LTC Bullet:  LTC Demagogy 

Wednesday, December 7, 2005 


LTC Comment:  Pearl Harbor Day is a good time to reveal a sneak attack on rational long-term care policy, after the ***news.*** 

*** THE WALL STREET JOURNAL informs us that it will publish Center President Steve Moses' op-ed about AARP's opposition to Medicaid LTC reform.  Therefore, we can't share that memorable commentary with you until they do.  But this issue is white-hot right now, so today's LTC Bullet covers similar ground from a different angle. *** 

*** LTCI TAX INCENTIVES.  Here's a link to an August 2005 update of states that offer them:  You'll also find the link in the Center for Long-Term Care Reform's Members-Only Zone at *** 

*** BE PART OF THE SOLUTION, NOT THE PROBLEM.  Join the Center for Long-Term Care Reform.  Contact Damon at 206-283-7036 or  Or simply sign up and pay dues online at  You'll receive all the benefits of membership AND    help us fight for rational long-term care public policy. ***



LTC Comment:  What drives AARP?  Advocacy of good public policy?  Or cynical, narrow-minded, misguided self-interest?  The Medicaid motives of this mammoth mouthpiece for maturity are now clear.   

"The nation's top senior citizen advocacy group has targeted members of Congress with advertisements in their hometown papers opposing House spending cuts, largely because of the bill's provision to change Medicaid. . . .  The group ran ads Friday in the local newspapers of several Republicans, including some liberals, and of some key lawmakers who will help merge the House and Senate versions of the bill, such as Sen. Charles E. Grassley, Iowa Republican and Senate Finance Committee chairman."  Source:  Amy Fagan, "AARP Ads Fight Medicaid Changes," The Washington Times, December 5, 2005,

A few good people in Congress finally muster the courage to reform Medicaid so it can better serve the interests of the truly needy and how does AARP respond?  Here's the notorious newspaper ad targeted against members in their local districts who defend Medicaid against abuse.  (The House budget reconciliation package at issue is the Deficit Reduction Act of 2005.  Review it at 


AARP Newspaper Ad 

Below a picture of two apparently upper-middle-class older women is the following text: 

"Can You Tell Who Really Needs Medicaid and Who Doesn't?  Neither Can the House Budget Bill. 

"We should not deny nursing home care to those who need it.  AARP supports Senate provisions that target loopholes wealthy people use to qualify for Medicaid but preserve this safety-net program for those who truly need it.  AARP opposes the House bill that would deny care to people who innocently helped family members or charities.  The House bill would even force some people to sell their homes to get care.  Denying needed help to people because they helped others defies basic American values and should not be the law of the land. 

"AARP urges Congress to oppose any budget bill that includes the House Medicaid provisions that deny nursing home care to people who have no other options." 


How many misrepresentations and outright lies can be compressed into 134 words?  Let's list them. 

First, consider the picture.  Two affluent senior women accurately represent AARP's membership but they should not be presented as appropriate candidates for Medicaid.  Medicaid is a means-tested public assistance program, i.e. welfare.  It cannot be a safety net for the poor AND cover AARP's wealthier clientele as well. 

Second, do the House budget proposals "deny nursing home care to those who need it"?  No, just the opposite.  By extending the asset transfer look-back period, ending the "half-a-loaf" giveaway strategy, and capping Medicaid's now-unlimited home equity exemption, the House seeks to ensure Medicaid's financial ability to provide long-term care, not just nursing home care, to people genuinely in need. 

Third, does AARP's support for the Senate provisions balance its opposition to the House bill?  By no means.  The Senate proposes relatively minor changes to Medicaid recommended by the National Academy of Elder Law Attorneys (NAELA), the trade association of the Medicaid planning attorneys who profit richly by qualifying their well-to-do clients for the welfare program's most expensive benefit.  In conference committee, the Senate proposals should supplement the House's, not replace them. 

Fourth, does the House bill "deny care to people who innocently helped family members or charities?"  Of course not.  Federal law states clearly that to trigger an eligibility penalty asset transfers must be done for the purpose of qualifying for Medicaid.  A gift for any other reason is not proscribed.  Besides, shouldn't public policy encourage people to save, invest and insure against the time when they may need long-term care rather than indemnifying them for giving their wealth away? 

Fifth, would the House bill "force some people to sell their homes to get care?"  No again.  All it says is that people who have more than $750,000 in home equity should not be eligible for public assistance to pay for their long-term care.  There are many ways to liquefy home equity without selling the house, including reverse mortgages for people able to remain in their homes and renting to relatives or others for people already living in LTC facilities. 

 Sixth, is it true that denying welfare "to people because they helped others defies basic American values?"  Exactly which "basic American values" require taxpayers to reimburse people for giving away their wealth and ignoring their personal responsibility to plan for retirement security and long-term care?  Such double-talk is damaging to the real American values that made this country great, including personal responsibility.  

Seventh, does the House bill "deny nursing home care to people who have no other options?"  No.  What it does do is eliminate the most common strategy to qualify for Medicaid without paying for one's own care.  Currently, people can give away half their assets, wait out a penalty period half the length originally intended by Congress, and sign up for Medicaid while preserving most or all of their wealth.  The House proposal to start the penalty period later will not dump impoverished people unable to pay their own way onto financially struggling nursing homes.  It will rather vastly increase nursing homes' private pay census, empower people to obtain quality long-term care in the private market at all levels of care, and undermine Medicaid planners' ability to abuse Medicaid for personal profit. 

There you have it:  one self-serving misrepresentation by AARP concerning Medicaid reform for each day of December so far.  If we don't do something soon to fix Medicaid along the lines of what the House of Representatives has proposed, the consequences will be severe.  Given the impending insolvency of Medicare and Social Security, compounded by Medicaid's current bankruptcy in all but name, failure to act will drag down the economy and undermine America's ability to provide a real safety net for the poor.  

AARP's sneak attack on responsible long-term care reform should "live in infamy" like the other one that occurred on this day 64 years ago.