Are your parents in a nursing home paid by Medicaid? Are you concerned the program will get cut?

[Anonymous]

Look, nobody knows what’s coming. The worst case scenario we’ll have to somehow manage our elderly parents at home with us. That’s what ppl in poor countries do. It’s hard but it’s not impossible.

[Anonymous]

Anonymous wrote:Look, nobody knows what’s coming. The worst case scenario we’ll have to somehow manage our elderly parents at home with us. That’s what ppl in poor countries do. It’s hard but it’s not impossible.

Have you done it. My in law had severe dementia. She was a loving and kind person to turned abusive, then couldn’t do anything or be left alone. Stooped talking, bathroom, etc. I did it for a year. 24-7 care till I was to my breaking point with young kids and couldn’t leave the house. No money for help. We had no choice but a long term Medicaid bed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I mean if you don’t pick her up from the hospital or wherever she is before she goes to a Medicaid nursing home, what are they gonna do? You just have to be cold hearted enough to wait them out.

I think OP is suggesting that there will not be "Medicaid nursing homes," not how will they get admitted.

The hospitals aren’t going to just evict ppl into the street. Certainly not at 70+ and nursing care level

Why not? Musk said get ready for hardship.

Uhm, I work in public health and the homeless shelter has several 70+ year olds with various degrees of health care needs including cognitive impairment. This doesn’t include the seniors living in their cars.

Are you saying they were evicted by the hospitals?

No, that’s not what they are saying.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s a separate program and long term care Medicaid and not regular Medicaid. Doubt they coul cut it as where would people go?

Women will be expected to stay home.

As a woman I did this but at some point it is not manageable without help. Long term Medicaid was our only option. Most people cannot do it especially with young kids.

The current system already penalizes adult children, often single women, who quit jobs in the prime earning years and move back home to take care of their parents. The kicker is that the parents' issues are so complicated that they may must move into a LTC facility. The house must be sold before the parent can receive Medicaid, so women in their 50s, 60s, 70s find themselves on the street without a home or a job.

DP.
There are ways to keep the house, please don’t dramatize.
I haven’t seen many women on the street unless they have mental health issues.

How do you keep the house? Please share the ways.

Elder law attorney will consult
AFAIK it’s irrevocable trust or a share of the house belongs to a relative, but I am NAL

So you really don’t know.

I know that people do it. So it’s possible.

Nursing homes come under long term care Medicaid. It’s a different program than regular Medicaid with separate qualifications and rules.

So? I was talking about it being possible to keep the house

It is only possible to keep the house IF there is a community spouse. But if an elderly person lives at home and is cared for by an adult child, the house has to go if the adult child is no longer able to care safely for their parent at home and must move into LTC. There might be a situation where the house is now in the adult child’s name, but there is at least a 5-year look back period to see if there has been a divestiture of assets.

[Anonymous]

Anonymous wrote:Look, nobody knows what’s coming. The worst case scenario we’ll have to somehow manage our elderly parents at home with us. That’s what ppl in poor countries do. It’s hard but it’s not impossible.

My FiL needed a Hoyer lift and two aides for 14 months. There was absolutely NO way my 80+ MiL and 50+ developmentally disabled SiL could’ve managed this at home. No way. OTOH, my father has dementia, remains quite amiable, and is able to remain living at home though now with a near FT aide as he is a flight risk and no longer able to manage his ADLs. If he were not amiable, then it would probably be impossible for my mom to manage, especially if he were aggressive.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Look, nobody knows what’s coming. The worst case scenario we’ll have to somehow manage our elderly parents at home with us. That’s what ppl in poor countries do. It’s hard but it’s not impossible.

My FiL needed a Hoyer lift and two aides for 14 months. There was absolutely NO way my 80+ MiL and 50+ developmentally disabled SiL could’ve managed this at home. No way. OTOH, my father has dementia, remains quite amiable, and is able to remain living at home though now with a near FT aide as he is a flight risk and no longer able to manage his ADLs. If he were not amiable, then it would probably be impossible for my mom to manage, especially if he were aggressive.

