Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Im not sure I understand your question? If she’s there, and Medicaid is paying, what makes you think they’d stop? Your relative, at their age, also has Medicare

Medicare doesn’t pay for nursing homes.

So how do people pay for nursing homes? It's very expensive

The overwhelming majority pay with Medicaid.

Are you a US adult and just discovering this?!

This. Most elderly run out of money, have to sell their house, and end up bankrupt before starting Medicaid.

No offense, but that's the way it's supposed to work. Medicaid is there when you have no money. You're supposed to save for retirement, spend your money on retirement. And if you run out, Medicaid is there. So many people want to hoard their money or pass it on to the next generation, while having Medicaid pay for their care.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Stay tuned. Overspending by the GOP will trigger automatic cuts in Medicare.

Government has been overspending for over a century.
Government will continue to overspend until it all crashes. Fiat currency be like it be.

Government hasn’t been overspending. It has been under taxing the rich.

The top 1% of earners paid 46% of federal income taxes in 2021, despite earning 15% of total income, according to the National Taxpayers Union.

The top 10% paid 75%, while the bottom 50% paid 2%.

The Joint Committee on Taxation confirms millionaires pay an average effective tax rate 3.5 times higher than most Americans.

What about billionaires with their fancy ways of extracting funds from their investments? It's not income so it's not taxed. They need to pay.

If we took all the billionaires’ money and funneled it towards Medicaid and Medicare, how long do you think it would last?

The top 5 percent of earners currently pay on average a 23 percent tax rate. If that was raised (through increases on various forms of income) to an average of 25 percent, the amount they would contribute would go from $1.3 trillion to $1.4 trillion a year, or about $100 billion a year. An average 2 percent tax increase. Its not going to save Medicaid and Medicare but its about how much they are planning to cut per year through the OBBB.

I get what you’re saying but I don’t think that can even touch the problem. If the full $100 billion went towards Medicaid alone- and no where else - it won’t make a dent. Medicaid alone cost over $870 billion in 2023. Medicare cost $848 billion in 2023. Upping the tax rate on billionaires, while arbitrary, doesn’t cause me much heartburn. However, it won’t make any difference and we still have the same problem.

Anonymous wrote:

Anonymous wrote:My spouse is an executive VP in the LTC business. They are not panicking yet. But everyone acknowledges that
Funding may be lost. If that happens your relative will be evicted if that is their payor source. And if the home shuts down, there won’t be any chance of them being forced to keep people who don’t/can’t pay. Thing is that this is an evolving situation and no one knows what will be affected. But the places that will be hit the hardest are those with insufficient private pay to cover the losses.

So in other words, the less expensive places in rural areas and elsewhere that do not depend on private pay will close. The tony places in DC that charge $20k a month and serve the elite will remain open.

Those aren’t even tony places. They are just the regular ones.

The elite are cared for at home.

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:I predict a lot more euthanasia.

YOU do not get to make the decision about when and how you die. THEY make that decision for you. It’s the ultimate expression of freedom, really.

/s

In theory yes. I’ve had two family members die in hospice and my experience is that it’s a hair breadth away from euthanasia. Basically the ER doctors will suggest a discharge to hospice rather than any sort of aggresssjvr care. Hospice will then take them off all the medications that keep them gojng. Hospice will then recommend the HAM sandwich — haldol, morphine and Ativan — to keep the patient calm. They will gtadually increase the dosage on that. What elderly person is going to survive that combination? I’m not complaining, I’m just saying that there is more room for euthanasia than most people think.

This is a little off-topic, but yes, this is basically what happens and not only to the elderly. My 40-year-old sister was dying of cancer and when he just couldn't stand it anymore, her live-in boyfriend called the hospice nurse one morning to administer the "emergency pack," which is exactly what the PP described above. My parents were planning to come to see her the next day, but hospice and boyfriend made the decision to end her life without any other family members. Fortunately, I arrived to be with her for her last breath while the boyfriend was vaccuuming the apartment and hospice nurse had gone home.

Was he your sister’s health care proxy?

Anonymous wrote:

Anonymous wrote:Im not sure I understand your question? If she’s there, and Medicaid is paying, what makes you think they’d stop? Your relative, at their age, also has Medicare

They will stop paying her nursing home fee. Why she is even in a nursing home at this age is the question-it might be from a long term disability, not related to age (?)

Not OP, but I had a relative enter a nursing home at age 69 after a series of strokes. She lived another 14 years.

