LTC Bullet #1,000:  Medicaid Planning:  Thousand Bullets Retrospective

Friday, May 24, 2013

Seattle—

LTC Comment:  Today the Center for Long-Term Care Reform celebrates its 1,000th LTC Bullet with this overview of 15 years of “Medicaid Planning” Bullets after the ***news.*** [omitted]


LTC BULLET #1,000: Medicaid Planning:  THOUSAND BULLETS RETROSPECTIVE

LTC Comment:  Once a week, usually on Fridays, we publish our LTC Bullet.  The Bullets are often policy pieces, sort of like op-eds.  You can always find the five latest Bullets here and archives of all 995 Bullets (so far), by date here and by topic here.  These 1,000 articles are a valuable historical resource.  Please make use of them.  Search for key terms using Control-F on your keyboard.

This year, in celebration of this thousandth LTC Bullet and the Center’s 15th anniversary (April 1), we are releasing a retrospective of the most interesting and dramatic LTC Bullets that we’ve published since the Center’s founding in 1998.  We’ll highlight one Bullet per year in each of seven major topics:  “The LTC Problem and Solutions”; “Reality Check:  The Facts on LTCI”; “Medicaid Planning”; “LTC Services”; “Politics and Legislation”; “Demographics and Other Data”; and “CLTCR News.” 

Today’s Bullet is our “Thousand Bullets Retrospective” Number 3 covering “Medicaid Planning.”  These “Medicaid Planning” Bullets address the impact Medicaid planning has on public programs and benefit recipients, the latest court and administration rulings and the effect on the marketability of private long-term care solutions.  Read our summary and check out the original at the link provided.  Enjoy this walk down memory lane.

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October 23, 1998:  LTC Bullet: Attorneys Promote Medicaid as Alternative to LTC Insurance.  “Elder law attorneys who specialize in Medicaid planning (i.e., transferring or sheltering assets in order to qualify clients for Medicaid's long-term care benefits) routinely defend their practice by arguing that LTC insurance is not an alternative for their clients. They publicly claim to be helping only those who cannot afford or otherwise qualify for insurance.  But what are they telling each other? In the Fall, 1998 issue of the NAELA Quarterly (the journal of the National Academy of Elder Law Attorneys), Baird Brown, a fellow and member of NAELA, clearly portrays Medicaid as the preferred alternative to LTC insurance.”

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February 3, 1999:  LTC Bullet:  Perils of Medicaid.  “A reporter from a prestigious financial planning publication contacted the Center for Long-Term Care Financing yesterday. She asked us to provide evidence that Medicaid nursing home care can be risky for consumers. Some Medicaid planning attorneys had told her that clients they artificially impoverish to qualify for the welfare program do not experience access and quality problems. We thought our readers would appreciate seeing the same evidence of potential Medicaid-related deficiencies gleaned from the gerontological literature that we provided to the reporter. That information follows.”

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August 15, 2000:  Bill Gates on Medicaid?  Should Microsoft Chairman Bill Gates have Medicaid pay the bill if he ever needs long-term care? It makes sense ‘if you follow the arguments of elder law attorneys to their logical conclusions,’ says an Arkansas state official and critic of Medicaid planning. Here's the story:

The August 2000 issue of the trade journal Contemporary Long-Term Care contains an article entitled ‘The Booming Business of Elder Law’ by New Hampshire nursing home administrator David Irwin.

Perhaps you've heard us say: ‘You can't sell apples (LTC insurance) on one side of the street when they're giving them away (Medicaid benefits) on the other.’ Irwin's article shows that Medicaid planners are still dispensing plenty of the free fruit that gums up the long-term care insurance market.

Easy money for Medicaid planners means tough sales for responsible financial planners and insurance agents. Want to see what you are up against? Here are some excerpts [in this LTC Bullet].”

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April 25, 2001:  They're Baaaack . . . Medicaid Planners Rise Again“Ever since Congress and then-President Bill Clinton nailed them with mandatory estate recovery (OBRA '93), "Throw Granny in Jail" (HIPAA '96) and "Throw Granny's Lawyer in Jail" (BBA '97), the Medicaid estate planning attorneys have laid low.  Their conference agendas and publications carefully avoided the phrase "Medicaid estate planning."  Even their highly publicized firebrands toned down the rhetoric considerably.  Their trade association, the National Academy of Elder Law Attorneys (NAELA), plateaued at just under 4,000 members after skyrocketing for years.  Of course, we know from following their actions—not just their words—that the actual practice of artificially impoverishing clients to qualify them for Medicaid hardly skipped a beat.  Whether from shame or fear of prosecution, however, the Medicaid planning bar hunkered down in defensive mode for several years and didn't promote their services as loudly as before.  That's all over now.”  [See also:  They're Baaack, Part II:  Frank Comments, They're Baaack, Part III: "Buy Cattle, Get Medicaid, They're Baaack, Part IV: "Abandon Your Spouse . . . Get Medicaid", They're Baaack, Part V: "A Person With $1 Million Is Not Wealthy" and They're Baaack, Part VI: "Medicaid for the Upper Crust".]