The difference is they can afford that. With Medicaid it means there is no money.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s a separate program and long term care Medicaid and not regular Medicaid. Doubt they coul cut it as where would people go?

Women will be expected to stay home.

As a woman I did this but at some point it is not manageable without help. Long term Medicaid was our only option. Most people cannot do it especially with young kids.

The current system already penalizes adult children, often single women, who quit jobs in the prime earning years and move back home to take care of their parents. The kicker is that the parents' issues are so complicated that they may must move into a LTC facility. The house must be sold before the parent can receive Medicaid, so women in their 50s, 60s, 70s find themselves on the street without a home or a job.

DP.
There are ways to keep the house, please don’t dramatize.
I haven’t seen many women on the street unless they have mental health issues.

How do you keep the house? Please share the ways.

Elder law attorney will consult
AFAIK it’s irrevocable trust or a share of the house belongs to a relative, but I am NAL

So you really don’t know.

I know that people do it. So it’s possible.

Nursing homes come under long term care Medicaid. It’s a different program than regular Medicaid with separate qualifications and rules.

So? I was talking about it being possible to keep the house

It is only possible to keep the house IF there is a community spouse. But if an elderly person lives at home and is cared for by an adult child, the house has to go if the adult child is no longer able to care safely for their parent at home and must move into LTC. There might be a situation where the house is now in the adult child’s name, but there is at least a 5-year look back period to see if there has been a divestiture of assets.

There are lots of rules to keep the house and sone savings if a partner or disabled family.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s a separate program and long term care Medicaid and not regular Medicaid. Doubt they coul cut it as where would people go?

Women will be expected to stay home.

As a woman I did this but at some point it is not manageable without help. Long term Medicaid was our only option. Most people cannot do it especially with young kids.

The current system already penalizes adult children, often single women, who quit jobs in the prime earning years and move back home to take care of their parents. The kicker is that the parents' issues are so complicated that they may must move into a LTC facility. The house must be sold before the parent can receive Medicaid, so women in their 50s, 60s, 70s find themselves on the street without a home or a job.

DP.
There are ways to keep the house, please don’t dramatize.
I haven’t seen many women on the street unless they have mental health issues.

How do you keep the house? Please share the ways.

Elder law attorney will consult
AFAIK it’s irrevocable trust or a share of the house belongs to a relative, but I am NAL

So you really don’t know.

I know that people do it. So it’s possible.

Nursing homes come under long term care Medicaid. It’s a different program than regular Medicaid with separate qualifications and rules.

So? I was talking about it being possible to keep the house

It is only possible to keep the house IF there is a community spouse. But if an elderly person lives at home and is cared for by an adult child, the house has to go if the adult child is no longer able to care safely for their parent at home and must move into LTC. There might be a situation where the house is now in the adult child’s name, but there is at least a 5-year look back period to see if there has been a divestiture of assets.

There are lots of rules to keep the house and sone savings if a partner or disabled family.

How about you provide the cites for what you keep claiming. As I indicated, the community spouse is able to keep the house and some savings ($150ish, perhaps more now with COLA). If the community spouse then needs LTC in a nursing home, then the house needs to be sold @ FMV (doesn’t need to be sold @ any price if the market is under water) IF the house is in their name.

There may be legal steps the family took to keep the house out of consideration for Medicaid LTC, but that would need to have been done at least five years prior to the application.

Perhaps there are exceptions that I am not aware of, but I have been through this process a number of times in two different states and the only instances in which the house was not sold was when it was in the name of a family member and that action had been taken at least five years prior to the application (and, of course, when there is a community spouse still residing in the home).