Nursing homes provide daily medical care as well as assistance with activities of daily living. Assisted living only handles ADLs.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Stay tuned. Overspending by the GOP will trigger automatic cuts in Medicare.

Government has been overspending for over a century.
Government will continue to overspend until it all crashes. Fiat currency be like it be.

Government hasn’t been overspending. It has been under taxing the rich.

The top 1% of earners paid 46% of federal income taxes in 2021, despite earning 15% of total income, according to the National Taxpayers Union.

The top 10% paid 75%, while the bottom 50% paid 2%.

The Joint Committee on Taxation confirms millionaires pay an average effective tax rate 3.5 times higher than most Americans.

What about billionaires with their fancy ways of extracting funds from their investments? It's not income so it's not taxed. They need to pay.

If we took all the billionaires’ money and funneled it towards Medicaid and Medicare, how long do you think it would last?

The top 5 percent of earners currently pay on average a 23 percent tax rate. If that was raised (through increases on various forms of income) to an average of 25 percent, the amount they would contribute would go from $1.3 trillion to $1.4 trillion a year, or about $100 billion a year. An average 2 percent tax increase. Its not going to save Medicaid and Medicare but its about how much they are planning to cut per year through the OBBB.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Stay tuned. Overspending by the GOP will trigger automatic cuts in Medicare.

Government has been overspending for over a century.
Government will continue to overspend until it all crashes. Fiat currency be like it be.

Government hasn’t been overspending. It has been under taxing the rich.

The top 1% of earners paid 46% of federal income taxes in 2021, despite earning 15% of total income, according to the National Taxpayers Union.

The top 10% paid 75%, while the bottom 50% paid 2%.

The Joint Committee on Taxation confirms millionaires pay an average effective tax rate 3.5 times higher than most Americans.

What about billionaires with their fancy ways of extracting funds from their investments? It's not income so it's not taxed. They need to pay.

If we took all the billionaires’ money and funneled it towards Medicaid and Medicare, how long do you think it would last?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My spouse is an executive VP in the LTC business. They are not panicking yet. But everyone acknowledges that
Funding may be lost. If that happens your relative will be evicted if that is their payor source. And if the home shuts down, there won’t be any chance of them being forced to keep people who don’t/can’t pay. Thing is that this is an evolving situation and no one knows what will be affected. But the places that will be hit the hardest are those with insufficient private pay to cover the losses.

Its a different medicaid, its long term care medicaid, not regular so its funded differently. Its anyones guess what will happen.

It is not funded differently.

Actually LTC in Medicaid is funded differently in most states, along with hospitals. Medicaid coverage of things like physician visits, Rx, therapy, etc is paid for by state income taxes, and the federal government matches what the state pays (from 50 -70%). But for the big "institutional" providers, a LOT of states raise money by taxing the providers themselves and then using the money to pay them back through Medicaid. As long as the tax rates are <6% it is allowed.

So if Medicaid in Indiana, for example, pays nursing homes $3 billion a year, and the federal government contributes 70% to Medicaid in Indiana, Indiana can tax the nursing homes 5%, which is under 6% and therefore legal, and raise $150,000,000. Indiana then submits the $150M to the federal government as its share of $650M in state spending (30%) and gets $500M in federal money (the other 70%). It uses that $500M plus the $150M in tax money as a huge chunk of the $3B it is spending on nursing homes.

States do the same thing with hospitals.

The OBBB is removing state's ability to raise money this way, calling it "fraud" even though it is currently legal.

In Indiana's case, if they can't do the provider tax thing, they are going to have $650 million less to spend on nursing facilities out of $3B they spend now.

That is a LOT of money that they will either have to:
a) raise out of state income taxes/sales taxes
b) cut from other state services to put in the Medicaid budget
c) cut from other parts of Medicaid, by cutting eligibility for optional groups or cutting other services
d) cut by reducing provider payments, mainly to nursing homes, which means they will close and people will have nowhere to go

The only way you get a TRILLION dollars out of Medicaid, which the OBBB says it does, is by cutting people, services, and provider payments. There is nothing close to $1T in fraud waste and abuse. There is just republicans who consider government-funded health care waste, and federal payments to states abuse and fraud.

