Sign Up For Expanded Medicaid and Tear Up Your Will.

[JEFF9K]

Expanded Medicaid has been touted as a great part of the Affordable Care Act, but, as it turns out, it will subject people to something called “clawback,” meaning that after you die, the government can take all your assets. Forget about making a will!

How Obamacare Raids the Assets of Low-Income Older Americans
Monday, 17 February 2014 12:42 By Yves Smith, Naked Capitalism | News Analysis

http://truth-out.org/news/item/21913-how-obamacare-raids-the-assets-of-low-income-older-americans

[bravenak]

1. You can't get Medicaid if you have assets.

You have to use it up to a certain level before you can qualify. Medicaid is a program for the indigent.

[JEFF9K]

3. Wrong.

Expanded Medicaid ISN'T means-tested.

[Hestia]

4. It's on Medicaid.gov

[bravenak]

7. Maybe my insurance licensing manual has an error.

Medicaid is for the poor. If you are not poor you qualify for a subsidy.
You're making it so I have to go back and redo that chapter even though I know I passed the unit test with a perfect score.
Thanks for that.

[PoliticAverse]

12. The Patient Protection and Affordable Care Act greatly expanded Medicaid and eliminated asset tests

replacing them with an only income-based qualification (note that not all states are participating in the expanded Medicaid).

"Beginning in January 2014, individuals under 65 years of age with income below 133 percent of the federal poverty level (FPL) will be eligible for Medicaid."

See: http://www.medicaid.gov/AffordableCareAct/Provisions/Eligibility.html

[1StrongBlackMan]

27. LOL ...

People are defying reality, i.e., creating an issue where none exists.

Even at 138% of poverty ... how much in "assets" are likely to pass via a will?

(Is that pic, you?)

[JEFF9K]

28. Eligibility is based on CURRENT INCOME ...

Lots of people are out of work, or working part-time, but have a house or money that they planned on leaving to their kids.

[bravenak]

31. If you have a million dollars, but no income, you will not qualify for Medicaid.

Try it out, you'll see that they do check your income and verify how much you have coming in and how much you have access to.

You are allowed to keep your home. If you have money you plan on leaving to your kids in a will and you used Medicaid, the state can get what they are owed before your children collect. It's always been like this and always will be because Medicaid is a poverty program.

[JEFF9K]

34. EXPANDED Medicaid in not regular Medicaid. ...

EXPANDED Medicaid in not regular Medicaid. ...
EXPANDED Medicaid in not regular Medicaid. ...
EXPANDED Medicaid in not regular Medicaid. ...

How many times do I have to say it?

[bravenak]

36. Doesn't matter.

Either you pay now, or they take the money when you die.

If you have a million dollars, and you used Medicaid, they will take every single dollar of what they spent to insure you and for your care, from your estate before your kids get one red cent. So if you are not poor and are sitting on a pile of cash, you should purchase your own insurance.
The reason they make you sign the forms about asset recovery is to prevent people who can otherwise pay for their own insurance from using poverty programs. Because one you accept they can recover all of their money from your estate. If you enter a nursing home they can begin the process then. Bye bye pile of cash and home.

They can't take the house from your kid if the child is disabled of under 21, but they can take it from your grown able bodied kids. They can't take it from your spouse. Or a sibling if they own the property with you.

Cost less in the long run to purchase your own insurance if you have cash and a home you want to pass on.

[JEFF9K]

73. There is a difference ...

There is a difference ... between "sitting on a pile of cash" and having a few thousand dollars that you want to leave to your loved ones.

[bravenak]

80. A few thousand dollars is most likely allowed.

I know in my state you can keep about 2500, your car, your home, and other personal property.
A few hundred thousand us a different matter. The state can go after the portion they paid, but the Feds are funding this right now, then they still fund it at a much higher proportion than the state.
If you die now under this expansion, the Feds are paying I think it's still 100 percent, so the state has no losses to recover until they are paying a portion of the care. If the federal government want the money back, I don't know what they do in that case since they usually leave this up to the state.

[AverageMe]

107. I don't see why the state (other people) should pay for my health care

if I have money that I want to leave to my kids who are over 18. My children should work and make it on their own. My money should pay my own bills, these are not the responsibility of other people.