I am not aware of circumstances of when there is a disabled family member - separate from the community spouse - living in the home and able to retain it. But this would not apply to an adult child who is the caretaker, unless they are disabled. I am confident that there are probably stringent guidelines defining disabled and is not determined solely by that individual.

There are a few fora on DCUM where folks come seeking guidance on what can be difficult legal/economic matters. Vague claims of what can be done are not going to cut it when one has to complete the very detailed Medicaid app for LTC. Of course, comments in the elder care forum should never substitute for legal advice, yet we also do not need to perpetuate claims that are not accurate. Or have so many exceptions that they do not apply to the majority of people.

[Anonymous]

With the last few days' worth of news, seems safe to say that if they are coming for Social Security, they will probably gut LTC Medicaid first.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Look, nobody knows what’s coming. The worst case scenario we’ll have to somehow manage our elderly parents at home with us. That’s what ppl in poor countries do. It’s hard but it’s not impossible.

My FiL needed a Hoyer lift and two aides for 14 months. There was absolutely NO way my 80+ MiL and 50+ developmentally disabled SiL could’ve managed this at home. No way. OTOH, my father has dementia, remains quite amiable, and is able to remain living at home though now with a near FT aide as he is a flight risk and no longer able to manage his ADLs. If he were not amiable, then it would probably be impossible for my mom to manage, especially if he were aggressive.

The difference is they can afford that. With Medicaid it means there is no money.

???

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
I work in health policy.

The Paragon Health Institute is a conservative health care think tank that will have a lot more sway over policy in the Trump administration.

Here is a recent white paper of theirs about how to reform long-term care in the U.S. They think Medicaid is the reason long term care is so expensive and that the country would be better off if all but the poorest families were required to pay for it on their own (without Medicaid’s help) or through new long-term care insurance arrangements. Better buckle up kids, this ride won’t be for the feint of heart.

Long-Term Care: The Solution

https://paragoninstitute.org/medicaid/long-term-care-solution/

“Congress should remove Medicaid as an end-of-life, wealth-preserving, fail-safe for the middle class and affluent. Medicaid should not reward people who neglect to plan responsibly for LTC by both paying for services and providing asset protection. New public policy should incentivize early planning for LTC that employs private wealth, including savings, home equity, life insurance, and a revitalized private LTC insurance market. Recent research documents lower risk of severe LTC expenses and indicates that consumers have more funds available to pay privately for LTC than previously believed. These facts suggest a way to revitalize the senior living market financially to the benefit of LTC consumers and providers alike. With more private LTC financing, fewer people will become dependent on Medicaid. Medicaid can then become a better payer of last resort than it is now. This paper explains how and why this new approach is plausible, practical, and preferable given current demographic and financial conditions.”

This "concept" of a plan has no basis in reality. My parents were thrifty and still needed Medicaid for LTC. I find this absolutely maddening.

But YOU have wealth. That's the kicker. The government doesn't want you passing along your elderly if they (or you) have resources. Medicaid is supposed to be for last resort. For the truly indigent. Like dogfood eating out on the street. Sounds like the Trump Administration is going to love this policy advice. If the government won't pay, what are you going to do?

"wealth-preserving, fail-safe for the middle class and affluent."

No, I don't have wealth. I assisted my parents, now some of my siblings as well as my college kids. I'm tapped out. This is all set up to keep working class folks working class while they privatize all profits for themselves.

Right. It’s all about rich people getting to pay less in taxes, which will result in middle class families having to spend any retirement and college savings on caring for elderly family members who pre-reform would have qualified for Medicaid help. When families have less money, they have to work longer, the supply of labor goes up and the cost of labor is cheaper for big business. Plus, if Medicaid becomes a minor payer for long term care, more people will be paying (higher) private rates for care.

Well you should clarify and make that be "the ultra rich" pay more. The middling rich--those who earn most income from a W2/CapGains/Interest/Dividends pay out the wazoo for taxes--there are no legal loopholes for them. 37% on most of income, Medicare, SS, and 8-10% on majority of income at state level. It puts them close to 55-60% tax overall. We don't need "more taxes" at that level. We need to find a way to tax the ultra rich.

