Bullet: What States Should
Do About the DRA, LTCi and HEC
Tuesday, October 3, 2006
LTC Comment: New
report by Steve Moses from the Flint Hills Center for Public Policy is a
guidepost for states on DRA implementation, Medicaid savings, and
private LTC financing growth. Details
after the ***news.***
*** WE'RE BACK.
The Center for Long-Term Care Reform's late Summer break is over.
Maybe you noticed we're a day late returning.
Damon, our VP for Admin. and the publisher of these e-pistles,
was delayed two nights--and put up in nice hotels--by Air Canada, due to
its difficulty returning him from Brazil.
Where, by the way, he celebrated his 30th birthday by
hang-gliding off a cliff in Rio. By
comparison, my and my wife's adventures were tame:
Singapore, Melaka and Koala Lumpur, Malaysia, ending on the
island of Tioman in the South China Sea for two nights.
But we're home, rested and ready, so here goes. ***
LTC BULLET: WHAT
STATES SHOULD DO ABOUT THE DRA, LTCI AND HEC
LTC Comment: The
Flint Hills Center for Public Policy, a small think tank in Wichita,
Kansas, is a dynamo of analysis and activism on Medicaid.
Its adjunct scholars, including Matt Hisrich and Michael Bond of
the Buckeye Institute in Ohio and historian Greg Schneider, have
published dozens of op-eds, articles, and reports on Medicaid reform. Flint Hills' long and detailed "Medicaid Handbook,"
distributed to all state legislators and the media, is a treasure chest
of information, analysis and advice available at http://www.flinthills.org/content/view/37/1/.
Now add another arrow to Flint Hills' Medicaid
quiver. Following below are
the press release and executive summary of a new report titled "Plain(s)
Talk on Medicaid and Long-Term Care Financing in Kansas:
A Case Study of Medicaid and LTC Financing in Kansas."
Read it at www.flinthills.org.
This study, funded with help from a grant by the Milbank
Foundation for Rehabilitation, was directed by the Center for Long-Term
Care Reform and authored by Center president Stephen Moses.
We thank Flint Hills' president George Pearson for
pushing so hard for so long on Medicaid reform and for retaining the
Center for this work. Special
thanks to Flint Hills Adjunct Scholar Professor Greg Schneider of
Emporia State University for organizing the site visits, participating
in the interviews, and publicizing the report through op-eds, talk
radio, television appearances, and personal briefings for Kansas
legislators and their staffs.
If your first thought is "What can I learn
from Kansas?," you have a very pleasant surprise coming on a whole
range of issues at www.flinthills.org.
FOR IMMEDIATE RELEASE
Plain(s) Talk on Medicaid in Kansas
(WICHITA) – The Flint Hills Center for Public
Policy announces the publication of a major new paper on the condition
of Medicaid and Long Term Care in Kansas.
“Plain(s) Talk on Medicaid and Long-Term Care
Financing in Kansas” offers a powerful argument for reform of long
term care financing in the state, arguing that continued Medicaid
financing of the majority of LTC is unsustainable given the cresting
demographic wave of the baby boom generation. Medicaid spending is
projected to consume $2.7 billion of the Kansas budget in the 2007
The Medicaid program, designed as a safety-net for
those truly in need, currently funds an unsustainably high portion of
LTC. Middle-and-upper-income Kansans can currently qualify for Medicaid
LTC due to eligibility rules that undermine the program’s original
Stephen Moses argues instead for the use of
untapped home equity and the purchase of long-term care insurance,
policies which would encourage individual responsibility in the
financing of long term care. Such changes will allow for limited state
resources to be dedicated to the poor rather than to people who should
save, invest, or insure for long-term care.
Author Stephen Moses of the Center for Long Term Care Reform in Seattle, a nationally recognized expert on Medicaid and long term care, visited the state in July. While in Kansas, Moses spoke to a variety of individuals with interest in Medicaid, including representatives from the state legislature, the governor’s office, SRS, nursing home providers, insurance agents and elder law attorneys. His recommendations for reform establish a powerful incentive to develop a sustainable system of long-term care in Kansas.
For media appearances and interviews, contact Flint
Hills Center senior fellow Greg Schneider at firstname.lastname@example.org
or (316) 634-0218. For copies of the report contact email@example.com
# # #
The Flint Hills Center for Public Policy is an
independent voice for sound public policy in Kansas. As a non-profit,
nonpartisan think tank, the Center provides critical information about
policy options to legislators and citizens. For more information, please
visit our web site at www.flinthills.org
or contact us at (316) 634-021 or firstname.lastname@example.org.
Since 1965, government (mostly Medicaid) has paid for the vast
majority of all professional long-term care (LTC) services (mostly
nursing home care) without requiring significant spend-down of personal
assets. The public thereby largely became anesthetized to the risk of
LTC. Individuals rarely buy insurance, for instance, or use home equity
to pay the expenses associated with care. Instead, they too often end up
depending on public financing. The result is that the whole system is
teetering on financial collapse, unable to fund care of consistently
high quality either in nursing homes or in less institutional settings.
Demographically, Kansas is no worse off than most states and
better off than many.
Kansas has cost-effectively evolved its LTC service delivery and
financing system toward less nursing home and more home care so far, but
future prospects for continued success are questionable.
Medicaid's LTC and other medical services for the elderly place a
heavy strain on state finances, divert resources from other priorities
such as children, and pose a fiscal challenge for the future.
Generous and elastic Medicaid LTC eligibility criteria bode ill
for Kansas' ability to fund home-based and nursing home care in the
Although operating a reasonably successful Medicaid estate
recovery program, Kansas is clearly not maximizing potential recoveries.
To the extent recoverable wealth remains unrecovered, Kansas Medicaid is
operating as "inheritance insurance" for heirs instead of as a
LTC safety net for people in need.
Home equity conversion is an enormous but largely untapped
potential funding source for LTC in Kansas that could substantially
relieve fiscal pressure on Medicaid and state taxpayers except that
Medicaid exempts the home and all contiguous property up to as much as
Although quality affordable LTC insurance is available in Kansas,
too few people buy it. This is partially because of the cost and
complexity, but mostly because consumers do not perceive that LTC is a
big financial risk for them. In fact, they are right because of the
generous availability of Medicaid-financed care.
o Kansas should implement, enforce, and publicize new federal rules and guidelines from the Deficit Reduction Act of 2005 in order to restrict Medicaid LTC eligibility, discourage Medicaid estate planning, and encourage private financing alternatives like home equity conversion and LTC insurance.