Opinion article: "The rich are using long-term care funds meant for the poor"

In my opinion only, my problem with this system is that we all pay into the system but only "the poor" receive any LTC benefit. It incentivizes the middle class to "become poor" using all kinds of financial tactics, to receive any benefit at all. The very wealthy don't need the benefit. The poor receive full benefit, but as any one in the middle class knows, if you're not already poor, paying for LTC will get you there in a hurry. I wish it wasn't designed that you receive either all the benefit or none at all. I would like to have even a partial benefit and pay the rest out of pocket. I resent being put in the position of looking greedy if I could use some assistance but don't qualify as poor.

We're working hard and saving what we can. We're not rich and we don't envy the rich because we hope one day to be rich enough that we can sit back and enjoy the fruit of our labor. We do get angry at the cheaters that cheat the system.

Pitching people against each other based on income is a what politicians do best to gain votes and power.

Cali doesn’t, according to this. https://www.medicaidplanningassistance.org/medicaid-eligibility-california/

A house is not an exempt asset if over a certain cap.

I also don't think the rich would want to be on Medicaid if they can afford the best.

Love this, lealonnie. Thank you so much for sharing! Very inspiring.

My father was an immigrant from Italy. Had 7 siblings who all had cardboard soles on their shoes for lack of $$$, that's how poor they were. He had an 8th grade education b/c he had to go to work to help the family out. He worked his butt off his whole life, till 11 pm most nights, just to put food on the table. Mom worked part time as a saleswoman at a dept store which is now Macy's. I grew up in a 3 bed 1 bath 1000sq foot home on Long Island where my grandmother lived with us, due to old Italian traditions.

So my parents didn't save enough for their old age, or have a LTC policy or life insurance policies that added up to more than $10K that came from an old job dad had at one time or another. The only $$ they had came from 2 stocks; one that mom got from profit sharing at Macy's and another that dad had bought decades earlier and never cashed out. So when the sh*t hit the fan and they had to go into Assisted Living, dad had to cash out those 2 stocks to the tune of $400K, believe it or not and by the grace of God, and put the $$$ in my name so I could manage their finances for the rest of their lives here on Earth. Which is what I did, w/o having to hide their assets & apply for Medicaid.

Dad died 10 months later and mom lived another 7 years. I managed to make that $$$ last all those years while mom lived in AL and then went into Memory Care AL to the tune of $7K a month not including incontinence supplies, meds or snacks/doctor co pays or extras. Mom died in February, about 6 months before she ran out of $$$ completely and I would have had to apply for Medicaid to fund her life in a SNF.

Many people seem to have a negative attitude about the 'haves' vs. the 'have nots' in life, the 'rich' vs. the 'poor'. My parents were the epitome of the 'have nots' who wound up 'having' a bit more in the end than anyone realized they had, them included. Yet we all chose to do the right thing with those found funds instead of squirreling them away for my inheritance or whatever, and placing them in a Medicaid funded SNF. I wanted them to have the best quality of life possible using their own hard earned money, is the point. If and when that $$$ ran out, Medicaid was there to use.

There was no 'financial smarts or awareness foresight or initiative' on my parents part with regard to their senior years and needs that would arise at that time. Because they didn't have any extra money to salt away FOR their senior years, basically. It was dumb luck that ensued, nothing more. The question became, do we apply for Medicaid when we have the $$$ to self pay, or do we self pay for a better level of private care and use up all that $$$?

THIS is what the article is talking about, in my opinion.

This has been very interesting, reading all the different points of view, and I thank you all for your comments. There are certainly many sides to this issue. The circumstances and values under which a person is raised definitely color how one might handle their own, or their parents' care in later years. It must be difficult for those who would lean toward taking responsibility and paying their own way, but who might not have had the financial smarts or awareness of how much it truly costs to keep someone in a care facility. I think I agree with BurntCaregiver that "No one can afford to save enough to keep themselves up in an LTC facility." Unless they've been very blessed with the upbringing, training and opportunities at the right time in their life, to know how to put everything in place for their future. Most of the folks I know spent their 20s and 30s creating their family and working toward finding a career that would support that family. The 40s and 50s are times of helping to launch the kids into their own satisfying lives, and enjoying grandkids and maybe a little more leisure and hobbies. Not a lot of thought was devoted to retirement years, caring for aging parents, or ensuring there is enough money for parents who may need help, let alone our own declining years; and who could even conceive of the actual costs of long term care? Add to that the ever-increasing lifespans provided by medical advances, unfortunately often without much quality of life.

I truly admire those who have had the foresight and initiative to plan so well that they can afford "the nicer amenities offered in private pay facilities, not having to share a room or bathroom." I would hate to see any of them settle for Medicaid-level services for themselves or loved ones, simply to "game" the system or retain assets for inheritance.