But people also need to plan. My LMC parents (in 80s, never earned more than $45-50K as family in their lifetime, normally it was much lower) managed to purchase LTC insurance and have kept it up. They also were truly frugal, our home was not nice, but it was a safe place with heat, water and a roof over the head. They lived on 1/2 acre+ and raised chickens and had a huge garden. They did 95% of their home repairs themselves until age 55/60. I personally helped dad reroof 2 homes while growing up---he figured it out because it needed to happen and we couldn't afford to pay someone.

Well those parents had over $750K when they sold their home (only $180K of it) and moved to a CCRC (we had to pay entry fee otherwise they qualified). They always made savings a priority and we lived frugally. I got $25 from them for bday and xmas and that was it. If it was a bad year, we got nothing. But they managed to save save save, despite many times of unemployment my first 15 years that set them back. Even after, they did whatever to have a job so they wouldn't fall behind.

Now they are living a decent retirement

This is great for your parents - truly - but utterly unhelpful for those of us with elderly parents who did *not* save adequately for retirement. Come on.

So then it's up to you to help them, or let them live with medicaid facilities. I just detailed how my LMC/lower income parents managed to amass a decent amount of savings---because they didn't live nicely, just with the bare minimum. They didn't have AC (live-in VA) until I was out of college, drove cars without AC until then as well.
But yes if your parents don't save you have two choices

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
I work in health policy.

The Paragon Health Institute is a conservative health care think tank that will have a lot more sway over policy in the Trump administration.

Here is a recent white paper of theirs about how to reform long-term care in the U.S. They think Medicaid is the reason long term care is so expensive and that the country would be better off if all but the poorest families were required to pay for it on their own (without Medicaid’s help) or through new long-term care insurance arrangements. Better buckle up kids, this ride won’t be for the feint of heart.

Long-Term Care: The Solution

https://paragoninstitute.org/medicaid/long-term-care-solution/

“Congress should remove Medicaid as an end-of-life, wealth-preserving, fail-safe for the middle class and affluent. Medicaid should not reward people who neglect to plan responsibly for LTC by both paying for services and providing asset protection. New public policy should incentivize early planning for LTC that employs private wealth, including savings, home equity, life insurance, and a revitalized private LTC insurance market. Recent research documents lower risk of severe LTC expenses and indicates that consumers have more funds available to pay privately for LTC than previously believed. These facts suggest a way to revitalize the senior living market financially to the benefit of LTC consumers and providers alike. With more private LTC financing, fewer people will become dependent on Medicaid. Medicaid can then become a better payer of last resort than it is now. This paper explains how and why this new approach is plausible, practical, and preferable given current demographic and financial conditions.”

This "concept" of a plan has no basis in reality. My parents were thrifty and still needed Medicaid for LTC. I find this absolutely maddening.

But YOU have wealth. That's the kicker. The government doesn't want you passing along your elderly if they (or you) have resources. Medicaid is supposed to be for last resort. For the truly indigent. Like dogfood eating out on the street. Sounds like the Trump Administration is going to love this policy advice. If the government won't pay, what are you going to do?

"wealth-preserving, fail-safe for the middle class and affluent."

No, I don't have wealth. I assisted my parents, now some of my siblings as well as my college kids. I'm tapped out. This is all set up to keep working class folks working class while they privatize all profits for themselves.

Right. It’s all about rich people getting to pay less in taxes, which will result in middle class families having to spend any retirement and college savings on caring for elderly family members who pre-reform would have qualified for Medicaid help. When families have less money, they have to work longer, the supply of labor goes up and the cost of labor is cheaper for big business. Plus, if Medicaid becomes a minor payer for long term care, more people will be paying (higher) private rates for care.

