Heeeeeeere's Obamacare!

[Ziggurat]

I'd like to see evidence that people get hit with a big bill if they stop qualifying for Medicaid (and they did qualify at the time they signed up). I can find nothing online about this.

I'm not familiar with the issue Wildcat is referring to, but in point of fact you can get hit with a big Medicaid bill even if you DO qualify for it. In particular, the state may come after your estate upon your death for all of the cost of any Medicaid benefits you received after age 55.

It's called Medicaid Estate Recovery, and it's not actually new. Many people within this category have little to no estate left upon their deaths, and so are unaffected. But with Medicaid expansion, more people who still have some estate they hoped to pass on are going to get hit by this, and there's going to be a rude awakening.

 

[WildCat]

I would assume so. They're not stupid, blindly diving into things without due diligence.

Didn't you say they were in the entertainment industry?

 

[WildCat]

I'd like to see evidence that people get hit with a big bill if they stop qualifying for Medicaid (and they did qualify at the time they signed up). I can find nothing online about this.

ETA: In fact, the best I can find is that in Illinois, they do a monthly check on each recipient and if you stop qualifying, they send you a letter informing you that you longer qualify. There's nothing there about hitting you with retroactive charges. I'd hate to think that a person would be so dumb as to pass up health coverage rather than simply verifying how a system works, but welcome to conservatism.

http://www2.illinois.gov/hfs/SiteCollectionDocuments/EEVClientFAQ.pdf

How can they possibly check monthly, when taxes are done annually? The state of Illinois knows only what I made throughout the entire year, not what I made any given month. Even if they had that information (and they don't) they have no information on the 2-flat I live in and own, whose income and expenses and depreciation and such plays a huge role in my tax returns.

 

[Unabogie]

I'm not familiar with the issue Wildcat is referring to, but in point of fact you can get hit with a big Medicaid bill even if you DO qualify for it. In particular, the state may come after your estate upon your death for all of the cost of any Medicaid benefits you received after age 55.

It's called Medicaid Estate Recovery, and it's not actually new. Many people within this category have little to no estate left upon their deaths, and so are unaffected. But with Medicaid expansion, more people who still have some estate they hoped to pass on are going to get hit by this, and there's going to be a rude awakening.

I think you're conflating Medicaid, as its used to house people in nursing homes, with Medicaid as its used for poor people who need insurance. Wildcat is too poor to afford insurance. He's not in a nursing home. According to the Illinois website, he would not have to pay back any money if he signs up for Medicaid and later makes more money, since they'll ask him to alert them if he starts making more money than he is now. As long as he does this, he'll get his health care paid for until that time. I notice you didn't include a link.

http://www.medicare.gov/nursing/overview.asp

http://aspe.hhs.gov/daltcp/reports/estaterec.htm

It's really too bad he didn't sign up. I support healthcare for everyone, even people like you two.

 

[Unabogie]

How can they possibly check monthly, when taxes are done annually? The state of Illinois knows only what I made throughout the entire year, not what I made any given month. Even if they had that information (and they don't) they have no information on the 2-flat I live in and own, whose income and expenses and depreciation and such plays a huge role in my tax returns.

You'd think you would have been interested enough to simply ask them. Apparently it's just up to you to alert them when your finances improve. Until then, you could have had free medical coverage.

 

[WildCat]

You'd think you would have been interested enough to simply ask them. Apparently it's just up to you to alert them when your finances improve. Until then, you could have had free medical coverage.

I have no idea whether my finances improved until I do my taxes at the start of the new year. A good month doesn't mean my entire year will be good, there are lots of variables I cannot predict.

 

[Unabogie]

I have no idea whether my finances improved until I do my taxes at the start of the new year. A good month doesn't mean my entire year will be good, there are lots of variables I cannot predict.

Which they account for. In the link I posted, they'll merely ask you for more information before stopping your benefits. So you apparently just assumed you'd get hit with a bill based on your own ignorance.