[SoCalNative]

78. Transfer of assets

five years or more prior to taking advantage of medicaid nips this in the bud.

[bravenak]

79. Is that how far back they go?

Five year asset search? That's better that I expected, I expected 10.

[YOHABLO]

37. Medicaid ''is a poverty program''? Oh those social entitlements .. damn those poor people.

[bravenak]

38. What do you mean by that?

It's a program for the poor. The middle class need not apply. It's a program for the indigent. Look it up.

[bravenak]

30. I think it's for people hiding assets, letting them know their estate will pay if they have one.

Most people with Medicaid have no estate to speak of.


(yes, the picture is me, people are nicer when they can see who they're talking to)

[El_Johns]

43. I currently make minimum wage but own a house. Under ACA I have to take the Medicaid options in my

state.

They are pitiful assets, no doubt, to someone like yourself, but I resent being forced to give them to the state for a health plan with a $6000 deductible.

[bravenak]

58. Medicaid is not what you have if you have a 6000 deductible.

You must have a private plan. I have Medicaid for my kids, and there's no deductible for care. There are co payments but they are low, 2, 4,6 dollars for prescriptions, no copayment for visits.
Unless this is some new strange way your state is administering the program.
Medicaid being a poverty program doesn't carry 6000 deductibles. It sounds like you have a bronze plan, lowest level, with a high deductible.

[1StrongBlackMan]

67. It's funny how the semi-informed ...

wish to argue with a subject matter expert. No matter how many times you give them facts, they will express their semi-informed opinion.

Sounds a lot like the "creationist/Science Guy debates" or the climate-change debates, or any discussion with the gop.

[bravenak]

68. I'm finding this very difficult to understand.

I'm being punked, I think. There's nothing more I can do here.

[1StrongBlackMan]

69. Why do you find it difficult to understand ...

this is the new DU where just saying "He should ..." means it can be done; where arguments about political events are trumpeted as "We made him do it/not do it" and non-accomplishments, at the same time; where my opinion trumps your facts (especially when seeing your face triggers my "more competent" gene).

[bravenak]

82. They make me want to rip my face off sometimes.

Or my hair. Or cry with frustration.
But I don't, since I know they do this shit on purpose. This is not real.


This is helping me study for my test, though. At least there's that.

[1StrongBlackMan]

91. Well ...

Good Luck! And Good luck on your test, too.

[bravenak]

92. Thank you.

[yeoman6987]

9. This is known

People who sign up for expanded Medicaid know they will take a hit in their estate.

[bravenak]

10. Good. I thought I was trippin for a second.

It's in the forms and they tell you when you sign up.

[El_Johns]

42. ACA changes that.

[bravenak]

45. They can still take money from your estate.

[El_Johns]

49. ACA forces people onto Medicaid because it forces people to buy health insurance under Medicaid.

It forces even full-time workers to do so if they don't make enough money.

[bravenak]

56. You mean to get subsidies to buy insurance?

I don't think you can buy into Medicaid yet. The subsidies don't buy you into Medicaid, they help you purchase private plans. There's no asset recovery involved if you use the subsidy to buy insurance, unless perhaps you were recieving the subsidy fraudulently because you are very wealthy. Then maybe the IRS will try to recover the subsidy monies from your estate.
I'm sure you don't intend fraud, your not a republican.

Full time workers should be recieving health insurance from their jobs unless the business has a waiver or not enough employees. In those cases they usually make enough to qualify for subsidized insurance as opposed to Medicaid. In cases where they are still not making enough to qualify for subsidized insurance they will qualify for Medicaid in participating states. In those cases of low income, there is rarely any estate to recover money from.

[El_Johns]

59. If you make 140% of the poverty level or less, you have to take the Medicaid option.

[bravenak]

60. Yes you do. Or you can opt out and pay the penalty.

Or refinance your home and set up a financial plan with an advisor paying you enough income yearly to bring you just above FPL to qualify for subsidies.
Or take payments from any retirement accounts you have, enough to bring you up above the FPL.
Or take an extra job or your wife can with just enough hours to bring you above the FPL so you can qualify for a subsidy.

But you are conflating Medicaid and a bronze level private plan purchased through the exchange.

[El_Johns]

61. I don't have a wife, or a financial advisor. I have the job I have because it's all I can get at

this moment, in this place, as a 60-year-old person.