Well you should clarify and make that be "the ultra rich" pay more. The middling rich--those who earn most income from a W2/CapGains/Interest/Dividends pay out the wazoo for taxes--there are no legal loopholes for them. 37% on most of income, Medicare, SS, and 8-10% on majority of income at state level. It puts them close to 55-60% tax overall. We don't need "more taxes" at that level. We need to find a way to tax the ultra rich.

But people also need to plan. My LMC parents (in 80s, never earned more than $45-50K as family in their lifetime, normally it was much lower) managed to purchase LTC insurance and have kept it up. They also were truly frugal, our home was not nice, but it was a safe place with heat, water and a roof over the head. They lived on 1/2 acre+ and raised chickens and had a huge garden. They did 95% of their home repairs themselves until age 55/60. I personally helped dad reroof 2 homes while growing up---he figured it out because it needed to happen and we couldn't afford to pay someone.

Well those parents had over $750K when they sold their home (only $180K of it) and moved to a CCRC (we had to pay entry fee otherwise they qualified). They always made savings a priority and we lived frugally. I got $25 from them for bday and xmas and that was it. If it was a bad year, we got nothing. But they managed to save save save, despite many times of unemployment my first 15 years that set them back. Even after, they did whatever to have a job so they wouldn't fall behind.

Now they are living a decent retirement

+1 the US tax system sucks. The super rich need to pay in way more. Musk should make up whatever shortfall personally since he’s the richest man in the world. He basically bought our country. Can’t Trump, the supposed master deal maker, get a better deal for selling our country?

Right now, the ultra rich will continue to use the legal means to avoid paying taxes. Look at WA state--they implemented a 7% Cap Gains tax in 2022, on amounts over $250K, not from home sales, so basically just targeted at Stock Sales/STock options for the rich. Not shockingly, Bezos move his "primary residence" to Florida shortly afterwards (a state with NO taxes). He's not the only one to do that---if you are able to easily do it, you will.

We are in the W2 rich, and we pay the max. There are no legal ways to avoid it. So I defiantly don't want to pay more. I want to tax the ultra wealthy but that definately won't happen in next 4 years.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
I work in health policy.

The Paragon Health Institute is a conservative health care think tank that will have a lot more sway over policy in the Trump administration.

Here is a recent white paper of theirs about how to reform long-term care in the U.S. They think Medicaid is the reason long term care is so expensive and that the country would be better off if all but the poorest families were required to pay for it on their own (without Medicaid’s help) or through new long-term care insurance arrangements. Better buckle up kids, this ride won’t be for the feint of heart.

Long-Term Care: The Solution

https://paragoninstitute.org/medicaid/long-term-care-solution/

“Congress should remove Medicaid as an end-of-life, wealth-preserving, fail-safe for the middle class and affluent. Medicaid should not reward people who neglect to plan responsibly for LTC by both paying for services and providing asset protection. New public policy should incentivize early planning for LTC that employs private wealth, including savings, home equity, life insurance, and a revitalized private LTC insurance market. Recent research documents lower risk of severe LTC expenses and indicates that consumers have more funds available to pay privately for LTC than previously believed. These facts suggest a way to revitalize the senior living market financially to the benefit of LTC consumers and providers alike. With more private LTC financing, fewer people will become dependent on Medicaid. Medicaid can then become a better payer of last resort than it is now. This paper explains how and why this new approach is plausible, practical, and preferable given current demographic and financial conditions.”

This "concept" of a plan has no basis in reality. My parents were thrifty and still needed Medicaid for LTC. I find this absolutely maddening.

But YOU have wealth. That's the kicker. The government doesn't want you passing along your elderly if they (or you) have resources. Medicaid is supposed to be for last resort. For the truly indigent. Like dogfood eating out on the street. Sounds like the Trump Administration is going to love this policy advice. If the government won't pay, what are you going to do?

"wealth-preserving, fail-safe for the middle class and affluent."