 

[WildCat]

Which they account for. In the link I posted, they'll merely ask you for more information before stopping your benefits. So you apparently just assumed you'd get hit with a bill based on your own ignorance.

I know it appears to be far more risk than I'm comfortable taking on at this time. I'm in good health apart from this flu I woke up with Saturday and am finally getting over, no cure for that anyway so it wouldn't have helped.

There's a lot of pressure on the state lately to purge medicaid rolls of unqualified recipients, and to get reimbursed for benefits they may have received.

This whole system was done in the most stupid way possible.

 

[Unabogie]

I know it appears to be far more risk than I'm comfortable taking on at this time. I'm in good health apart from this flu I woke up with Saturday and am finally getting over, no cure for that anyway so it wouldn't have helped.

There's a lot of pressure on the state lately to purge medicaid rolls of unqualified recipients, and to get reimbursed for benefits they may have received.

This whole system was done in the most stupid way possible.

Sigh. I just posted a link that shows you don't incur any risk. And to make sure, I suggested you call your local Medicaid office and ask. If you don't want to avail yourself of services that were created to help people just like you, that's your choice. But it's not because "the system" is stupid.

 

[Ziggurat]

I think you're conflating Medicaid, as its used to house people in nursing homes, with Medicaid as its used for poor people who need insurance.

No, I'm not. States are obligated to pursue estate recovery for nursing home expenses, but they have the option of pursuing it for ANY Medicaid expense incurred after the recipient is 55.

 

[MattusMaximus]

Sigh. I just posted a link that shows you don't incur any risk. And to make sure, I suggested you call your local Medicaid office and ask. If you don't want to avail yourself of services that were created to help people just like you, that's your choice. But it's not because "the system" is stupid.

The phrase "cutting off your nose to spite your face" comes to mind in reading WC's latest posts. Of course, I'm not surprised... there are entire state legislatures full of people with the same mentality regarding the ACA. They'd rather go without than even consider the possibility that the ACA might actually provide some benefit to society; and then when they go without, they'll shout "See?! Obamacare didn't help me at all!"

 

[Trakar]

I'm not familiar with the issue Wildcat is referring to, but in point of fact you can get hit with a big Medicaid bill even if you DO qualify for it. In particular, the state may come after your estate upon your death for all of the cost of any Medicaid benefits you received after age 55.

It's called Medicaid Estate Recovery, and it's not actually new. Many people within this category have little to no estate left upon their deaths, and so are unaffected. But with Medicaid expansion, more people who still have some estate they hoped to pass on are going to get hit by this, and there's going to be a rude awakening.

It only occurs if the person was institutionalized for an extended period prior to their death and leaves no surviving spouse or relative living in the estate while they were institutionalized (why would a person without a surviving spouse or relative living in the home keep a house they owned and have medicare pay for a nursing home room?).

http://aspe.hhs.gov/daltcp/reports/estaterec.htm

 

[Ziggurat]

It only occurs if the person was institutionalized for an extended period prior to their death and leaves no surviving spouse or relative living in the estate while they were institutionalized (why would a person without a surviving spouse or relative living in the home keep a house they owned and have medicare pay for a nursing home room?).

http://aspe.hhs.gov/daltcp/reports/estaterec.htm

No, you are wrong. Read your source again. It says quite explicitly that states may recover ANY Medicaid cost incurred after the age of 55. States are only required to recover certain Medicaid costs, but the have the power to recover them all.

 

[Unabogie]

No, you are wrong. Read your source again. It says quite explicitly that states may recover ANY Medicaid cost incurred after the age of 55. States are only required to recover certain Medicaid costs, but the have the power to recover them all.

You're strangely impervious to facts. Medicaid is the largest funder of nursing homes in the country. As part of that process, people are expected to deplete their own resources before Medicaid will kick in. This ought to be a GOOD thing according to you, since we WANT Medicaid to house people in nursing homes but we also don't want to pay for things that people can pay for themselves. So when you go into a nursing home, and then you die, Medicaid will then double check to see if you had assets you didn't tell them about before they graciously paid for your extended stay in a medical facility.

