LTC Bullet: We Help New York with Medicaid LTC Redesign
Monday, March 7, 2011
LTC Comment: The Empire Center for New York State Policy published our report on Medicaid and LTC financing in New York. Check it out after the ***news.***
*** I'M IN ATLANTA, GEORGIA for the 11th Annual Intercompany Long-Term Care Insurance Conference. Check it out here. You can even read the PowerPoint "session presentations" here. I'll debate Connie Harner (who promoted CLASS for Ted Kennedy's Senate HELP committee and heads Advance CLASS now). AARP's Rhonda Richards joins Ms. Garner on the pro-CLASS side of the debate and John Greene of NAHU teams with me on the anti-CLASS side. We'll give you a full report after the event. ***
*** BIG MOE. Probably nothing is more important to state Medicaid programs (and to the marketability of private LTCI) right now than "Maintenance of Effort" (MOE) rules in the stimulus (which expire June 30, 2011), but are extended in PPACA (health reform or "ObamaCare.") MOE rules deny states federal Medicaid matching funds if they tighten eligibility. Desperate to save money without cutting coverage or bankrupting providers, states have asked for more "flexibility" and clarification regarding MOE. Finally, CMS has obliged with this letter to state Medicaid directors which offers no help and is about as clear as mud. In the meantime, the feds keep forcing states to cover LTC for middle class and affluent recipients due to mandatory lenient and elastic income and asset eligibility rules. For details, check out our recent New York, California, and Pennsylvania reports here. ***
*** 3 IN 4 NEED MORE: "On March 8 in Atlanta, the '3 in 4 Need More' campaign will get a boost from Dr. Marion Somers, the long-term care planning advocate who is a frequent guest on programs such as Good Morning America, Today Show, and NBC Nightly News. In an informal press conference at the Eleventh Annual Intercompany Long Term Care Insurance Conference -- March 6 - 9 at the Marriott Marquis, Atlanta, Georgia -- Dr. Marion's endorsement will be recorded for TV and Internet exposure. 'We are delighted that she will be lending her support,' says Jonas Roeser, President of the 3 in 4 Association, promoters of the '3 in 4 Need More' campaign." ***
LTC BULLET: WE HELP NEW YORK WITH MEDICAID LTC REDESIGN
LTC Comment: The Empire Center for New York State Policy, a project of the Manhattan Institute for Policy Research, is dedicated to promoting freedom, opportunity and enterprise in the Empire State.
On March 3, the Empire Center published our report titled "Long-Term Care Financing in New York: How to Save Money While Serving the Needy." Read the press release here or below. Save a .pdf copy of the report here.
In cooperation with the Empire Center, the Center for Long-Term Care Reform has published a longer version of the same report titled "Long-Term Care Financing in New York: The Consequences of Denial." Don't miss this full-length version with its clever "cartoon" cover designed by Lynn Voss of GoldenCare USA. Check it out here http://www.centerltc.com/pubs/NY-Consequences_of_Denial-CLTCRfull.pdf.
Media coverage of our report has already begun. Read "Cost of Long-Term Care Too Costly: Report," in the North Country Gazette. Check out "Medicaid reform is vital to building new New York" in the Rochester, NY Democrat and Chronicle. Read my op-ed titled "The poor aren't the big problem" here or below.
Steve's op-ed in the Rochester, New York Democrat and Chronicle, Sunday, March 6, 2011:
"The poor aren't the big problem"
Written by Stephen Moses, Guest essayist
Long-term care is high-risk and high-cost, especially in New York.
People 65 and older face a 70 percent probability that they'll need some LTC and a 20 percent likelihood they'll need five years or more. Nursing homes average $336 per day in New York, over half again the national average. Home care alternatives are prohibitively expensive for full-time care.
So, why isn't the public in New York scared to death about the risk and cost of LTC? Simple. The government pays for most of it. Medicaid is the dominant payer, picking up the bill for 72 percent of all nursing home residents and paying nearly three times the national average per capita for home health care.
But hold on! Medicaid is welfare. It's a means-tested public assistance program. Don't people have to spend down into impoverishment before they qualify for Medicaid?
If that were true, everyone would worry about long-term care for their parents and themselves. They'd spend down rapidly, tap home equity, or buy private insurance. But they don't, so what gives? The truth is almost everyone qualifies easily for Medicaid-financed LTC in New York. Income rarely interferes because Medicaid subtracts the cost of medical expenses, including nursing home charges, before asking if you're “poor” enough. You don't need to be low income. All you need is a cash flow problem.
Likewise, excess assets aren't an obstacle for most people. Medicaid allows only $13,800 in liquid assets but exempts $750,000 worth of home equity and ignores unlimited resources in one business, a car, term life insurance, home furnishings and pre-paid burials. If you still don't qualify, consult a Medicaid planning attorney for advice on artificial self- impoverishment.
Here's the problem. N.Y.'s Medicaid program is buckling under the cost of LTC already, but the public has been anesthetized to its risk and cost so doesn't save or insure. Both policy makers and the public are in denial. Something has to give because the age wave of baby boomers will sink the system for sure.
Here's the solution: Target scarce Medicaid LTC resources to New Yorkers most in need by tightening eligibility, reducing the home equity exemption and maximizing federally mandatory estate recoveries. Use some of the savings to encourage the purchase of private LTC insurance and the use of reverse mortgages to fund LTC privately.
Moses is a long-term care expert.
Empire Center press release:
Report Finds Long-Term Care Is Too Costly