[_wp3r]

The OP may be over the top and on the fear-mongering side of things, but there are some very difficult situations monetarily especially for elderly recipients. While there is some policy to not completely bankrupt surviving spouses, the reality of a long term care spouse utilizing medicaid is that the surviving spouse must reduce assets to below $2500 with few exceptions or shelters. That policy will almost guarantee that the surviving spouse if not a homeowner, will be strongly below the poverty line for the rest of their life. The primary cause of that scenario is the huge gap between enough money to be retired(50k-150k), and the amount of money required to be retired without assistance(350k-500k). Full time skilled care like a retirement home, can easily cost $7k a month on the low end, with averages around 28months.

The OP may be able to make a more widely accepted argument, by more empathetically communicating that medicaid is at best emergency support for crisis, and not a vehicle for long term or widespread medical care. He is correct that using Medicaid as a primary vehicle for ACA coverage expansion ensures a very large group of people will have huge negative motivations to exit poverty, even more so than were previously. I would guess that the OP has first hand experience with Medicaid policy completely eliminating a family member's entire life's monetary worth, which is a hard pill to swallow when someone has paid into Medicaid for decades.

http://www.longtermcarelink.net/eldercare/nursing_home.htm https://www.ahcancal.org/ncal/facts/Pages/State-Data.aspx

edit: typo medicaid

[rebootthesystem]

In the US it is extremely easy to rack-up hundreds of thousands of dollars in medical bills. A single operation can cost $200K. Be ill for an extended period of time and the idea of millions of dollars in medical care isn't out of the realm of the possible.

And so, imagine selling the family home to try to pay medical bills or provide more favorable circumstances only to get a knock on the door by the Medicaid estate recovery folks who have first dibs on the proceeds of the sale.

Not only that, the sale also means the patient is now kicked off Medicaid because they have money.

I'll repeat it because the shift in perspective is important:

If a private insurance company had exactly the same clauses in their policies people would be up in arms, they would be brought up on charges and some of their management would land in jail. Yet we are willing to accept this from our government? And enroll people by the tens of millions?

This should not be. We should provide care to the needy without any such preconditions. Our government should not sink hooks into them at all.

Readers seem to be confusing passion for fear mongering. This is real and, as far as I am concerned, it is seriously immoral. We should not be in the business of doing this to our own citizens. This isn't health insurance. Not sure what it is, but I know what it is not.

This is the point that is being missed in my exposure of this issue: This is an abomination. The US should not have a program fraudulently presented as insurance that takes people's property at all. Even if the net effect was that this only affected ten people, it would be wrong.

We should take care of those who need care and not set hooks into them or their estate.

[maxerickson]

You've typoed medicare/Medicaid in your first paragraph.

The income limits for Medicaid expansion are really low, people aren't going to pass on a $10 an hour job + subsidized ACA plan to stay on Medicaid.