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LTC Bullet: States Put LTC Puzzle Pieces Together


Tuesday June 16, 1998

Seattle--

In the current issue of the prestigious journal "Health Affairs," Josh Wiener and David Stevenson of the Urban Institute confirm: "state officials believe that reducing [Medicaid] asset transfer is a critical prerequisite to motivating citizens to purchase long-term care insurance policies and, more generally, to viewing long-term care as a private responsibility."

The complete quotation follows: "Over the past several years policy-makers and the media have focused attention on middle-class and wealthy elderly persons who transfer, shelter, and
underreport assets--so-called Medicaid estate planning--to appear poor enough to qualify for Medicaid-financed nursing home care. Congress has legislated against these practices on numerous occasions (most recently in the Balanced Budget Act [BBA] of 1997), but some argue that the legislative prohibitions are easy to circumvent.... Although the rhetoric surrounding the issue is passionate and all states acknowledge it as somewhat of a problem, Massachusetts, New Jersey and New York were the only ANF [Assessing the New Federalism study] states in which asset transfer was thought to be a major public policy issue. It is of particular concern in New York, where there are approximately 1,200 elder-law attorneys and where newspaper and magazine advertisements relating to asset transfer are said to be ubiquitous. The litigious culture and the hostility of the state courts to rules requiring middle-class citizens to impoverish themselves make cracking down on asset transfer difficult. Nonetheless, state officials believe that reducing asset transfer is a critical prerequisite to motivating citizens to purchase long-term care insurance policies and, more generally, to viewing long-term care as a private responsibility." (Joshua M. Wiener and David G. Stevenson, "State Policy on Long-Term Care for the Elderly," Health Affairs, Vol. 17, No. 3, May/June 1998, p. 86.)

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