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LTC Bullet: Georgetown, GAO and Kaiser: The Bermuda Triangle of Good LTC Policy

Wednesday, January 25, 2006

Seattle--

LTC Comment: LTC doubletalk is not the exclusive province of Medicaid planners and AARP lobbyists. Otherwise often reliable analysts get long-term care policy wrong too. More after the ***news.*** [omitted]

*** LTC COUNTDOWN: Seven days and counting to the budget reconciliation vote in the House of Representatives that can make or break Medicaid and long-term care. A vote "for" will yank Medicaid back from its abusers, return it to the people it is supposed to serve, the needy, and create strong incentives for everyone else to plan responsibly for long-term care. Call, write, email, telegram, and yell to your Member of Congress: "Pass this critical Medicaid reform; vote for the deficit reduction bill." Find and write your Rep. at http://www.house.gov/writerep/. ***

***AARP CAUGHT IN CONFLICT OF INTEREST. Today's Wall Street Journal has a front-page article by Sarah Lueck and Vanessa Fuhrmans titled "New Medicare Drug Benefit Sparks an Industry Land Grab" which states: "AARP, the powerful seniors' organization, is in the awkward position of providing impartial advice to seniors while at the same time selling them products. . . . The seniors' group often draws fire for its dual role as a seniors' advocate and a sales organization. . . . The two sides of AARP operate separately but communicate frequently. . . . When the AARP is considering a new product, the policy side gives it advice about local markets, for example." If you have an online WSJ subscription, check this story out at http://online.wsj.com/article/SB113815997252255612.html?mod=home_page_one_us. Otherwise, pick up a copy of the paper. Kind of makes you wonder why AARP fights to preserve Medicaid long-term care benefits for its affluent members on the one hand while selling them long-term care insurance on the other. ***

LTC BULLET: GEORGETOWN, GAO AND KAISER: THE BERMUDA TRIANGLE OF GOOD LTC POLICY

LTC Comment: Misleading reports published by the Georgetown University Long-Term Care Financing Project, the Government Accountability Office (GAO), and the Kaiser Family Foundation are being used to divert members of Congress from voting for sensible, critically needed Medicaid eligibility reforms.

We've been asked to provide a single page of bullet points debunking this specious research and its conclusions. That's not easy to do. The Medicaid LTC issue is complicated and easily manipulated by policy sophists who oversimplify it to mislead well-intentioned but unwary decision makers.

But if you follow the links in this one-pager and consider all the evidence and logic, you can reach only one conclusion. To preserve Medicaid as a safety net for the poor, we must reform it as proposed in the deficit reduction bill already passed by the Senate and House and awaiting final confirmation by the House.

Georgetown, GAO and Kaiser: The Bermuda Triangle of Good LTC Policy

Propaganda masquerading as research is a disservice to seniors, tax-payers and lawmakers. Here's why you cannot take these sources seriously when they claim seniors are broke, asset transfers are rare, and Medicaid should not be reformed.

POINT: The Georgetown Long-Term Care Financing Project claims in a paper at http://ltc.georgetown.edu/pdfs/nursinghomecosts.pdf that "The argument that something needs to be done about abuses of the Medicaid eligibility rules is not supported by the facts. The studies reviewed in this paper do not support the claim that asset transfers are widespread or costly to Medicaid, or that restricting Medicaid eligibility would substantially increase savings or purchases of private long-term care insurance."

COUNTERPOINT: The studies reviewed in the Georgetown paper show no such thing. Georgetown completely ignores the overwhelming evidence, obvious to anyone with eyes and ears open, that Medicaid estate planning is commonplace, that Medicaid nursing home census is inordinately high, that Medicaid long-term care costs are out of control, and that empirical evidence of widespread catastrophic private spending for long-term care is non-existent. For our proof see "LTC Bullet: Where There's Smoke, There's Fire," Wednesday, May 18, 2005 at http://www.centerltc.com/bullets/archives2005/558.htm.

POINT: The Government Accountability Office concludes in a report at http://www.gao.gov/cgi-bin/getrpt?GAO-05-968 that asset transfers made shortly before applying for Medicaid LTC benefits average small amounts.

COUNTERPOINT: This GAO report asked the wrong questions, used the wrong methods, searched the wrong data, and, consequently, provides little information of value. The important issue about Medicaid asset transfers is not what people gave away shortly before applying for Medicaid but rather what they owned (especially home equity) several years before needing long-term care. That is when they could have, should have and would have saved, invested or insured for long-term care if Medicaid were not so easy to manipulate and obtain. We debunked the GAO report in "LTC Bullet: GAO on TOA Underwhelms," Wednesday, October 5, 2005 at http://www.centerltc.com/bullets/archives2005/581.htm.

POINT: The Kaiser Commission on Medicaid and the Uninsured repeats Georgetown's and GAO's spurious findings without acknowledging contradictory evidence and analysis in an issue brief at http://www.kff.org/medicaid/7452.cfm. Uncritically parroting poor research taints Kaiser's other often excellent, objective work.

COUNTERPOINT: Kaiser's argument in a nutshell: many older Americans are poor, infirm and need expensive long-term care. Therefore, we should continue to allow affluent people to receive Medicaid while sheltering unlimited home equity and giving away unlimited assets three years in advance. For the antidote to such patent nonsense, consult "Aging America's Achilles' Heel: Medicaid Long-Term Care" at http://www.cato.org/pub_display.php?pub_id=4376.