And no, I'm not conflating.

[bravenak]

62. Are you paying any money for premiums?

Co payments? Deductibles? If so, it's probably not Medicaid.
If you have a small monthly payment from $.01 on up, with your $6000 deductible, you most likely have a subsidy applied to your account and are recieving private insurance through the exchange.
It sounds like a bronze plan.
Those plans while cheap, are not Medicaid. There is no asset recovery involved in such cases.
Nothing to worry about if the information you have been giving me is correct, it's not Medicaid.

[questionseverything]

81. medicaid for adults have co pays for almost everything

so you are incorrect there

the part of the op you are missing is, rich peoples' estates are not taxed unless there are over 5.3 million...so wether recovery is right or wrong it is not equal

and only those over 55 are affected by this rule so it is age discrimination

[bravenak]

83. It's always been like this.

I pay co pays that are so small, 2, 4, 6 dollar copays. One time it was 1 dollar. That's a Medicaid copayment. I know Medicaid personally.
No deductible of 6000 dollars in Medicaid ever, since it's a poverty program.

This person does not have Medicaid if he has a 6000 deductible.

Those under 55 like me, who find themselves flush with cash, are liable for the money during our lifetimes, they can attach our paycheck, take liens out, take our tax refunds. For those over 55, they wait until you are dead or dying before they start proceedings. So it's not age discrimination, since younger people are required to pay of ever able, as are older people, they just don't have to pay while they are alive.


Rich people do not qualify for poverty programs. The interest they earn from the money they have keeps them above the FPL. No recovery since they received no benefits.

[questionseverything]

85. co pays are not small for adults in illinois

my adult daughter has several on going medical problems

co pays for docs visits , x rays ,tests, are between 10 and 40 bucks a week for her....when you make less than a hundred a week that is not small and now the state limits how many scripts they will pay for a month to 4...which does not cover her needs

Medicaid is better than nothing but it is not equal or fair

[bravenak]

86. That is a very small amount compared to what everyone else pays.

No monthly premiums, Low co pays, 10 to 40 bucks a week is pretty damn good. If your daughter is very sick she may want to see if she can qualify for SSDI, once she qualifies for SSDI for a period of 24 months, she will be eligible for Medicare and can use that for coverage, with Medicaid to fill in the gaps, or buy into part B, and get a medigap plan, and part D if she can afford it of some combination there of.

I got sick while on Medicaid and I was in a coma for a week . My bill was about 1200 for my portion, including the ambulance, the state payed tens of thousands. Without Medicaid I would have had to file bankruptcy. As it is I am paying 20 bucks a month on my bill to keep my credit clear.

Medicaid is the cheapest option out there for poor people. I think it should be completely free and we should have single payer, but this is what we got, we gotta work it best as we can.

[questionseverything]

88. single payor is the only humane option

and since you think 40% of her weekly income is "pretty damn good" ,I hope that you personally are always charged that for your healthcare

ssdi is nearly impossible to get on now because the test is, "can you sit or stand for 20 minutes"

you said....
Medicaid is the cheapest option out there for poor people. I think it should be completely free and we should have single payer, but this is what we got, we gotta work it best as we can.
/////////////////////////////////

why should healthcare be parceled out according to how much money a person makes?

why should the poor be regulated to second class citizens?

the only mandate should of been on docs and providers to treat everyone equally

as long as people like you defend the for profit insurance industry we will never reach single payer

[bravenak]

93. I said it's pretty damn good compared to what others pay.

Nice hope for my future, thanks for that. I didn't put your daughter in the situation she is in, it's nice to know that you like to spread the pain around.

1. SSDI is not impossible to get on if you are totally and permanently disabled.
2. I don't control her income. I suggested SSDI, but for some reason, that pissed you off.
3. At my last job my health insurance was 800 dollars a month, 2000 deductible before my insurance paid anything, and then they paid 80 percent. I always had to pay for doctors visits out of pocket, and office visits at my doctor are 125 dollars per visit. That's 500 dollars everytime my family got a virus together, plus prescriptions, not covered, all out of pocket. I made 13 bucks an hour at that job, so yeah it was pretty harsh and far more than your daughter has to pay. I have a child with special needs and she costs plenty for occupational, physical, and other types of therapy. So you can save your hate/blame game for somebody who actually screwed you over.
4. As long as you blame the messenger instead of coming together for a solution, people like your daughter are going to be in this situation.