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September 5, 2002:  Medicaid Planning Full Disclosure.  “LTC Bullets readers frequently send us examples of flyers and web sites promoting easy access to Medicaid nursing home benefits. Complaints about Medicaid planning are just as likely to come from state and federal welfare administrators as they are to come from insurance agents and financial planners. Over the years, eight Congresses and three Presidents have struggled to discourage the widespread practice of artificial impoverishment to qualify for Medicaid. The government even went so far as to make it a crime: "Throw Granny in Jail" (repealed) and "Throw Granny's Lawyer in Jail" (unenforceable). Nothing seems to work. Now come Ross Schriftman, Associate Chair for Long-Term Care, and the National Association of Health Underwriters (NAHU) Long-Term Care Committee with a fascinating idea they have under consideration. Why not require Medicaid Planners to disclose the nature, consequences, and suitability of the self-impoverishment products they offer just as insurance agents and carriers must do for the legitimate financial products they market? You'll find the proposal that the NAHU folks are considering [in this LTC Bullet].”

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March 4, 2003:  In the Lion's Den of Medicaid Planning.  “Medicaid planners wave a magic legal wand and shift the cost of long-term care from affluent elders to taxpayers and LTC providers while delivering a financial windfall to client heirs. See how one senior advocate and health care columnist spoke truth to power in a lion's den of Medicaid planners [in this LTC Bullet].”

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March 4, 2004:  No Wonder They Don't Buy LTCi.  “Do Medicaid estate planners really advise adult children to grab their parents' money, yank them from private-pay assisted living facilities, stick them in a nursing home on welfare, and transfer the cost to taxpayers and providers? Read an actual Medicaid planning ‘engagement letter’ that does exactly that.”

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August 8, 2005:  The Great Debate on Medicaid and LTC.  “On September 7, 2005 at the Cato Institute in Washington, DC, Steve Moses, president of the Center for Long-Term Care Reform, will debate Vincent Russo, a leading elder law attorney in New York and a former president of the National Academy of Elder Law Attorneys.”  Watch or listen to a recording of the debate here:  http://www.cato.org/events/medicaid-long-term-care-crisis-who-should-pay.

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August 3, 2006:  Dueling Letters.  “When I saw two articles justifying and promoting Medicaid planning in Life Insurance Selling magazine, I sent the following letter to the editor, Gordon Bess.  He published it with the Medicaid planner's reply in the magazine's July 2006 issue.  Both letters follow, republished with permission from Life Insurance Selling (www.lifeinsuranceselling.com).”  

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May 30, 2007:  Medicaid Pushers.  “Another NAELA member offers easy Medicaid LTC and seduces insurance producers with a promise of huge incomes.”  Read about it in this LTC Bullet.

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June 3, 2008:  Medicaid Planning Update.  “We have not published an LTC Bullet to expose the damaging practice of Medicaid estate planning for a long while. Following is kind of a grab bag, but it'll give you a feel . . . more like nausea . . . for the lucrative business of poverty-making.”

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February 4, 2009:  Why Stimulate Medicaid Planning?  “The stimulus bill could help the poor elderly, the states, LTC providers, and encourage responsible LTC planning by closing Medicaid loopholes, but it doesn't.”  Click the link above to find out why.

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August 31, 2010:  Medicaid Planning Up, LTCI Down.  “It's no secret that long-term care insurance sales have languished over the past few years, despite a recent blip up.  But government-financed LTC is on a rampage of expansion. It isn't just the new CLASS program, which is actuarially unsound and bound to wither and die. It's Medicaid, the historically dominant funder of long-term care for most Americans--rich, poor and in between.”

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July 19, 2011:  Russian Mafiosos, Medicaid and LTC.  “Remember the film maker who posed as a pimp and brought down ACORN?  Well, James O'Keefe is at it again.  Only this time, his hidden camera is aimed at Ohio's Medicaid eligibility workers.  Following are excerpts from ‘New O'Keefe investigation uncovers Medicaid fraud’ by Matthew Boyle in yesterday's ‘The Daily Caller.’  Read the whole article and view the 23-minute video here.  Then read our ‘LTC Comment’ on this scandal's relevance to LTC financing.”

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February 24, 2012:  Medicaid Planning for Long-Term Care.  “This week, in LTC Bullet:  Medicaid Planning for Long-Term Care, we tackle the controversial topic of how affluent people artificially self-impoverish to qualify for Medicaid LTC benefits and what the government has attempted unsuccessfully to discourage the practice.”