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

[Anonymous]

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 paragraph is written by someone who is either completely ignorant of the retirement situation for a huge number of Americans (no more pensions, gutted 401(k) employer contributions, always scheduled to work under FT hours to be denied benefits, etc) or simply doesn't care that corporations feel NO compunction in helping their employees with LTC.

It's frankly appalling that this is the playbook of the incoming admin. "...[W]hy this new approach is plausible, practical, and preferable." Nearly 40% of Americans make under $100,000, 25% of them make under $75,000. Many of these people live paycheck to paycheck due to high housing cost and medical expenses. What is plausible or practical here for them to save at the rate needed to cover LTC???

They have no clue how some live. My mil had zero money but $1k in social security. Medicaid took all but $75 a month or so.

[Anonymous]

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.

Be real. No one is quitting without long term income. Stop making up stuff. I could do as someone married.

What’s this word salad?

[Anonymous]

What are these MAGA supporters going to do when they cannot obtain Medicaid for their parents' LTC? This is no longer a hypothetical with plans to gut Medicaid and similar programs in order to pay for the imminent Trump tax cut. And there will not be the same number of folks out there to provide care for seniors if many of the people holding these jobs are deported, including people who may be denaturalized.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The government is never going to toss people with Alzheimer's and no money onto the street to die so this is all just fear mongering.

Are you aware of how difficult it is to obtain Medicaid? If it is put into a block grant, there is going to be no way that there will be enough money for all those in need.

Dp. Not it’s not. I just got my state’s version of Medicaid for my newly arrived father. It was a 3 month wait but it wasn’t hard.

He's not a citizen but gets medicaid? How does that work?

It works in a state where anyone income eligible can get the state Medicaid. Even before the expansion to illegal immigrants (which my father isn’t) green card holders were eligible (my father is one). Now, anyone can get it if they are poor, and it made the wait times extremely long.

[Anonymous]

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.

[Anonymous]

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.

It depends on the state. Some states say that adult children have a financial obligation to help support elderly indigent parents.

That’s true, choose the state wisely

[Anonymous]

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.

[Anonymous]

If you’re in Maryland and under Maryland Medicaid, your elderly parents can get home care at home paid by Medicaid if they aren’t bad enough to be institutionalized but need a daily caregiver to come in and cook, clean, bathe them and go to the grocery store for them. Medicare is the one that bizarrely doesn’t have a home care option. Medicaid does

[Anonymous]

Anonymous wrote:If you’re in Maryland and under Maryland Medicaid, your elderly parents can get home care at home paid by Medicaid if they aren’t bad enough to be institutionalized but need a daily caregiver to come in and cook, clean, bathe them and go to the grocery store for them. Medicare is the one that bizarrely doesn’t have a home care option. Medicaid does

Correct me if I am wrong, but isn’t there a waiting list for these services, which are provided through a waiver program? In other words you don’t simply have to prove you qualify (like for Medicaid for nursing home care), there also have to be open slots available.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The government is never going to toss people with Alzheimer's and no money onto the street to die so this is all just fear mongering.

Are you aware of how difficult it is to obtain Medicaid? If it is put into a block grant, there is going to be no way that there will be enough money for all those in need.

Dp. Not it’s not. I just got my state’s version of Medicaid for my newly arrived father. It was a 3 month wait but it wasn’t hard.

He's not a citizen but gets medicaid? How does that work?

It works in a state where anyone income eligible can get the state Medicaid. Even before the expansion to illegal immigrants (which my father isn’t) green card holders were eligible (my father is one). Now, anyone can get it if they are poor, and it made the wait times extremely long.

There are about a half dozen states that provide Medicaid to at least some people regardless of immigration status, so long as they are eligible by income. But these states can only use state funds for any coverage of undocumented immigrants in these cases — it’s illegal to use federal Medicaid funds for this purpose— and usually the populations covered are kids and/or adults younger than 50, not people who would get nursing home care.

Here is a KFF Health News story about this state-funded coverage:

States Expand Health Coverage for Immigrants as GOP Hits Biden Over Border Crossings

https://kffhealthnews.org/news/article/states-health-coverage-medicaid-immigrants-expansion/#:~:text=Subscribe%20to%20KFF%20Health%20News,program%20for%20low%2Dincome%20people.

[Anonymous]

Anonymous wrote:What are these MAGA supporters going to do when they cannot obtain Medicaid for their parents' LTC? This is no longer a hypothetical with plans to gut Medicaid and similar programs in order to pay for the imminent Trump tax cut. And there will not be the same number of folks out there to provide care for seniors if many of the people holding these jobs are deported, including people who may be denaturalized.

The kinds of Medicaid cuts the Republicans have talked about — repealing or cutting funding for the ACA Medicaid expansion and/or funding Medicaid with a block grant to each state — are also going to weaken the finances of rural hospitals, many of which already are on the brink of closing. MAGA gonna have to drive to the big city for ER and other hospital care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What are these MAGA supporters going to do when they cannot obtain Medicaid for their parents' LTC? This is no longer a hypothetical with plans to gut Medicaid and similar programs in order to pay for the imminent Trump tax cut. And there will not be the same number of folks out there to provide care for seniors if many of the people holding these jobs are deported, including people who may be denaturalized.

The kinds of Medicaid cuts the Republicans have talked about — repealing or cutting funding for the ACA Medicaid expansion and/or funding Medicaid with a block grant to each state — are also going to weaken the finances of rural hospitals, many of which already are on the brink of closing. MAGA gonna have to drive to the big city for ER and other hospital care.

They'll never put 2 and 2 together.

[Anonymous]

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."

[Anonymous]

Anonymous wrote:

Anonymous wrote:What are these MAGA supporters going to do when they cannot obtain Medicaid for their parents' LTC? This is no longer a hypothetical with plans to gut Medicaid and similar programs in order to pay for the imminent Trump tax cut. And there will not be the same number of folks out there to provide care for seniors if many of the people holding these jobs are deported, including people who may be denaturalized.

The kinds of Medicaid cuts the Republicans have talked about — repealing or cutting funding for the ACA Medicaid expansion and/or funding Medicaid with a block grant to each state — are also going to weaken the finances of rural hospitals, many of which already are on the brink of closing. MAGA gonna have to drive to the big city for ER and other hospital care.

This is spot on.
Lots of Medicaid monies were block grants to states, eligible for federal match, etc. etc, and that's why there's such a difference in what resources you can get by state. If MAGA follows their wishes, it won't matter. The states still need that fed money. Reimbursement rates (which are dismal) will be worse, and hospitals will close.

[Anonymous]

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.