I said I was for single payer, so you decide that I'm defending the profit driven industry???


I blame you for not fixing this mess in our nation before my time. Now my generation has to fix this shit and you want to blame me for this??

You all gave us Reagan and Bush, you could have done health care reform years ago if you would have fought for single payer before i was born and not left my generation with a screwed up economy, a robbed SS fund, and thirty years of conservatism. We're just here to pick up the broken shards of our democracy and economy and try to solve the problems you and your generation were to busy to give a crap about until recently. Now you want to blame me for what existed when I got here?

You want to play the blame game, it's cool with me, I'm great at that game.

[questionseverything]

96. i will admit i let me emotions take over for a second

when you cavalierly said 40% of her income was "pretty damn good" to be paying especially when I had already said Medicaid has rules that do NOT meet her needs

I only have my life experiences to go by but ssdi requirements have tightened greatly in last decade....which is nothing but a cost cutting thing...I personally am tired of the poor and the middle class being delegated to second class citizens in one of the richest countries of the world...but that is just me

about this line.....As long as you blame the messenger instead of coming together for a solution

////////////////////

I worked my buns off for a guy that said he had a solution, a public option guy ,we elected that guy but we got this lousy insurance industry program with no competition anyways

hey just so you will feel better the 50 and older crowd really gets screwed under the aca,3 times the premium cost with high out of pockets that amount to between 26-33% of income...you can look at it as our punishment for leaving the country in a mess but you will find as you get older you are just as powerless as we were

[bravenak]

97. I don't really blame you. Only if you blame me.

I definitely don't blame the president not being superman enough to convinced everybody to go along with single payer. Even our own democrats sabotaged that for us. Remember Bart Stupak?
It's guys like him (blue dogs) along with republicans who prevented us from having a public option.

I understand that your daughter has a small income. For many with insurance, if they get sick, they have thousands upon thousands of dollars in deductibles, co pays, out of pocket, out of network charges, etc. It's enough to bankrupt many families. 40 dollars a week for a very sick person to pay is low comparatively.

SSDI is one way to make Medicaid work better for her, that's why I suggested it. If she able to work though, she doesn't qualify.

Im a very realistic person. I've paid more out of pocket in medical expenses than I made some months and have to borrow to cover my rent, so 40 dollars doesn't seem so bad to me. Maybe you can cover it for her, or another relative. She is still recieving very inexpensive care.

Health insurance has always been very expensive for the over 50 crowd, and many were uninsurable before the ACA. It's not perfect, but I do not want to go back to the old way.


I fully Expect that when I get older there will be nothing left for me in SS or Medicare, since it gas never been managed properly in my lifetime. I expect to purchase LTC, and fully fund my own retirement. That's how life goes, I am prepared and making plans now for that eventuality.
So never fear, I won't screw myself by expecting any help from the government.

[questionseverything]

100. just saying

you said.....So never fear, I won't screw myself by expecting any help from the government.

////////////////////

since your kids are on Medicaid, you are already getting help from the govt

[bravenak]

101. Nice how you chose to only quote the last line of the message. Not really, it's sad.

You did not publish my quote in its entirety. You selected one phrase from a paragraph.

I was saying that I will not rely on SS or MEDICARE since it may not be there. I will plan my own retirement. I'm 32 and I have plenty of time and marketable job skill to maintain my living standard after retirement. I will not depend on anything that I can't be sure will be there. I'm already starting my financial planning for the next 30-40 years. I won't screw myself by expecting any help with that from the government.

Just to be clear as glass.

[Glorfindel]

76. Medicare is not Medicaid. Your state couldn't "expand" Medicare

If I were you, I'd do a bit more investigation. You have obviously been poorly served by the insurance agents you consulted if they didn't explain the difference between Medicare and Medicaid. You may be paying too much for very little coverage. It's worth checking out.

