Bullet: LTC Insanity
Tuesday, February 14, 2006
LTC Comment: Like
the persistent paramour in "Fatal Attraction," mindless opposition to
the Deficit Reduction Act just won't die. Is
the DRA the law of the land or not? Details after the ***news.***
Happy Valentine's Day.
TOLD YOU SO. Newsday.com ran
a story February 9 titled "Remaking the Medicaid rules: New law governing coverage and those eligible is expected to
steer more adults to long-term care policies." Read it http://www.newsday.com/business/ny-lead4618401feb09,0,1316278.story?coll=ny-business-headlines.
Here's a quote: "Jesse Slome, director of the American
Association for Long-Term Care Insurance, predicts the new, tougher provisions
will double the number of long-term care insurance policies to 14 million in
five years, the 'most significant' impact of anything that's come down the pike
in years for long-term care insurers. 'It
has not been a level playing field,' said Slome, whose group has about 2,000
members nationwide. 'Up until now,
you had so many Medicaid loopholes. Medicaid
planning gave middle income and affluent people the ability to have the
government pay for them to leave an inheritance for their children.'"
Just as LTC Bullets predicted, the center of gravity in long-term
care financing is shifting from abuse of welfare to responsible financial
planning. But our job isn't done yet.
See the next item. ***
*** LONG-LIVED LOOPHOLES.
The Sunday (2/12/6) New York Times ran a story about the new
half-million dollar limit on Medicaid's home equity exemption:
"New Medicaid Rules on Home Ownership," http://www.nytimes.com/2006/02/12/realestate/12home.html.
The Times' story quoted no one except Medicaid planning attorneys,
two of the three of whom were members of the National Academy of Elder Law
Attorneys. (NAELA is the Medicaid
planners' trade association.) Here's
a sampling of their comments: "Linnea Levine, a [NAELA] lawyer in Harrison, N.Y., said
that homeowners, including those with more than $500,000 in equity, can use a
life estate to protect the home while remaining eligible for Medicaid."
"Ralph M. Engel, a Manhattan lawyer, said that another option for a
homeowner with more than $500,000 in equity would be to take out a mortgage to
reduce that equity. And what should
one do with the proceeds of that mortgage?
'You could give it to your kids and hope you won't need Medicaid in the
next five years,' he said. 'Or you could take a trip around the world.'" It seems New York's omnipresent practitioners of artificial
impoverishment will continue to gorge on filthy lucre from Medicaid if public
officials and tax payers let them. We
must stay the course. ***
NEW MEXICO MOVES ON MEDICAID. The
sense of the Senate "memorial" in New Mexico which we highlighted in
"LTC Bullet: State Moves
Toward Private LTC Financing Alternatives," Tuesday, February 7, 2006
passed on a vote of 42 to nothing. The
memorial urges consideration of LTC insurance and home equity conversion to
relieve Medicaid's fiscal woes and proposes a study and conference toward that
end. Members of the Center can find
our Bullet on New Mexico's progress in The Zone at http://www.centerltc.com/members/ltcbullets/610.htm.
NOT A MEMBER? Join the Center for
Long-Term Care Reform now so you don't miss another minute of our constant daily
coverage of long-term care financing policy.
Sign up at http://www.centerltc.com/support/index.htm
or contact Damon at 206-283-7036 or firstname.lastname@example.org.
He will Zone you in immediately. To
schedule a conference call with Steve Moses about the Deficit Reduction Act and
how to capitalize on its provisions to protect more Americans from the risk and
cost of long-term care, call or email Steve at 206-283-7036 or email@example.com.
LTC BULLET: LTC
LTC Comment: Faithful
reader, if you've been with us from the start, you know what a tortuous route
the Deficit Reduction Act of 2005 took on its way to enactment.
Months of hearings in the House and Senate, followed by
edge-of-your seat votes in both chambers, leading to a miracle in the conference
committee that actually strengthened the bill, on to passage in both houses by a
hair's-breadth only to have the House forced to re-vote because of a technical
change in the Senate version, and at long last passage in final form by two
votes in the House, leading to a signing into law by the President.