I predict it will be an issue for many seniors and their families. I’m thankful that my dad at 85 is in excellent health and has saved more than enough. I have an aunt without children who will eventually need a nursing home but thankfully has LTC and has a healthy pension and a home that can be sold. But my MIL in another state would not be able to afford a nursing home if needed and I suspect would end up on Medicaid. I hope she stays healthy to the end because DH and I can’t afford to pay. Nursing homes are expensive. When my family member was in one, it was 15k a month. It must be more now. So many people are at risk.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I predict a lot more euthanasia.

YOU do not get to make the decision about when and how you die. THEY make that decision for you. It’s the ultimate expression of freedom, really.

/s

In theory yes. I’ve had two family members die in hospice and my experience is that it’s a hair breadth away from euthanasia. Basically the ER doctors will suggest a discharge to hospice rather than any sort of aggresssjvr care. Hospice will then take them off all the medications that keep them gojng. Hospice will then recommend the HAM sandwich — haldol, morphine and Ativan — to keep the patient calm. They will gtadually increase the dosage on that. What elderly person is going to survive that combination? I’m not complaining, I’m just saying that there is more room for euthanasia than most people think.

Good. Relatives should not fight it

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Just curious what will happen to elderly 71 year old disabled parent who is medicaid in a nursing home. We pay nothing. Would she lose her spot in a nursing home?

71 is very young to be in a nursing home. She is not elderly. I am assuming she is otherwise disabled, as opposed to being elderly, so that is likely what will impact her status.

Elderly is a medical concept in this context and 65 is the age one is considered by medical professionals to be sadly elderly. If you make it to 75+ that’s late elderly. Many Americans have serious health conditions by the time they are early to mid 60s which is why mid 70s is the average age life expectancy for Americans. The better educated and wealthier tend to live much longer because they didn’t do a lifetime of body crushing work and they had easier access to preventive health care and high quality diet etc.

Not sadly elderly, EARLY elderly

Hate the autocorrect 🤬

I’m sorry, this made me laugh. Sadly fit here as well

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Im not sure I understand your question? If she’s there, and Medicaid is paying, what makes you think they’d stop? Your relative, at their age, also has Medicare

Medicare doesn’t pay for nursing homes.

So how do people pay for nursing homes? It's very expensive

The overwhelming majority pay with Medicaid.

Are you a US adult and just discovering this?!

This. Most elderly run out of money, have to sell their house, and end up bankrupt before starting Medicaid.

Many also don’t have money or homes and living off of very little so qualify is no problem.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Just curious what will happen to elderly 71 year old disabled parent who is medicaid in a nursing home. We pay nothing. Would she lose her spot in a nursing home?

71 is very young to be in a nursing home. She is not elderly. I am assuming she is otherwise disabled, as opposed to being elderly, so that is likely what will impact her status.

Elderly is a medical concept in this context and 65 is the age one is considered by medical professionals to be sadly elderly. If you make it to 75+ that’s late elderly. Many Americans have serious health conditions by the time they are early to mid 60s which is why mid 70s is the average age life expectancy for Americans. The better educated and wealthier tend to live much longer because they didn’t do a lifetime of body crushing work and they had easier access to preventive health care and high quality diet etc.

It is very rare to see a lot of people in their 60s and early 70s in a nursing home. It is an anomaly if there are some, a problem that likely has been around long term or has a specific situation. I don't care what or how cultural labels came to be, but 71 is not elderly in the sense if requiring a nursing home.

+1

Average age of nursing home residents: 81.1

https://www.theseniorlist.com/nursing-homes/statistics/

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Im not sure I understand your question? If she’s there, and Medicaid is paying, what makes you think they’d stop? Your relative, at their age, also has Medicare

Medicare doesn’t pay for nursing homes.

So how do people pay for nursing homes? It's very expensive

The overwhelming majority pay with Medicaid.

Are you a US adult and just discovering this?!

This. Most elderly run out of money, have to sell their house, and end up bankrupt before starting Medicaid.

Well the purpose of Medicaid is to protect the destitute. So it’s working the way it’s supposed to.

One thing though. Most are not bankrupt in the legal sense but rather the pedestrian use of the word.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Im not sure I understand your question? If she’s there, and Medicaid is paying, what makes you think they’d stop? Your relative, at their age, also has Medicare

Medicare doesn’t pay for nursing homes.

So how do people pay for nursing homes? It's very expensive

The overwhelming majority pay with Medicaid.

Are you a US adult and just discovering this?!

This. Most elderly run out of money, have to sell their house, and end up bankrupt before starting Medicaid.