[pipoman]

2. The way it has always been. .

[Tom Rinaldo]

14. Yes but it is still a problem, larger now than it used to be.

Some states are revamping their state medicaid laws to do away with this mandatory payback provision but most states have it (it is an option that the federal government offers states regarding their individual medicaid programs - but that option effected far fewer people before expanded medicaid came along under the Affordable Care Act.) By setting the eligibility level higher (I was told it is 138% percent of the poverty line in NY State - which translates to an income close to $16,000 a year) many people who earn little enough to be eligible for subsidies in the insurance pools that the ACA establishes no qualify for them. They instead must accept enrollment in medicaid If they accept that in most states their estates are billed for the cost of care that they receive under it. It is an option to refuse medicaid and buy a plan through the ACA exchanges, but only at full price without subsidies - which is unaffordable for most everyone making under @16,000 a year, especially for those in older age groups. Or one can refuse medicaid and not buy a plan through the ACA, but then one is liable for the individual mandate penalty fee.

[Downwinder]

5. I have no assets, hence no will.

Only thing is, Texas did not expand Medicaid.

[bemildred]

6. It's not yours anyway, once you are dead. nt

[bravenak]

8. +1

[former9thward]

21. So its the state's?

By some divine law?

[bemildred]

22. It's not yours, you are dead.

If it belongs to anyone, it belongs to your heirs, if you have any, or to the state. What do you propose instead?

[philosslayer]

94. If the state paid to provide your care

Who else do you think should pay? Its more humane that taking it while you're still living.

[El_Johns]

53. That's a hot selling point. Tell it to the Rockefellers.

It never ceases to amaze me how easily the concerns of the working poor are dismissed.

"Oh, you'll be dead anyway, who cares that you can't leave your house to the kids."

[bemildred]

71. The poor are poor because of cheap labor politics, not estate tax law.

If someone gets Medicaid, and then later gets rich, should the taxpayers not get some "clawback" from that person? Other people need the help too.

[bemildred]

103. Inheriting doesn't mean much if you don't leave much.

I would tax the shit out of the rich when they die, if that's what you want.

[bemildred]

105. Right, and the way you do that is: good jobs, universal free health care, and a fair tax system.

There is no way you have anything to leave on minimum-wage no-benefits jobs with our current "health care" system, because we all get sick and die eventually, and then you are instantly broke.

[bemildred]

109. Right, we could fix that with universal free health care.

No bills, no debt. No debts, no "clawback", it's an entitlement for everybody.

[bravenak]

11. Ok. I reread the chapter.

Medicaid is a welfare health care program for indigent persons. It was established by the federal government but is administered by the states. The eligibility requirements for Medicaid vary somewhat from state to state. Gen- erally, to be eligible for Medicaid, a person must qualify for either (1) Aid for Families with Dependent Children (also known as public assistance or welfare) or (2) Supplemental Security Income, an assistance program under Social Security for indigent persons who are age 65 or over, blind, or disabled. For those who do qualify, Medicaid covers most health care costs, including hospital and doctor bills and nursing home care.
23. 9. 1 Financial Tests
Each state establishes its own limit on the income and financial resources that a Medicaid recipient may have and still qualify for Medicaid. The recipi- ent must spend down or exhaust income and resources to a minimum amount before Medicaid becomes available.
The recipient—an individual, couple, or family—is permitted to retain a small amount of monthly income plus certain assets (or what the law refers to as resources). The recipient is allowed to keep his home. Within important limits, the recipient may also be able to keep some personal property.

[Tom Rinaldo]

16. "The recipient is allowed to keep his home".

Correct. As long as the recipient or spouse resides there. The asset of a home does not disqualify someone from receiving benefits and their house won't be taken out from under them. After death though it is a different story. From the research that I did for those states that utilize the option for their programs, individuals between the ages of 55 to 65 (and no I don't understand why people between those ages are the ones effected) can have the state seize their home asset after death to pay back Medicaid expenses the state incurred while they used that program, from age 55 to 65. In some cases there can be expenses owed even if an individual never billed medicaid for any medical treatments. That happens when some states contract with private companies to manage their medicaid programs for set fees that are paid whether or not the individual uses the program.

All of this effects me so I did a lot of research on it. I welcome being corrected where I am wrong if I am wrong.

[bravenak]

20. I think they can retrieve money from the estate for certain costs.

I'm going to keep looking for more clarity on this. I might try to email someone and see if I can get more info on his much they can retrieve from an estate.