Right now, I pray that what will be available for my mother-in-law will not be as dismal as it sounds like it may be. I have advocated for her in as many ways as I can, but can't do more than that.

My opinion is a little different. My husband and I both saved for our old age. We paid for long term care insurance. We never looked for tax loopholes and didn't try to shelter assets and plan on using Medicaid. I was brought up that if you had the money you paid taxes and paid your own way. My paternal grandparents were farmers. My dad paid for my grandparents nursing home fees.

Over the last year I have spent several months in the nursing home and self paid. My long term care insurance has kicked in for some of my care. I am now at home and paying for aides. I am on home dialysis and in a wheelchair. I'm fortunate to have remodeled my home earlier with many handicap features which are good now.

I do not want to be in a nursing home that accepts Medicaid. I want the nicer amenities offered in private pay facilities. I don't want to share a room or bathroom. Medicaid facilities have to cut corners because of the low reimbursement.

My son and stepsons all had their educations at good schools paid for and all have successful careers. My son and his wife already inherited a bunch of money from their grandparents and her parents. We have gifted them money to pay on homes. etc. I don't feel a need to leave big inheritances. If I do fine, if I don't leave a bunch of money they don't care. They are all very supportive of me and want me to have the best care I can given my circumstances.

I believe that Medicaid rules should be standardized in every state. And I believe MERP should be uniformly enforced.

You know what? No one can afford to save enough to keep themselves up in an LTC facility. At some point unless people are millionaires, they end up on Medicaid and usually living in a poor quality facility because they're on Medicaid.
I am of the opinion that all hospitals, nursing homes, assisted living facilities, clinics, and anything else assosicated with the field of caregiving should be non-profit if they want to collect government, tax-payer monies (Medicare/Medicaid). If they want to be private then go ahead. No Medicare/Medicaid.
Places like nursing homes charge a fortune then cut corners on things like CNA care, fod quality, housekeeping, all kind of things. Most nursing homes are a chain franchise owned by a giant parent company and if they're not then they are owned by a group of investors. Either way all the shareholders have to get paid and they do.
So really, the rich are getting paid off the fnds of the poor. Then again what else is new?

I don't think the article was that well written and leaves too many questions unanswered, but besides that, it reminded me of a sad contradiction in the way many in America view other's behavior. Why is it when the wealthy or upper middle class, or people who hold the highest offices in our country commit fraud or take advantage of the tax laws or otherwise cheat the system no one seems to care (or not enough do), while many of the same people are quick to spit out their vile on the the poorest and the struggling and the middle class who are just trying to get by whenever they appear to be doing something to take advantage of the system?

I used to think it wasn't right to do Medicaid planning to shield assets from Medicaid recovery. I think a bit differently now, because there are such differences between states. 5 year lookback everywhere but CA; THEY only have a 2.5 year lookback. Retirement accounts have to be used before Medicaid in some states, but not in others. That is unfair. I am in a state where MY retirement accounts will have to be used when my spouse's are depleted. If it doesn't happen everywhere, I will do my darndest to see it doesn't happen to me or vice versa. We are planning to meet with an elderlaw attorney to shield our money as legally allowed in my state. Why should MY kids be treated differently for inheritance than the kids in some other states if I need LTC?

The article title seems deceptive to me.

The rich are likely to be willing to pay for their comforts rather than settle for shared rooms and the amenities offered at the Medicaid level facilities. A couple million or more, not counting the house, will pay for the average length of stay and likely leave a (smaller) inheritance anyway.

The dwindling middle class are more likely to try to exploit every loophole and settle for good enough care in the hope of giving their heirs a chance at a middle class life too.

Like avoiding income tax or maximizing available benefits, I can’t blame people for reasonable exploitation of the system as it currently exists. Still, I can see that adjusting the rules so the funds remain available to provide care to a growing demographic who don’t have the resources to pay makes sense.

Nata, I saw the link in news feed but it’s failing to show up in your above post. One thing admin or their coders could really do is make links show as hyperlinks rather than text, making it easier to access in mobile.

https://www.msn.com/en-us/news/politics/the-rich-are-using-long-term-care-funds-meant-for-the-poor/ar-AA11flN4

I don’t think this article is talking about your situation, but rather that of families that get a free house handed to them for the cost of upkeep, because Medicaid does not pursue these liens in a timely matter.

I live in the Bay Area of California. A home that cost 400k in even 2011 is now triple in value. Nothing stopping a family from renting it out, getting money, and Cashing in a decade later, at which point Medicaid is only owed what it spent 10 years ago.