Done deal? We
all thought so. But now there may
be a glitch. According to media
reports of dubious accuracy, a clerk accidentally changed a number in the Senate
bill after it passed the Senate, but before it passed the House.
If that's true, for the second time the versions passed by the Senate and
House were not identical. And for a
second time, the difference has nothing to do with the meritorious Medicaid and
LTC Partnership provisions that interest us most.
Déjà vu all over again, except that this time President Bush signed the
According to the Constitution, bills must pass both houses
of Congress before the President can sign them into law.
That's always been interpreted to mean they must pass both houses in
identical form, but the Constitution doesn't say so explicitly.
Here's what the Constitution does say:
Bill which shall have passed the House of Representatives and the Senate, shall,
before it become a Law, be presented to the President of the United States; If
he approve he shall sign it, but if not he shall return it, with his Objections
to that House in which it shall have originated . . .."
(Article 1, Section 7)
Evidently, clerical errors have occurred before but they
were always caught and corrected before the White House signing ceremony.
Not this time according to reports.
But are the reports accurate?
We've also heard from a reliable source that the clerical
glitch may have occurred after both Houses passed the law in identical form but
before it went to the President for signature.
If that's true, it would seem a simple resigning by the President would
solve the problem.
But even if a jot or tittle was off kilter in the versions
passed by Congress, one can reasonably ask "So what?"
It was obviously just a clerical mistake by some poor Congressional staff
functionary who is probably mortified by his or her highly publicized boo-boo.
What sort of perverted soul would rub salt in a wound like that by
throwing the whole government into turmoil just to cause trouble?
According to National Public Radio, people and
organizations are standing in line eager to do just that.
Congress doesn't revote . . . there is a long line of people who could sue,
starting with those affected by the billions of dollars in cuts to Medicare and
Medicaid, said Sara Rosenbaum, a law professor at the George Washington
University School of Public Health." Never
mind that the purpose of those "cuts," actually slight reductions in
the their rate of growth, is to save those health care entitlement programs from
inevitable financial collapse otherwise.
can read and/or listen to NPR's coverage of this fiasco at http://www.npr.org/templates/story/story.php?storyId=5203356.
what now? Could the profiteers on
poverty who oppose the historic reforms in the Deficit Reduction Act actually
find a judge willing to enjoin enforcement of this law on such technical,
legalistic grounds? Answer:
probably yes, most likely in some backwater district of the ninth
the very least, 5000 Medicaid planning attorneys won't rest until they locate a
promising plaintiff and a flexible judge willing to initiate such mischief.
Well, that's what we get for passing legislation that saves Medicaid for
the poor by reducing the lucrative livelihood of well-to-do Medicaid planners.
there a silver lining? Sure.
This will probably all blow over quickly.
Even if the passed versions were not identical and even if the dark side
sues and even if an appeals court agrees, odds are the Supreme Court would
quickly set a constitutional issue like this straight.
the meantime, everyone who matters is proceeding on the assumption that the DRA
is law. That holds for the
Congressional leadership, for the Centers for Medicare and Medicaid Services
(CMS), the federal agency charged with enforcing the law, and for your Center
for Long-Term Care Reform.
reactionaries fighting to preserve Medicaid planning abuses should also realize
that the 2007 budget process is well underway.
Members of Congress may not appreciate their efforts to undermine the
Deficit Reduction Act which just resolved so many key issues, albeit to their
perceived detriment. They
have much at stake this year too.
Bullets" is confident these new complications will all work out in the end.
But it never ceases to amaze us how viciously the opposition will fight
to defend the corrupt status quo--Medicaid as golden goose for the affluent
instead of safety net for the poor.
So, we must endure one more slash at the DRA from the
zombies of political obstructionism. Patience
and reason will prevail in the long run. But
keep a hardwood stake and a heavy mallet ready just in case.
We'll keep you posted on developments as they unfold.