Bullet: LTC Denouement . . . for
Thursday, December 22, 2005
LTC Comment: We
warned "don't count your chickens before they're hatched," and now,
sure enough they'll be incubating for at least another month and a half.
Details after the ***news.***
*** LTC PROVIDER PLEADS FOR PASSAGE.
The following email received by the Center for Long-Term Care Reform
yesterday is published with permission from the sender.
We feel it articulates well what is at stake in the current legislative
fight for rational LTC policy reform.
the executive of a faith-based, not-for-profit continuing care retirement
community, I see way too much inappropriate Medicaid planning going on.
While it's understandable that people want to leave their children some
money or support a favorite charity, that is not the purpose of Medicaid.
My 225-bed skilled nursing facility is now over 80-percent Medicaid.
We are losing money and the board has asked us to develop a plan to
downsize the nursing home. Access to high quality nursing homes is going to be a huge
challenge in the not-too-distant future as a result of over-reliance on Medicaid
funding. I hope the bill with the
proper language is passed and signed into law. I've contacted each of the Senators. Thank you for all your efforts to get this legislature this
far. Sincerely, F. Jay Shetler,
President and CEO
Retirement Community, Glendale, Arizona ***
LTC BULLET: LTC
LTC Comment: The
Oxford English Dictionary defines denouement as "The unravelling of the complications of a plot, or of a
confused situation or mystery; the final resolution of a play, novel, or other
story of Medicaid reform that we've presented to you over the past few days
certainly qualifies as a confused situation.
And it's just been resolved UNsatisfactorily, at least for the time
being. Here's the story.
By some miracle late last week, the House/Senate Conference
Committee on the deficit reduction package agreed to authorize LTC Partnerships
and place stringent new controls on Medicaid planning.
Early Monday morning, after a Sunday all-nighter, the House
passed the Conference Committee's agreement in toto and referred it to
Yesterday, the Senate passed the Conference Committee's
agreement but with a few minor "parliamentary" changes.
So, as of now, we have strong legislation passed in both
houses of Congress that would authorize LTC Partnerships, extend the Medicaid
transfer of assets look back period from three to five years, end the
"half-a-loaf" divestment strategy, stop millionaires from sheltering
their home equity, and restrict numerous other technically legal, but
egregiously unethical Medicaid planning tricks.
Unfortunately, because the bill passed by the Senate is not
identical to the bill passed in the House, this legislation cannot be sent to
the President to be signed into law unless and until the House of
Representatives passes it again, with the slight, substantively almost
meaningless changes made by the Senate.
But, there's the rub.
Members of the House of Representatives are back in their districts all
across the country nestled cozily by their fireplaces, Christmas trees, and/or
That would not have to be a problem.
They could approve the Senate version of this important legislation by
unanimous vote right from home. It
could go straight to the President and be signed into law before Christmas or
Hanukkah. And that's exactly what
Speaker Denny Hastert asked Minority Leader Nancy Pelosi to allow in an urgent
Quoth the Speaker:
Ms. Pelosi: I am writing to ask you
for unanimous consent to approve the conference report on H.R. 4241, the Deficit
Reduction Act of 2005. As you know,
the House approved this measure on December 19, 2005 in a 212-206 vote.
Unfortunately, the Senate has now made minor changes, such as simple
reporting requirements, that send the legislation back before the House.
Our members have already returned home to spend the holidays with their
families. By passing these changes
through unanimous consent, we can avoid unnecessary disruption in the enactment
of important program additions and reforms contained in this legislation. . . .
I don't think any of us wants to see a situation where some of our
neediest Americans are denied care and help because of politics.
It is Christmas season, and not the time to engage in partisan squabbles. So I would ask you respectfully, to put politics aside, agree
to unanimous consent of these changes and put the American people first.
Dennis Hastert, Speaker of the House
the Minority Leader:
Humbug. Well, not exactly, here's
how she actually responded by press release:
will request a recorded vote where all Members return to Washington to make
clear their values to the American people.
Democrats will work with our allies to fight for a budget that represents
the values and needs of all Americans."
what's the bottom line?
important changes to long-term care policy that have been passed by both houses
of Congress cannot become law until they're passed again by the House in a form
identical to the Senate's version.
Leader Pelosi refuses to allow a unanimous vote from home as requested by
Speaker Hastert nor President Bush appears to be willing to call the House back
into session immediately for this vote.
House of Representatives will not reconvene in Washington, DC under its regular
schedule until Tuesday, January 31.
gives defenders of the status quo like AARP and the Medicaid planners over a
month to mobilize opposition to these critical reforms.
process of obstruction has already begun as these quotes from today's news
coverage make clear:
"The House had narrowly
passed the bill, 212 to 206, in a predawn vote on Monday, and now, with a new
vote in the House coming, opponents of the budget bill -- from organized labor
to the powerful seniors lobby AARP -- began gearing up for another fight."
"A coalition of labor unions
and liberal interest groups immediately swung back into gear, drafting a list of
18 House Republicans in hopes of persuading eight to change their vote.
"'Make no mistake -- we're
going to keep on fighting until we permanently derail these reckless budget and
tax cuts,' said Gerald W. McEntee, president of the American Federation of
State, County and Municipal Employees, the union that has largely bankrolled the
fight against the budget measure."
The opposition's strategy is
force consideration of the Administration's budget and tax cut proposals
together so as to derail both by arguing that poor people will be hurt in order
to deliver tax relief to the rich. Demagogy?
Sure, but it could succeed and derail responsible LTC reform.
We'd ask the opposition to
consider this. Giving Medicaid back
to the poor by curtailing artificial impoverishment and encouraging private LTC
financing alternatives is really a FAIRNESS issue.
Why use scarce public welfare resources to indemnify baby-boomer heirs of
well-to-do seniors? Ironically,
most of the affluent beneficiaries of Medicaid planning abuses are likely to be
Republicans! Democrats who think
the issue through will realize they're cutting off their noses to spite they
faces by obstructing rational LTC policy reform.
Anyway, for now, everything's
been thrown into a cocked hat. It
looks like we won't know the final outcome until well into next year.
In the meantime, keep the faith, enjoy the holidays, and gird your loins
for another fight, coming soon in the New Year.