[Mojorabbit]

24. Does this mean a spouse might lose the house after the other passes? nt

[Tom Rinaldo]

25. No I don't think so.

The kids might though depending on the costs that must be recovered. Again, I'm not claiming to be an expert . I did spend most of a day looking into this but I'm not married so I may not have looked closely enough at that aspect, but if I remember correctly a spouse is protected.

[riverwalker]

35. depends on the state

in Minnesota, a spouse (the non-Medicaid spouse) can continue to live in the house, but when he dies, they take it (to cover what the Medicaid spouse recieved). Lots of families get that surprise letter.

[tsuki]

54. No. They get to live there until they move out or die.

[nykym]

84. Does that mean

once you turn 66 you're in the clear?
no asset recovery.

[Tom Rinaldo]

89. That's my current understanding, if you don't owe them from before then

This is all damn confusing, and it is rarely spelt out clearly. I spent hours trying to figure this out online, doing multiple searches for information, and I spent an hour on wait time in order to speak with a human through the NY State web site. But I don't remember what info I picked up where. The health rep told me that my income was (barely it seems) over the line where I would have been put into the medicaid program so I stopped trying to figure it out at that point

[YOHABLO]

39. Yeah .. like a car

[bravenak]

57. In a nutshell.

And maybe a couple grand.

[2pooped2pop]

13. Isn't that pretty much if you are put into a home or require in home care?

and hasn't Medicaid always done that? Please enlighten me a bit.

[Tom Rinaldo]

17. Not in most states for those between 55 and 65. See my replies above. n/t

[geek tragedy]

15. Koch Brothers talking points circulated by their useful idiot Yves Smith, who may

be the leftwing Ted Cruz. She cites noted Paulbot loon Paul Craig Roberts to support her fearmongering.

http://thinkprogress.org/health/2014/01/24/3202611/medicaid-asset-recovery/

Critics of the Affordable Care Act are seizing on a decades-old provision in Medicaid law to scare lower-income Americans from signing up for health care insurance, warning newly eligible enrollees that the federal government could take their house and other assets once they die.

“I was leaning toward not getting Medicaid, because there is somewhat of a stigma,” Steve Olin, 60, told the Washington Post. “Then, when I heard about the estate recovery, I was really sure.” The paper describes this “little-known aspect of Medicaid” as “the latest anxiety to spring from the health-care law” that is “causing fear.”

But the provision has little to do with reform. In 1965, the federal government permitted states to “recover from the estates of deceased Medicaid recipients who were over age 65 when they received benefits.” The provision was grounded in the rather conservative theory that wealthier individuals should take responsibility for their health care costs and pay back taxpayers for hundreds of thousands of dollars of care. As Washington & Lee law professor Tim Jost put it, “it’s only fair that the state can recover for long-term care if there are significant assets left behind.”

[El_Johns]

44. The state takes EVERYTHING, and not just from rich people. I have personal experience with this.

[kelly1mm]

18. There is a lot of discussion of this provision in early retirement blogs. While the ACA

makes early retirement much more possible (you can get coverage not for very little if your income, not assets, is low), some ER people have very low incomes and live off savings/assets. However, some are having to bump up their income from (for example) $15,000 for a couple to about $23,000 per couple to get above 138% of poverty line and thus, into the exchanges, with about 98% premium subsidy and no claw back vs. Medicaid which is free, but comes with a claw back. Most are using the IRA to RothIRA conversion to 'bump' their income up to 138% FPL. I will be starting to do that next year as my wife and I are retiring after the end of this school year. Our interest and dividends are about $17,000 per year so we will have to do the Roth conversion of about 6k per year beginning in 2015.

[Hoyt]

19. OK, don't take expanded Medicaid. Then, your house is at risk if you get sick and before you die.

I think asset recovery is unlikely for most folks, because they likely won't have any assets if they qualify for Medicaid.

And, under any scenario, no one will have their assets in jeopardy until after the beneficiary dies (assuming one isn't going on regular Medicaid) -- in which case if mom doesn't have Medicaid coverage or any other coverage, the hospital or doctor is going to take it before the kids get it anyway.

And, there is still the question of whether states will go after any assets -- assuming they find someone with some assets -- as this article suggests. http://articles.chicagotribune.com/2014-02-05/site/ct-medicaid-liens-illinois-biz-0205-20140205_1_health-insurance-expansion-health-care-law-provision


Point is, I agree it needs to be clarified, but this is not something to go crazy over and criticize Obamacare.