Granted, this isn't how liberals would play it. We'd have all medical care be free at the point of "sale" and that would include our elderly. You, however, think of this as spending Other Peoples' Money so your opinion on that is not worth a whole lot.

What Wildcat is facing is the new, expanded Medicaid as a payer of doctor's visits. This depends, not upon you selling all of your assets first, but of showing a yearly income below a certain threshold. And as I've shown you many times, Illinois simply requires you to show your 2012 income and then alert them if you start making more money. At that point, they'll cut off your benefits and you have to go on the exchange to find insurance (although you'll get subsidies with Other Peoples' Money there too, which should give you the chills and make you mad at Wildcat for being such a moocher and a taker.)

Of course, Wildcat could simply call the local Medicaid office and verify this assertion so he could have both health insurance (again, with MY money) and peace of mind, but for some unknown reason he's content to go without.

Likewise, you're free to call their office and verify that the link I posted is the truth, but really, who cares? Your real gripe isn't that people will have to pay the money back sometimes. Your gripe is that some of them WON'T have to pay it back and will just keep all the Other Peoples' Money. Which is why, again, your opinion isn't worth a whole lot on this subject.

 

[Ziggurat]

You're strangely impervious to facts. Medicaid is the largest funder of nursing homes in the country. As part of that process, people are expected to deplete their own resources before Medicaid will kick in. This ought to be a GOOD thing according to you, since we WANT Medicaid to house people in nursing homes but we also don't want to pay for things that people can pay for themselves. So when you go into a nursing home, and then you die, Medicaid will then double check to see if you had assets you didn't tell them about before they graciously paid for your extended stay in a medical facility.

It's funny that you should accuse me of being impervious to facts when nothing you said here contradicts what *I* said.

Look, it's all in Trakkar's source.

At a minimum, states must recover amounts spent by Medicaid for long-term care and related drug and hospital benefits, including Medicaid payments for Medicare cost sharing related to these services. However, they have the option of recovering the costs of all Medicaid services paid on the recipient’s behalf.

All Medicaid services, Unabogie, not just long-term care. I'm not the one impervious to facts, Unabogie, you are. I'm right, you are wrong, and this isn't a matter of opinion.

 

[Unabogie]

It's funny that you should accuse me of being impervious to facts when nothing you said here contradicts what *I* said.

Look, it's all in Trakkar's source.



All Medicaid services, Unabogie, not just long-term care. I'm not the one impervious to facts, Unabogie, you are. I'm right, you are wrong, and this isn't a matter of opinion.

From the link's introduction:

Medicaid imposes stringent limits on income and assets of recipients, consistent with its mission to provide a health care safety net for the poor and for those whose personal resources are insufficient to pay the full cost of care. In order to fulfill this mission, Medicaid also recovers expenses paid on behalf of recipients from their estates under certain circumstances. Medicaid is the largest source of funds for institutional long-term care expenses. It pays nearly half of the total amount spent on nursing homes, followed, respectively, by out-of-pocket funds of long-term care consumers, Medicare, private long-term care insurance, and other public and private funding sources.1

They're talking about long term care, not the ACA. You're just wrong. But go ahead, call the local Medicaid office and ask if Wildcat would have to pay money back if he started making more money than last year. Please. Do it. I'd love to hear what they tell you. Better yet, it's Wildcat's life. He should have called already, but for some reason he hasn't.

Of course, what you snipped was my pointing out that you think ALL of this money should be denied to Wildcat and people like him. You think that ALL elderly should do without Medicaid, since it's Other Peoples' Money.

THAT is what you really care about. This is just sophistry on your part since you think it's a handy cudgel, when in reality it's just boring.

