The issue that needs to be examined is the ‘claw back’ provision of Medicaid. Unfortunately, even many legislators are unaware of this problem. This provision in the law is punitive and prejudicial. It will be imposed only on the very poor – those who qualify for Medicaid. This is a death tax that will be imposed only on the very poor. Will poor unmarried citizens be ‘penalized’ for their low income and also for not having a spouse? Those who are dirt poor will now even have their dirt taxed away from any heirs. Of course, those with accountants, lawyers, financial planners can avoid this unfair tax – but poor people do not have that kind of support system.
It would be helpful if legislators addressed this problem. If they don’t – decisions will be made by nameless, faceless, anonymous bureaucrats who can never be held responsible for their decisions. Silent, voiceless, disenfranchised citizens will be victimized.
Part of the problem is that the laws around health care are too complex. No one understands them. It has been reported that the law providing for the Canadian Health Care system was 14 pages – as compared to the more than 2000 pages for ACA.
How many other surprises are hidden in the new law and the old law? If ACA expands the ‘claw back’ provision, increasing numbers will be affected. This is one more reason why we need a simple Single Payer system. Those few who know about the ‘claw back’ provision are now searching for a way to opt-out of Medicaid. Apparently there is no legal way to opt-out.
I hope I am wrong about all of this, but here is a link to a respected source.
Obamacare: The Final Payment–Raiding the Assets of Low-Income and Poor Americans
Anything you can do to publicize this will help.
ROSEMARIE JACKOWSKI
BENNINGTON VT
Paul Craig Roberts
Is touted as the co-founder of Reaganomics. I would take anything he has to say with a mountain of salt.
Thanks for the comment
I take anything anyone says with a grain of salt… but, to automatically reject a view is an ad hominem fallacy.
Roberts is not the only one who is bringing this information out.
Is the Vermont Health Care Plan worse than the Banking Mortgage Scandal? This hidden Tax Trap on the poor needs to be exposed. Thousands of families could lose their homes.
Roberts just found out about this?
Odd that Roberts is going around touting this as some new fangled thing that is part of the dreaded Obamacare since this has been policy since 1993. It has nothing to do with Obamacare.
So while Robert and others may be bringing this out one has to surmise that they have an agenda regarding Obamacare, don’t know what they are talking about or know what they are talking about and are attempting to mislead people. I’ve known about this for some time as my family was affected by the law.
Fact Check.org
http://www.factcheck.org/2014/01/medicaid-estate-recovery-program/
Does the Affordable Care Act allow states to confiscate the estates of seniors on Medicaid when they die?
A: No, but a 1993 federal law requires states to recover Medicaid costs for long-term care from the estates of deceased Medicaid beneficiaries over the age of 55.
Be cautious about who you read on the internets and whose information you post without doing a simple google search would be the lesson here.
Just a little more info
Estate confiscation has been allowed for even longer than 1993, but it was left up to the discretion of the states. It was in 1993 that states became “required” to recover whatever costs they could for long-term care expenses. So this is really old hat information. Sorry but I doubt Roberts didn’t know about this or if he didn’t he’s a bit of a dummy since he’s supposed to be an “expert.” As far as I’ll be concerned anything he has to say in the future will be regarded as unreliable.
But I suppose there are many out there who are reading about this on the internet, either the post your submitted or posts like it, who believe that this is some new part of the horrible awful Obamacare. So posting lies or misinformation does serve it’s purpose. Hence it is imperative that those who post this sort of stuff check their facts out carefully first or you just continue to spread what is false information. As I said a simple Google search would have sufficed.
An interesting article about this issue
It seems states are becoming aware of the problem. I guess the argument is that it is okay to require claw-back if you opt for Medicaid but not if you are required to use it. However then we could have a discussion about whether this is fair or not for those who need Medicaid. It has certainly caused problems for those who remarry as older adults and then one gets seriously ill and requires nursing home care.
http://seattletimes.com/html/localnews/2022469957_medicaidrecoveryxml.html
But it needs to be clear that this is a policy that has existed for some time. It’s just that the requirement of using Medicaid for lower-income folks places any estate they would have in jeopardy. In order to qualify for Medicaid the only thing that one would have that would really count as “estate” would be a home I suppose. I’ve never liked this provision to begin with, can cause all sorts of complications when parents or older relatives re-marry. Perhaps this will cause a change, hope it’s not state by state as Washington state is making moves to do but on a nationwide basis.
One more interesting tidbit
http://www.kiplinger.com/article/insurance/T037-C000-S002-the-crackdown-on-medicaid-planning.html?kipad_id=53
There is now a five year “look back” period allowed so if one goes into nursing home care and has to sign up for Medicaid any gifts given to children or family members 5 years back up to the time of signing up for Medicaid are vulnerable. This places a restriction on people realizing that the family member will need nursing home care and giving away all monetary assets to avoid losing them. Otherwise Medicaid requires that all personal assets be depleted before they’ll kick in money for care. Now this may sound punitive, as does the clawback provision, but there is an argument to be made as to how much care taxpayers can pick up without requiring users to also kick-in their own assets.
Especially with a large number of aging citizens coming up, are taxpayers responsible for paying if the senior has some assets, not many, but some. While those who have done better financially in life may not face this requirement as they won’t be on Medicaid, is it really punitive to expect people to pick up what they can of these expenses? Leaving a house to children is a nice idea and I understand why people would like to do that but leaving an “estate” isn’t really a given requirement or expectation. Should taxpayers then have to shoulder the burden of that additional expense? The reality is that those more financially well off will probably deplete their resources also, just in larger amounts.