[bemildred]

23. +1. nt

[JEFF9K]

29. People take comfort in the fact that ...

People take comfort in the fact that ... when they die they can leave something to their loved ones.

And please read the linked article. EXPANDED Medicaid is different from regular Medicaid.

[Hoyt]

32. They take comfort in having coverage, and not having to sell their home before

they die too. I think most folks will be glad to take the coverage/treatment than sell their house to cover it. But, they don't have to. And, we are assuming folks will need that much care to deplete everything they have. Finally, as link above indicates, many states probably won't go after the assets.

[El_Johns]

52. "Probably". I think we can assume they will, because they already do. And if I'm signing up for

something, I don't want to hear "probably," "maybe," "likely". I want all the terms spelled out.

Which is why I will pay the penalty this year.

[Hoyt]

64. Then, if you get sick, there go your assets. At least with Medicaid, you get to keep them while

alive, and quite likely while passed away, for whatever good they do you. The "probably" with coverage is a lot more certain with Medicaid than without.

[SharonAnn]

75. Then, take comfort in having your family pay for your care until you die.

Seriously, it's usually the long-term care in nursing homes that is the big driver. These Medicaid bills can be enormous.

So people should not have to pay for their care? They should put (shelter) their money in houses, then have taxpayers pay for their nursing home care, then their "estate" should go to their heirs (children)?

In order to be fair about that, then person or the heirs (children) should pay for the nursing home care before the person dies. Let's see if they understand that.

Wanting to "eat your cake and have it, too".

I'd love an arrangement where others paid my costs and I got to keep my assets!

[El_Johns]

46. Easy to say for people not subject to the provision. Yes, it is something to criticize Obamacare

for. I currently make minimum wage. I also own a home, bought in better times. A small home, but I own it.

I resent being forced into Medicaid. I work, I am not indigent. I resent being required to cede my assets.

[Hoyt]

65. If you don't get sick, you don't cede your assets. You definitely do, if you get sick with

no coverage.

[El_Johns]

47. Your house is at risk even with ACA Medicaid policies -- $6000 deductible. If you're making minimum

wage range that's already about 1/3 to 1/2 of whatever you earn.

It's designed to ruin you either way.

[JimDandy]

63. You don't have Medicaid if you have a $6,000 deductible. n/t

[MFM008]

26. wonderful

if i had money, id have assets. They are welcome to the junk I have, it will save my family from having to burn it......

[bravenak]

33. Asset recovery.

Under certain conditions, money remaining in a trust after a Medicaid enrollee has passed away may be used to reimburse Medicaid. States may not recover from the estate of a deceased Medicaid enrollee who is survived by a spouse, child under age 21, or blind or disabled child of any age. States are also required to establish procedures for waiving estate recovery when recovery would cause an undue hardship.

States may impose liens for Medicaid benefits incorrectly paid pursuant to a court judgment. States may also impose liens on real property during the lifetime of a Medicaid enrollee who is permanently institutionalized, except when one of the following individuals resides in the home: the spouse, child under age 21, blind or disabled child of any age, or sibling who has an equity interest in the home. The states must remove the lien when the Medicaid enrollee is discharged from the facility and returns home.

[Hoyt]

41. Excellent information.

[El_Johns]

48. They take everything unless you have a surviving dependent. And when the dependent dies, they take

everything, period.

You can't leave your property to your adult children or other relatives.

[Hoyt]

66. You can't do that if the hospital takes them because you got sick with no coverage.

[hollowdweller]

72. I've always felt that that is the real "Death Tax"

Because it affects so many people.

It's interesting that so much attention has been paid to the estate tax, which tends to only affect people of means, when the medicare clawback mainly affects poor people.

One of the big problems in our country is that the lower and working classes are unable to move up and or accumulate any wealth that would then allow their children to be better off.

I've always thought the provisions being discussed here are another way that we hurt social mobility for the working class.

We should do away with it and instead raise the estate tax.