No, I don't have wealth. I assisted my parents, now some of my siblings as well as my college kids. I'm tapped out. This is all set up to keep working class folks working class while they privatize all profits for themselves.

Right. It’s all about rich people getting to pay less in taxes, which will result in middle class families having to spend any retirement and college savings on caring for elderly family members who pre-reform would have qualified for Medicaid help. When families have less money, they have to work longer, the supply of labor goes up and the cost of labor is cheaper for big business. Plus, if Medicaid becomes a minor payer for long term care, more people will be paying (higher) private rates for care.

Well you should clarify and make that be "the ultra rich" pay more. The middling rich--those who earn most income from a W2/CapGains/Interest/Dividends pay out the wazoo for taxes--there are no legal loopholes for them. 37% on most of income, Medicare, SS, and 8-10% on majority of income at state level. It puts them close to 55-60% tax overall. We don't need "more taxes" at that level. We need to find a way to tax the ultra rich.

But people also need to plan. My LMC parents (in 80s, never earned more than $45-50K as family in their lifetime, normally it was much lower) managed to purchase LTC insurance and have kept it up. They also were truly frugal, our home was not nice, but it was a safe place with heat, water and a roof over the head. They lived on 1/2 acre+ and raised chickens and had a huge garden. They did 95% of their home repairs themselves until age 55/60. I personally helped dad reroof 2 homes while growing up---he figured it out because it needed to happen and we couldn't afford to pay someone.

Well those parents had over $750K when they sold their home (only $180K of it) and moved to a CCRC (we had to pay entry fee otherwise they qualified). They always made savings a priority and we lived frugally. I got $25 from them for bday and xmas and that was it. If it was a bad year, we got nothing. But they managed to save save save, despite many times of unemployment my first 15 years that set them back. Even after, they did whatever to have a job so they wouldn't fall behind.

Now they are living a decent retirement

This is great for your parents - truly - but utterly unhelpful for those of us with elderly parents who did *not* save adequately for retirement. Come on.

So then it's up to you to help them, or let them live with medicaid facilities. I just detailed how my LMC/lower income parents managed to amass a decent amount of savings---because they didn't live nicely, just with the bare minimum. They didn't have AC (live-in VA) until I was out of college, drove cars without AC until then as well.
But yes if your parents don't save you have two choices

I'm not the PP. Your parents saved and...they were also lucky. My parents were very frugal with five children, one who was developmentally disabled and lived with them for nearly their whole life. (Interesting how the state provides little money when an AC with a disability lives at home, but really amps up the monthly check when they are in a group home.) My father's sister and her children needed support at various points along the way due to fleeing an abusive spouse. Yes, she worked FT, but not every job pays enough to "amass a decent amount of savings," especially when you are a single mom.

My parents lived a life similar to your parents, though their frugality - no AC in house or car - extended until way after we were out of the home. And then it was a bare minimum.

So, again, your parents saved and they were also lucky enough to not have to part with savings at various junctures because other family members were in need.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
I work in health policy.

The Paragon Health Institute is a conservative health care think tank that will have a lot more sway over policy in the Trump administration.

Here is a recent white paper of theirs about how to reform long-term care in the U.S. They think Medicaid is the reason long term care is so expensive and that the country would be better off if all but the poorest families were required to pay for it on their own (without Medicaid’s help) or through new long-term care insurance arrangements. Better buckle up kids, this ride won’t be for the feint of heart.

Long-Term Care: The Solution

https://paragoninstitute.org/medicaid/long-term-care-solution/

“Congress should remove Medicaid as an end-of-life, wealth-preserving, fail-safe for the middle class and affluent. Medicaid should not reward people who neglect to plan responsibly for LTC by both paying for services and providing asset protection. New public policy should incentivize early planning for LTC that employs private wealth, including savings, home equity, life insurance, and a revitalized private LTC insurance market. Recent research documents lower risk of severe LTC expenses and indicates that consumers have more funds available to pay privately for LTC than previously believed. These facts suggest a way to revitalize the senior living market financially to the benefit of LTC consumers and providers alike. With more private LTC financing, fewer people will become dependent on Medicaid. Medicaid can then become a better payer of last resort than it is now. This paper explains how and why this new approach is plausible, practical, and preferable given current demographic and financial conditions.”