 

[WildCat]

Sigh. I just posted a link that shows you don't incur any risk. And to make sure, I suggested you call your local Medicaid office and ask. If you don't want to avail yourself of services that were created to help people just like you, that's your choice. But it's not because "the system" is stupid.

The phrase "cutting off your nose to spite your face" comes to mind in reading WC's latest posts. Of course, I'm not surprised... there are entire state legislatures full of people with the same mentality regarding the ACA. They'd rather go without than even consider the possibility that the ACA might actually provide some benefit to society; and then when they go without, they'll shout "See?! Obamacare didn't help me at all!"

There's nothing in it for me, sorry. I'm not telling anyone else what to do or preventing them from doing anything. Nor did I create the ridiculous mess that is health care in the USA, with different rules for all 50 states and still more rules depending on if you're old, young, poor, Indian, a military veteran, a government employee, a railroad employee, etc etc etc. If it was up to me I'd dismantle the whole thing create a single system that covers everyone.

 

[Ziggurat]

They're talking about long term care, not the ACA.

I'm not talking about the ACA either. I said from the start that estate recovery isn't new. And you're wrong: as the quote in my previous post shows, ANY Medicaid expense may be recovered, not just long term care. Read past the intro, Unabogie.

You're just wrong. But go ahead, call the local Medicaid office and ask if Wildcat would have to pay money back if he started making more money than last year.

I have no idea if this has any effect on Wildcat, because I don't know if Wildcat is over 55. I said from the start that this is a separate issue from the one Wildcat is referring to. And estate recovery can kick in regardless of your income, and in fact has nothing to do with income.

Of course, what you snipped was my pointing out that you think ALL of this money should be denied to Wildcat and people like him. You think that ALL elderly should do without Medicaid, since it's Other Peoples' Money.

I have never once argued for the elimination of Medicaid. This is a cheap ad hominem attack. Considering you still can't get your facts straight, I guess attacking my motives must seem like the way to go.

ETA: another source regarding estate recovery:

For individuals age 55 or older [establishes who we're talking about], states are required to seek recovery of payments from the individual's estate for nursing facility services, home and community-based services, and related hospital and prescription drug services. States have the option to recover payments for all other Medicaid services provided to these individuals [anyone 55 or older], except Medicare cost-sharing paid on behalf of Medicare Savings Program beneficiaries.

The only difference between long-term care expenses and all other Medicaid expenses is that the former MUST be recovered, while the latter CAN be recovered. So again, Unabogie, you're just plain wrong. Estate recovery is not limited to long-term care expenses.

ETA2: And in the case of Illinois, the DHS can indeed go after every Medicaid expense:

Illinois statute authorizes DHS to make a claim on the probate estate of a deceased Medicaid recipient or the deceased Medicaid recipient's surviving spouse (but see Hines v. Department of Public Aid below) for all medical assistance payments made on behalf of the recipient while the person was over sixty-five (65) years of age or who was a resident of a long term care facility for at least 120 days. The amount of the State's claim includes:

• All financial assistance paid to or on behalf of recipient;
• All medical assistance paid out (except for Community Care Program Services) prior to October 1, 1993, for a recipient while 65 years of age or older;
• All medical assistance paid out on or after October 1, 1993 for a recipient while 55 years of age or older;
• All medical assistance paid out at any time for an medical assistance recipient who resided for at least 120 consecutive calendar days in one or more long term care facilities and the Department has a lien on the real property.

All Medicaid expenses, Unabogie. Illinois will go after them all.

 

[Unabogie]

I have never once argued for the elimination of Medicaid. This is a cheap ad hominem attack. Considering you still can't get your facts straight, I guess attacking my motives must seem like the way to go.

Do tell. You keep talking about Other Peoples' Money. Do you support Medicaid? Medicare? The ACA? Single Payer? I'd hate to assign views to you that you don't hold.

 

[balrog666]

I'd hate to assign views to you that you don't hold.

Bwaaaaaaaaaaaaaaaahahahahahahaha! Good one!