe the facts about this?

              If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

              by beverlywoods on Tue Apr 15, 2014 at 11:35:56 AM PDT

              [ Parent ]

              •  Yes, for people on existing Medicaid plans. I'm (0+ / 0-)

                done arguing. As it stands today, the website does not list any programs that fall under the new ACA program. That was my only point. They are evidently going to incorporate the ACA into that, which I wasn't arguing they wouldn't.

                Thanks for the conversation.

                •  as far as states are concerned (0+ / 0-)

                  expanded Medicaid is Medicaid. Unfortunately. Estate recovery applies.

                  Please, those of you who are skeptical - fine, be skeptical, but please go back and read through my string of diaries on this subject, and follow the many, many links documenting the issue, think about the states that have changed their policies recently and why they decided they had to do this, and put the picture together for yourself.

                  Or, as I say, call NH DHHS, or your local friendly legislator, and ask them to look into this. A lot of them haven't really grasped it yet, but the info is now out there if they look for it.

                  If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

                  by beverlywoods on Tue Apr 15, 2014 at 12:10:43 PM PDT

                  [ Parent ]

    •  and in the long run re the private insurance (0+ / 0-)

      I would imagine the state would expect to recover for whatever premiums they are paying. If they were giving some insurer, for instance, $800 per month to cover me, then $800 per month would be what they would try to recover from my estate.

      In other words, my "insurance," instead of being subsidized, is a sort of reverse mortgage that becomes a lien on all of my assets, probate and non-probate. Thus in this example I could have 8 years where I never go to the doctor and the state comes around at my death with a bill for $80,000.

      Private insurers need not be visibly present to produce this kind of result. Since NH like many states is moving to "managed care"  there is a monthly premium or "capitation charge" assigned through that.

      I couldn't get a figure out of NH Medicaid, perhaps understandably since I think it has not really gotten underway yet. In AZ according to ddocuments ppublished by the state government, those monthly premiums add up to $40,000 per year.

      I am thinking that it would be reasonable for starters to have a law that Medicaid must provide a quarterly accounting of the bill they are running up for estate recovery in each person's name.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Tue Apr 15, 2014 at 04:35:03 AM PDT

      [ Parent ]

      •  It says that the funds are federal, which is maybe (0+ / 0-)
        •  characterized as a specially NH way to go about it (0+ / 0-)

          Yes, we'll take Medicaid funds, but only if we can figure out a way to put even more of them into the pockets of private insurers than would end up there through other means.

          Oh, and by the way, we will then set out to bill the full costs of those premiums to the recipients and their families and heirs.

          So it's the best of both worlds: we can have people on private insurance, and have it still considered being on welfare and subject to recovery.

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Tue Apr 15, 2014 at 11:08:55 AM PDT

          [ Parent ]

      •  While I share your concern to a substantial (1+ / 0-)
        Recommended by:
        Cedwyn

        degree, though not entirely, it is not helpful to describe the possibility of estate recovery as a lien on your assets. It isn't. That word has a legal meaning and you are not helping by using it metaphorically instead of accurately. There's a kossack in another diary describing how she's got all her belongings packed in her car but she's paralyzed with fear and doesn't know what to do because she's heard there would be a lien on her bank account so she won't be able to pay rent and somebody on the phone told her she'll have to sell off assets to pay Medicaid as the bills come due and and and ... it's cruel and ridiculous and it stems from comments like yours. People are going without health care because of such misinformation.

        Feel free to spend every damn dime of your assets. The state does NOT have a lien on them unless you go into a nursing home and they decide to lien your interest in any home you own at that point. And even then, if you leave the nursing home and move back into your own home, the lien is dissolved.

        The only thing at risk is what your heirs can collect when you die. Here's a thought: tell them to expect nothing then, unless they want to subsidize your health insurance now. I'm not saying the situation is fair -- it's totally unfair when there is no recovery of subsidies -- but the catastrophizing that's going on about it is getting tiresome. I've referred many people to your diaries because I thought you were researching and getting the facts right. I'm sorry I'll no longer have that option.

        •  Re this other person you mention (0+ / 0-)

          I've never suggested the kind of things you are talking about.

          Perhaps it would make more sense to blame the DHHS offices that have put lines in forms people have had to sign to get coverage, saying things like "I understand that if I sign up for Medicaid, the state may attach my assets, including money I have or money that is owed to me..." etc. etc.

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Tue Apr 15, 2014 at 12:18:09 PM PDT

          [ Parent ]

        •  and if you are getting tired, I'm sorry (0+ / 0-)

          No one is making you read or recommend my diaries.

          But please consider this: I live here, I am in the midst of this situation, and every day I wake up and go to bed wondering how best to deal with this situation.

          Do I move over the state line into Maine, hoping they will not expand Medicaid? That's terribly ironic, since of course for the sake of the uninsured in Maine I hope they do.

          Do I give up on being insured, and go without coverage?

          Do I give up all my current work and friends and community, and move to a state that does not have such draconian provisions?

          Do I decide that it's OK to bill my heirs for an unknown amount that may well wipe out anything they may get from me, and reward the state of NH for adding this liability to its  wildly regressive tax system?

          Or do I continue my current plan, which is working 7 days a week to try to make enough to stay on private coverage?

          These are big decisions. For me they are stressful. But for someone else they may in fact be catastrophic. What I am trying to do is draw attention to this before too many catastrophes happen.

          If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

          by beverlywoods on Tue Apr 15, 2014 at 12:34:28 PM PDT

          [ Parent ]

  •  and speaking of who benefits (0+ / 0-)

    If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

    by beverlywoods on Tue Apr 15, 2014 at 07:33:52 AM PDT

  •  One possible solution (0+ / 0-)

    would be for President Obama to require that the IRS not penalize people who claim a higher income in order to qualify for a subsidy.

    This would allow many of the people who are in the states that refuse medicaid expansion to get health insurance at a more affordable rate.

    Shop Liberally this holiday season at Kos Katalog

    by JamieG from Md on Tue Apr 15, 2014 at 12:29:16 PM PDT

    •  they could just extend the subsidies down (0+ / 0-)

      to zero income, for those who prefer private coverage because of this or other issues. You'd think this would be very popular with the free marketeers - except maybe it would cost a bit more.

      If you act out of anger, the best part of your brain fails to function. - the Dalai Lama

      by beverlywoods on Tue Apr 15, 2014 at 12:37:05 PM PDT

      [ Parent ]

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