This "concept" of a plan has no basis in reality. My parents were thrifty and still needed Medicaid for LTC. I find this absolutely maddening.

But YOU have wealth. That's the kicker. The government doesn't want you passing along your elderly if they (or you) have resources. Medicaid is supposed to be for last resort. For the truly indigent. Like dogfood eating out on the street. Sounds like the Trump Administration is going to love this policy advice. If the government won't pay, what are you going to do?

"wealth-preserving, fail-safe for the middle class and affluent."

No, I don't have wealth. I assisted my parents, now some of my siblings as well as my college kids. I'm tapped out. This is all set up to keep working class folks working class while they privatize all profits for themselves.

Right. It’s all about rich people getting to pay less in taxes, which will result in middle class families having to spend any retirement and college savings on caring for elderly family members who pre-reform would have qualified for Medicaid help. When families have less money, they have to work longer, the supply of labor goes up and the cost of labor is cheaper for big business. Plus, if Medicaid becomes a minor payer for long term care, more people will be paying (higher) private rates for care.

Well you should clarify and make that be "the ultra rich" pay more. The middling rich--those who earn most income from a W2/CapGains/Interest/Dividends pay out the wazoo for taxes--there are no legal loopholes for them. 37% on most of income, Medicare, SS, and 8-10% on majority of income at state level. It puts them close to 55-60% tax overall. We don't need "more taxes" at that level. We need to find a way to tax the ultra rich.

But people also need to plan. My LMC parents (in 80s, never earned more than $45-50K as family in their lifetime, normally it was much lower) managed to purchase LTC insurance and have kept it up. They also were truly frugal, our home was not nice, but it was a safe place with heat, water and a roof over the head. They lived on 1/2 acre+ and raised chickens and had a huge garden. They did 95% of their home repairs themselves until age 55/60. I personally helped dad reroof 2 homes while growing up---he figured it out because it needed to happen and we couldn't afford to pay someone.

Well those parents had over $750K when they sold their home (only $180K of it) and moved to a CCRC (we had to pay entry fee otherwise they qualified). They always made savings a priority and we lived frugally. I got $25 from them for bday and xmas and that was it. If it was a bad year, we got nothing. But they managed to save save save, despite many times of unemployment my first 15 years that set them back. Even after, they did whatever to have a job so they wouldn't fall behind.

Now they are living a decent retirement

This is great for your parents - truly - but utterly unhelpful for those of us with elderly parents who did *not* save adequately for retirement. Come on.

So then it's up to you to help them, or let them live with medicaid facilities. I just detailed how my LMC/lower income parents managed to amass a decent amount of savings---because they didn't live nicely, just with the bare minimum. They didn't have AC (live-in VA) until I was out of college, drove cars without AC until then as well.
But yes if your parents don't save you have two choices

Or maybe just one choice — grandma moves into the basement— if Republicans gut federal Medicaid funding to pay for tax cuts.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Look, nobody knows what’s coming. The worst case scenario we’ll have to somehow manage our elderly parents at home with us. That’s what ppl in poor countries do. It’s hard but it’s not impossible.

Have you done it. My in law had severe dementia. She was a loving and kind person to turned abusive, then couldn’t do anything or be left alone. Stooped talking, bathroom, etc. I did it for a year. 24-7 care till I was to my breaking point with young kids and couldn’t leave the house. No money for help. We had no choice but a long term Medicaid bed.

No but my older family all did it, not with dementia but other ailments. Only one mentally ill relative (grandma) went to a psych ward.