[YOHABLO]

40. Bottom line folks ... hide your assets !!

[daybranch]

50. This is a very questionable statement

The author mentions that states (some states) can claw back medicaid expenses paid by the state. While that may be true , it is also important to remember that for the next 2years, the states will not be contributing to the cost of the Medicaid expansion. So no expenses will be incurred by states due to medicaid expansion in the next two years so obviously you cannot claw back something that never went out. After two years, the states will have to pay 10 percent of the costs of the medicaid expansion. In those states that have these claw back laws, then it is possible they may claw back up to 10 percent of their outlays for an individuals care under medicaid. So I guess the question is this, do I believe that two years from now, I should start refusing medicaid on the premise that avoiding 10 percent of the cost of medical services being provided to me is more valuable than my life?
Seems like a no brainer for me. Bless Obama Care and especially medicaid expansion. It is the most Christian action that our government has taken in a long time.

[El_Johns]

51. Why should working people have to give up their assets to get health insurance that they are paying

for, and paying high deductibles for as well?

[bravenak]

87. I've determined that you don't have Medicaid.

[moriah]

99. Uh, Medicaid is kinda, uh, free. With no deductible. At least in my state. Arkansas, even.

Sure, prescriptions cost between $0.50 and $3.00, and you may have to wait a week if you get a new chronic maintenance drug to get the pre-authorizations approved. But no premiums or deductibles.

People buying into the Exchange are not subject to what's discussed in this article.

[moriah]

74. That's when you turn over the deed of the house to the kids first.

Mom has already said that since she doesn't have private long-term care insurance, she'll probably put the deed in my sister's name here shortly.

That way when she gets Medicare, she won't lose the house and it'll stay in the family. And that's how we saved it when my grandfather died -- my grandmother put the house in my mom's name shortly before he passed. He was taken care of at home, but she wanted to make sure that the house stayed in the family when she got sick. It was many years later, and she gave my sister and I the split of her savings she'd planned to leave as our inheritance when we were both at places where we needed the money, also before she got sick.... though she didn't believe in banks much.

You can't take it with you when you go... better to decide who gets it and get the assets transferred before death, if you really want them to go where you want. It's been that way for a long time, for the rich and poor alike.

[Hoyt]

77. We are talking Medicaid, not Medicare. With Medicaid, there is a look back period, where gifts

to kids can be taken to cover nursing home expenses. So deeding it to kids does not always work.

And, a friend of mine -- who deeded his house to the kids -- lost it when the kid got drunk and killed a family in auto accident.

[JEFF9K]

90. Just talked to my friend/lawyer ...

Just talked to my friend/lawyer ... he says it's very common to get Medicare and Medicaid confused and that there is no "clawback" with MediCARE.

[moriah]

98. When you go into a nursing home, you end up on QMB Medicaid Spenddown unless....

.... you have private long-term care health insurance.

She has health insurance now through her employer, and Medicare will kick in at retirement age. Her plan is to transfer the assets prior to that just in case.

Edit to add: I'm not a dimwit, and the snark wasn't necessary. If you had a relative whose dealt with nursing home admission when the only potential asset was the family home, you'd be aware that even Medicare recipients will be enrolled on Medicaid to handle long-term care. Or if you'd called that lawyer/friend. It's better to do it far in advance of the need, because of concerns about "gifts", etc.

[JEFF9K]

106. Snark?

Snark? What snark? I was just stating a fact about the confusion re Medicare and Medicaid. My lawyer friend does estate planning and deals with successful people who often get the two confused.

You are correct about the importance of advance planning.

[Sunlei]

95. Longterm nursing homes have always done this as part of the 'contract' to get in.

btw many credit card companies will also flag the home & bank accounts and get card-bill paid before the children get anything from will/probate.

So what kids can do when parent dies (and only owned a house) is do not sell or change the deed on that family home.*

*edit- don't forget to pay the mortgage(required insurance), state/local property taxes & Neighborhood fees .or the bank/state/local Gov will take the home away- anyway.

[mainer]

111. Why do I see nothing wrong with this?

You have assets that can't be touched while you're alive. You need medical care, and taxpayers pay for it all. Then you die, and your house and other untouchable assets pass, untaxed, to your heirs -- who didn't help with your medical bills. The taxpayers get stuck with your medical bills, and your kids get an inheritance.

If the government is going to take care of you, then you (if you have assets) should give something back.

[JEFF9K]

112. Something should be exempt from the consfiscation.

Maybe $10,000.00 or so. Enough to bring a measure of happiness to you and your heirs.