LTC Bullet:  LTC Doubletalk 

Tuesday, January 24, 2006 


LTC Comment:  Medicaid planners and their academic and media enablers are talking out of both sides of their mouths:  asset transfers are rare but preventing them will devastate seniors.   Say, what?  Details after the ***news.*** 

*** LTC COUNTDOWN:  8 days and counting to the big vote on budget reconciliation scheduled for Wednesday, February 1 in the House of Representatives.  Go to "Write Your Representative" at and urge your Member of Congress to vote YES on the budget reconciliation/deficit reduction bill.  That's a vote against Medicaid planning abuse and in favor of responsible long-term care planning. *** 

*** CENTER MEMBER URGES YES VOTE on budget bill.  Here's a cc of an email message to a member of Congress that we received this morning:  

"Please vote YES for the upcoming budget reconciliation bill!  Save welfare for the truly needy!  The Budget bill encouraging people to plan and save and buy long term care Partnership policies is a good one.  Currently welfare planning is everywhere.  I just got off the phone with a baby boomer who said, 'We just put Aunt X in a nursing home in Ohio after 'getting rid of' her money.  We can do that, too!  We don't need to buy long term care insurance.'  (This couple owns two movie theaters.)  Great!  How are my kids going to pay for this guy and 77 million others who are relying on an under-funded failing Medicaid program?  If more people see the teeth of welfare recovery and the benefits of tax deductions and asset protection with Partnership LTC insurance, we can turn this future around.  Please vote YES for the upcoming budget reconciliation bill!  

Our thanks to Center for Long-Term Care Reform member Barbara Hanson for taking this action.  What will you do to enlighten members of Congress and the media? *** 

*** THE CENTER FOR LONG-TERM CARE REFORM doesn't have a foundation sugar daddy or easy money from the government.  If you value our fight for rational long-term care reform, please join and help.  To become a member, go to and/or contact Damon at 206-283-7036 or  We'll keep you up-to-the-minute day-by-day on developments in this edge-of-the-seat political thriller.  Think of it as "LTC-24." *** 


LTC Comment:  Lately, the media has been full of warnings from Medicaid planners.  Don't wait!  Medicaid reform is coming!  Grab yours now before it's too late!  Transfer your assets before that mean, nasty Congress closes the loopholes.  Here are some examples: 

According to Rachel Silverman writing in today's Wall Street Journal ("Limits Loom on Nursing-Home Aid:  Advisers Urge Elderly Clients To Act Before Rules Tighten Eligibility for Medicaid," January 24, 2006, p. D2,, subscription required for online access): 

"With proposed new rules expected to take effect next month that would toughen eligibility for Medicaid-funded nursing-home stays, lawyers and financial advisers are urging elderly clients to make plans now that might increase their chances of being eligible for government aid. . . .  Advisers have been scurrying to alert their clients about the proposed new rules and are encouraging seniors to make plans now before the legislation is likely to become law." 

Who are these legal opportunists urging their clients to jump on the government gravy train before it's derailed?  Sleazy shysters, bottom feeders at the government trough?  Heavens no.  The lawyers cited in the article are at the peak of their profession, leaders in the National Academy of Elder Law Attorneys (NAELA). 

For example:  "Bernard Krooks, an elder-law attorney in New York, has written letters to his clients warning them of the expected changes.  'Transfers made before the law is enacted will not be subject to the new penalty-period rules and other new provisions,' Mr. Krooks's letter says.  His firm has lengthened its hours to accommodate an increase in business." 

Bernie Krooks is a former president of NAELA.  I sat side-by-side with him as we testified April 27, 2005 before the House Energy and Commerce Committee.  

At that time, he promised members of that key committee, a Congressional committee that is charged with preserving Medicaid for the truly needy, that asset transfers are no big deal and should not be curtailed.  Check it out at  Page 115 for Krooks' testimony; page 111 for mine.  

Here's a quote from Krooks' testimony:  "Clients donít come to me seeking Medicaid.  That is a myth." (p. 116)  Now he's making hay while the sun still shines and the Medicaid loopholes remain open.  If Medicaid planning is a myth, it has obviously been a very profitable one. 

Another example:  "Vincent J. Russo, an elder-law attorney in Westbury, N.Y., has been giving a series of seminars on the rule changes." 

Vinnie Russo is also a past president of NAELA.  I debated him at the Cato Institute on September 7, 2005.  View our debate about Medicaid estate planning at  

In our debate, Russo insisted Medicaid planning is no big deal.  Now he appears to be squeezing every dime out of unwitting clients and taxpayers before the practice of artificially impoverishing affluent clients becomes harder to do. 

Finally, the WSJ article mentions "Michael Gilfix, a Palo Alto, Calif., elder-law attorney."  Gilfix is a founding member of NAELA and a big-time Medicaid planner in the lucrative Northern California Medi-Cal market.  I've debated Gilfix publicly several times over the years.  We once appeared on opposite sides of the issue in a PBS special. 

According to the WSJ article, he's helping a client shelter a home from the (hopefully) forthcoming $500,000 limit on Medicaid's home equity exemption.  What do you suppose a home in Palo Alto, near Silicon Valley and Stanford University, is worth after 30 years of appreciation?  Should that home equity be used for long-term care or should Medicaid go on protecting it for prosperous homeowners? 

Think maybe divesting or sheltering that kind of wealth has been a profitable business that Medicaid planners have fought to preserve?   

The Medicaid planners' doubletalk about Medicaid and long-term care doesn't come exclusively from affluent lawyers taking advantage of the welfare program.  They would be run out of town on a rail if they didn't have help from enablers in richly endowed foundations and from the media. 

Think about all the "studies" produced by the Kaiser Family Foundation intended to show that old people have no wealth to protect from Medicaid spend down and that asset transfers are uncommon and small.  You'll find several examples at  

If all the elderly are poor and asset transfers are insignificant, why are the Medicaid planners fighting to preserve the status quo?  Why are AARP and big charities running expensive ad campaigns to prevent Medicaid reform?  

The truth is that older American's are the richest demographic cohort in this country.  Preserving their wealth by taking advantage of Medicaid is lucrative for the planners who do it, for their financially well-off clients, and for the big trade and advocacy organizations who represent them.  

But that's not to say all older Americans are rich.  Many are poor.  And they are the people we should save Medicaid for as a long-term care safety net by prying it out of the grasping hands of Medicaid abusers.  That's why passage of the budget reconciliation bill is so critical. 

The greed and narrow self-interest of Medicaid planners and their foundation-supported cheering section would wither in the light of objective analysis and media exposure.  Unfortunately, the Medicaid planners have seduced many analysts and reporters who should and would criticize Medicaid planning severely if they understood what is at stake. 

Just think of all the media stories you've read that spout the party line:  don't reform Medicaid long-term care.  Watch for those stories and when you find them, email the reporters and send them to the "Moses LTC Blog" for the truth.  Forward our LTC E-Alerts and LTC Bullets to them and urge them to contact me for "the rest of the story." 

Stay tuned as we approach the exciting climax of this story on February 1. 

Steve Moses