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 http://www.centerltc.com/members/index.htm.
*** BE PART OF THE SOLUTION, NOT THE PROBLEM. Join the Center for Long-Term Care Reform. Contact Damon at 206-283-7036 or firstname.lastname@example.org. Or simply sign up and pay dues online at http://www.centerltc.com/support/index.htm. You'll receive all the benefits of membership AND help us fight for rational long-term care public policy. ***
LTC BULLET: LTC
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.
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, http://www.washingtontimes.com/national/20051204-113549-6448r.htm.
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
"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
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
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
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.