I suspect that this provision came into being because of families giving away and depleting resources in order to qualify for Medicaid when the family member still had money and home or homes. Must have been some large numbers doing this, enough to cause attention. Is it fair? I’m not sure where I come down on this. Used to feel these policies were unfair but if you really look at it and think it over, well, I’m not so sure now. If one is required to use Medicaid is fair to continue these polices. Well, someone who would qualify for Medicaid would end up on it one way or the other if seriously ill, so is the requirement really an issue.
Complex, complicated and certainly worthy of discussion.
Sorry, you don't seem to 'get it'.
Rosa…I believe some of your information is no longer valid. Just a couple of months ago Oregon wrote a law to protect its citizens from the NEW risks of ACA Medicaid ‘claw-back’.
Here is the bottom line: ACA Medicaid allows every state to make its own ruling on ‘claw-back’. In the past only long term care counted. Now there is the risk that ALL Medicaid costs will have to be repaid if the poor person had any property – such as a family home. I have been in contact with VT legislators and hope they will take action on this… like Oregon has.
My purpose in writing the article was to inform. Some will take the information. Others, such as you, will reject it. That’s fine. I have been receiving a lot of ‘thank you’s’ from around the country. Vermonters need to have this information.
Not About "Getting It" It's About Accurate Info
I’m not rejecting your information. What I am objecting to is the lack of clarity, especially in the Paul Rogers article.
What I am objecting to is the impression being given that the claw-back is something new, particular to ACA. As Fact Check points out, this is simply not true. It is also misleading.
There may be some new risks related to ACA but the risks are not part of ACA, they are risks directly coming from a 1993 law. Even Paul Roberts notes this but he does so almost at the end of his article. He knows full well that most people will only read the first 1/3 or so of his article on-line and if that is all you read it really appears as if the claw-back is part of ACA or Obamacare. This information has been put out there and misunderstood enough that Fact Check felt impelled to weigh in on the erroneous assumption that this was part of Obamacare, see my link.
So while you may be receiving a lot of “thank you’s” you may also be spreading the erroneous assumption that this is part of the Obamacare bill. As I stated, it has been law since 1993. It’s fine to inform people, most are totally unaware of the clawback until they are dealing with it personally. But I feel that it’s important that it be clear that Obamacare had to deal with existing law regarding this issue.
I would also like to see single payer. however I have family members some quite young who have pre-existing conditions and other issues that are going to make their lives easier and more livable because of the ACA. And I think opening the door is better than waiting and waiting because single payer is going to come about once that door is opened a crack and not on it’s own.
Also you are wrong when you say that in the past it was only long-term care that was affected and now there is “the risk that ALL Medcaid costs will have to be repaid. Fact is that risk has also existed since 1993.
Here’s a quote from your own Roberts: OBRA 1993 requires all states that receive Medicaid funding to seek recovery from the estates of deceased Medicaid patients for medical services received in a nursing home or other long-term care institution, home- and community-based services and related hospital and prescription drug services regardless of age. It also allows, at state option, recovery for all services used in the Medicaid state plan at age 55 or older.
So HERE is the bottom line: Since 1993 it has been required that every state seek recovery from long -term care expenses. AND since 1993 it has been allowed for states to opt for recovery of all Medicaid costs.
The risk that all Medicaid costs will have to be repaid has existed since 1993 depending on what state you live.
I think that people need to be informed of these provisions just as you do so we are on the same page there. But you, like many others, seem to be operating under the mistaken belief that these risks are new and a result of Obamacare. Not true. These risk have existed since 1993. The only thing new, as I said in earlier posts, is the question about people being required to use Medicare which will place any estates they have at risk. And there is the question also of whether one has a right to protect estate assets when using Medicare.
Those opposed to Obamacare have gone after every angle to discredit the program. I think it is imperative that even if you don’t support the program you be clear about what is actually in the program.
And you quote Paul Rogers who is really, as another poster said, someone to be taken with a large, very large, mountain of salt when reading. Even his title for his article that you cite: “Obamacare: The Final Payment–Raiding the Assets of Low-Income and Poor Americans” is misleading and he knows it full well because he does at least note deep within his article that it is the OBRA 1993 law that is responsible. It’s obvious he’s gone out of his way to mislead.
So feel free to inform but I’m just looking for some accuracy. We all can make mistakes but when you say “I Don’t Get it” then it seems you’re pretty locked into your assumption that you are correct. I’m just kind of tired of people inaccurately criticizing Obamacare when it’s an attempt at least and will help a lot of people.
I’m sure Paul Rogers gets a lot of thank you’s also but that doesn’t mean that he isn’t going out of his way to discredit Obamacare as much as possible. If youre going to inform people, Vermonters or otherwise, then some accuracy please.
As I said the risks that you are informing people about have existed since 1993, this is NOT something new. It is not true that in the past only long term care counted. The risk that ALL Medicaid costs might have to be repaid has existed since OBRA 1993 was passed.
Increased risk is the issue
Yes, I agree with what you say about the 1993 law. The problem is that ACA has increased the risk. That is why Oregon passed its new law.
Now, unless the rest of the states act as Oregon has, we will have poverty being even more institutionalized than it has been. ‘Claw-back’ is the perfect way to make sure that poverty passes from one generation to the next.
I support Single Payer which includes dental, vision, and long term care. That would solve all of these problems and also save money. Medical care is a human right and should not be a for-profit business. We need to get insurance companies and Wall Street out of health care. We need to cap salaries of hospital CEOs. The only thing preventing this is the prejudice and hatred toward the poor. A perfect example of that is the anti-panhandler law recently passed in Bennington. Now the poor do not even have First Amendment rights.